The signal to noise...

The @bphealth teams have been working hard, if you’re in NYC later this month and interested in HealthTech innovation, come on by! -cch

startuphealth:

On Thursday, March 29th - come meet 20 amazing healthcare entrepreneurs who are twelve weeks into building and growing successful healthcare businesses. Join us at Blueprint Health’s SoHo loft as we showcase the inaugural class of Blueprint Health companies and celebrate the rise of NYC as a healthcare innovation hub. Request an invite here.  Space is limited.

At the beginning of December, the 2011 mHealth conference took place in Washington DC.  For conference attendees, it was a chance to be lost amongst thousands of others in the cavernous Gaylord National Resort & Convention Center (sans WiFi or conference supplied beverages, not to mention snacks/meals) and hear about the intersection of technology, business, research and policy.  For those that weren’t able to attend in person, and prefer watching versus reading - most all of the conference sessions were recorded and the videos have been graciously posted for free viewing here.  There have been quite a few posts written by attendees in recent weeks, and among the good ones I’ve read, John Moore’s summary from Chilmark Research is (per the usual) pretty straight forward and spot-on.

Regardless, I promised a few folks who couldn’t make it my thoughts on the conference, the topic of “mHealth”, and broader health & technology trends in general.  So here are my (overdue) main takeways and thoughts: 

1) We should hope for the death of “mHealth“… and soon!

• I’m not saying this simply to be controversial and say so with the utmost respect for the visionary folks behind the mHealth movement and the vibrant ecosystem that has spawned as a result.  However, smarter folks than me (including some guy named Todd Park who’s the CTO of HHS) have stated this in public.  But you might wonder why this would be my first takeaway, on the heels of the largest and most well attended mHealth summit ever (~3,700 attendees), the thick 75 page program guide, and 95 presentations recorded and thought-provoking videos posted?  Simply put, mHealth needs to be embedded within normal healthcare delivery.  At present, it suffers from the specialization and sub-specialization endemic within the healthcare profession which results in hyperfragmentation and discrete, often uncoordinated provision of services (there are ~50 main medical specialties, with about 1/2 having ~4-6 further subspecialties). Most mHealth companies (and products and services) are tackling thin vertical healthcare opportunity slices instead of being part of an integrated, horizontal package of care and value delivery.  Part of this is due to larger systemic forces; as Dr. Atul Gawande points out, there are ~14,000 known diagnoses, ~4,000+ medical surgical procedures, and ~6,000+ medications in the world today.  While those who know me know that I am a fan of any type of healthcare innovation, this hyperfragmentation doesn’t really help the industry from a holistic macro perspective (i.e. tackling one or more of the big three issues: improved efficiency, improved outcomes, reduced costs).  There are those who argue that integration of standalone mHealth technologies, products and services requires common standards and protocols, and that such collaboration must be fostered and facilitated by the government.  While the government can certainly catalyze standardization for device-to-device communication and integration, private entities can play a role as well.  The not-for-profit West Wireless Health Institute for example is working with a number of healthcare stakeholders (public and private) to develop a common infrastructure and framework along these lines, starting with their Infrastructure Independence initiative.  The sooner the term “mHealth” and all its associated forms goes away and gets folded and integrated into standard healthcare delivery, the better for the healthcare industry (and economics) of our country. 

2) The immediate mHealth opportunities aren’t in apps, they’re in platform connectivity and data synthesis.

• Look, mobile apps are hot and ubiquitous, I get it.  But guess what?  Most consumers (beyond the Technoratti, the Quantified Self and Health 2.0 geeks) don’t care about their health enough to download health apps, less use those apps regularly (at least several times a week at the minimum, ideally daily).  Health apps aren’t even in the top ten of downloaded app categories for consumers: games, weather, and social networking top the list.  Health apps come in with a rank of #17 for consumers.  What about providers you ask?  Well, over 85% of healthcare professionals don’t use the apps they have downloaded - there is definitely app overload for providers and consumers alike.  So even though there are now ~12,000 health apps in the Apple store, you’re competing with literally tens of thousands of games.  And no, the solution is not “to gamify” or the “gamification” of mHealth or health apps.  The immediate value opportunities are in platform connectivity and data synthesis.  There are a myriad of mobile devices and sensors out on the market, consumer and provider targeted, fragmented and discrete for the most part as previously noted.  Ingesting the data being collected and transmitted by these proliferating devices and simply connecting them to decision support tools, and EMRs is a huge opportunity.  It might not be as sexy as a direct to consumer mobile app, but working with enterprise customers to more efficiently deliver care and improve outcomes in a timely manner solves a tremendous point of pain for providers and payors now and going forward in a world of changing risk and payment models (capitation, bundled payments, ACOs, etc).  Connectivity and then data (big or not) synthesis and analytics are clear opportunities for innovation.  Those that play in this space, probably aren’t accurately labeled or silo’ed as mHealth companies, but should be considered broader healthtech ones and for good reason.  

3) The U.S. mHealth should learn from emerging market mHealth innovation models!

• John Moore touched on this in his mHealth Chilmark post, and I’d like to believe we share this view perhaps because of our side conversation in the hallway during the Monday session around what we thought was good so far at the mHealth summit earlier this month (and I’ve written about this before) - but we both thought that the emerging market tracks were of keen interest and value.  So what’s so compelling about emerging market mHealth innovation?  To me, it’s around distribution (a big N) and engagement (how often does that N use your product).  An mHealth post by a well known healthcare VC stated her opinion that it was a bit weird to see MNOs like Verizon and AT&T have strong presence and presenting at mHealth.  I’m scratching my head as to why this would seem odd, because it appears plainly obvious to me.  MNO’s (mobile network operators) and their devices are integral parts of the lives of those who live in emerging markets.  There are more cell phones than landlines in most of these areas, and therefore cell phones are used not just for communication, but for financial transactions and currency.  It’s a big market as well, an estimated $200 billion market for cell phone airtime in developing countries.  In short, in emerging markets most people have cell phones (the distribution N), and depend on their cell phones for daily acts of life (the engagement).  Combine this with health initiatives, it’s no surprise that in emerging markets, MNOs play an integral role in mHealth because of their device distribution and daily utilization - and they achieve this often times using 1G networks and feature phones!  With the ubiquity of smartphones in our LTE and 4G developed world, it makes complete sense to have MNOs play a more active role in mHealth in the US.  There are now more mobile devices (~328 million) in the US and it’s territories than people (315 million) which means that many people in our country have not just 1 mobile device, but several technology enabled mobile gadgets!  The MNOs are (typically) device and company agnostic: Apple or Samsung or HTC, smartphone or tablet, the MNOs simply want to push these products into consumers hands and then have consumers be dependent upon the MNOs for all the associated data consumption and service needs through these devices.  In addition, beyond solving the distribution question of devices, MNOs are in a unique position to leverage clear incentives for health use/engagement (additional data service credits, additional cell phone airtime minutes, free downloads from their app stores, etc.) and can even pre-install health apps, eliminating the friction associated with app discovery and downloads.  Having MNO’s play a big role going forward in mHealth and healthcare period here in the US seems pretty much like a no-brainer to me, but perhaps I’m way off the reservation on this one.  WellDoc, who was at mHealth, and their MNO partnership with AT&T is a prime example of a forward thinking mHealth company working to advance diabetes care with some great results thus far.  MNOs can, will, and should play an increasingly bigger and important role in mHealth in the US, not simply because of their communications infrastructure and bandwidth, but because of the prevalence of the devices they distribute which are basically human appendages at this point for most consumers, starting at earlier and earlier ages (the average age for kids who receive first cell phones is now down to less than 12 years of age).  Even assuming annual cell phone service expenditures in the US has remained at 2007 levels (~$610), this implies a current US market size of $200 billion for cell phone services given ~328 million mobile devices on the market.   Health/technology VCs (including the prior one mentioned previously) have commented on the lack of excitement around the projected $400M market for mhealth smartphone applications and services (and there was a VC panel at mHealth whereby panelists posited that the odds are low on whether there could be a billion dollar+ mHealth company), and this is a fair opinion if this discrete view is taken of “mHealth”.  However, perhaps a better rough estimate of the future market potential might be achieved by approximating if just 1% of annual US cell phone service expenditure was dedicated to health, then this results in a $2 billion dollar annual opportunity which certainly should be a bit more appealing for startups and investors alike.   The other lesson to be learned from emerging markets, I believe, is the simple distillation of healthcare problems, and the functional, utilitarian solutions that can be created to solve them without the latest technological gadgets and attempts at (shudder) “gamification”.  This can be easier said than done, as Steve Jobs said, “Simple can be harder than complex”, but perhaps the technological constraints associated with emerging markets has helped foster simple innovative solutions. 

Those are my main (overdue) mHealth thoughts…  as always, happy to chat further about any of these viewpoints and health/tech data innovation period.

-cch

This post is a bit overdue, but given that I have been spending a bunch of time recently thinking about innovation and start-ups, I wanted to share some more thoughts around start-up accelerators and incubators in general, but specifically as it relates to what I will call the new crop of “HealthTech” accelerators that have popped up recently: Blueprint Health (NYC), Health Box (CHI), and Rock Health (SF) and to some extent, Startup Health (NYC), although Startup Health is aiming to be more of an accelerator academy for more established start-ups past seed stage (whereas the first three are more seed stage accelerators).  This is a follow-up blog post of sorts to my guest post for Pulse & Signal a few months ago as part of the sanofi-aventis Data, Design, Diabetes 2011 challenge (for which I was a mentor for). 

But before sharing, a few disclaimers:

Disclaimer #1 - I am a mentor/adviser to Blueprint Health, but also know Halle Tecco and Nate Gross from Rock Health since last year when they were working on the idea as part of an HBS 2nd year field study with Bob Higgins, and I also know Steve Krein of Startup Health. 

Disclaimer #2 - I strongly believe that we are at a time for the rise of a strong and emerging ecosystem for health and technology start-ups and innovation, given a lot of recent macro factors emerging for this complex healthcare industry and the general macro trends of the past 3-5 years in technology.  To this extent, as it relates to the healthtech accelerators mentioned above specifically and other accelerators out there generally, I (personally) don’t view it as a “US vs. them” zero-sum game… I believe in collaboration and an “all boats will rise” philosophy and approach.  I know many folks in this healthtech ecosystem who (rightly or wrongly) share this view, and perhaps because we’re pragmatic and are fans of anyone that is innovating in this space and helping to improve the healthcare industry - it’s frankly unrealistic to believe there will be a single magic bullet to cure all of this industry’s ills, and we need as many smart and passionate people/start-ups tackling the many problems in the US healthcare industry. 

So… lately, there has a been a lot of buzz around healthtech accelerators.  This is very much due to the “success” of tech start-up accelerators such as Y Combinator and TechStars over the past years.  These accelerators have focused primarily on tech or digital start-ups, and although a few healthcare related companies have gone through their programs, healthcare certainly isn’t the core program focus or draw.  Realizing that healthcare is a slightly different and complex industry (quick: name a few other industries where it’s “standard” that the main customer/recipient of services doesn’t pay for 100% of the bill at the time services are rendered), it’s great that TechStars and some others not only realize this healthcare complexity, but also desire to promote innovation in this unique and important industry and therefore are supporting health industry specific accelerators (Blueprint Health is a charter member of the TechStars network).  A bunch of health start-up companies I’ve come across and have had discussions with the past few months have asked me about more information on these healthtech accelerators, including the differences between, and the pro’s/con’s of one versus another.  

So, I figured it’s worth sharing my advice around things to think about when considering accelerators here for anyone to read (hopefully it’s of some value), which basically boil down to three important things you should determine for each program:

1) FIT: Is your start-up a fit for the accelerator, in terms of your team’s experience, stage of your company, and geography.  Most accelerators are geared towards first time entrepreneur teams and early stage companies.  Team is important, and usually means at least two people are working full-time on the NewCo.  Early stage typically means you have both an idea and a product/service to show (even if in alpha or beta), and have raised some friends/family money to get the idea off the ground.  Note - there is no exact rule around how much money raised is needed or is too much for an accelerator; my friend Jason Baptiste of OnSwipe had already raised over a $1M in seed money but still decided that TechStars NYC was a worthwhile program to enter in order to help accelerate the company.  In terms of geography, the right, middle, and left coasts are each represented for the main healthtech accelerators, and this is an important consideration depending on where the current NewCo is based, and whether three months onsite in an intensive accelerator program is feasible for all the team members, particularly if it’s a new city.  

2) TRACK RECORD - Program & People: When determining which accelerators are worth applying for, be sure to check out the track record in terms of past program classes and their outcomes.  Not all seed stage start-ups succeed, and not even the best early stage Series A and B VC firms bat 1.000 in terms of each of their investments resulting in a successful exit.  But both TechStars and Y Combinator do a great job of providing clear and transparent data on how their incubated companies are doing, as evidenced by this information from TechStars.  Beyond looking at objective quantitative data, be sure to talk to some past program participants around their experience.  The main question to ask them is whether they thought the program experience was beneficial to them as a company and as entrepreneurs.  If the program accelerated the path of the NewCos more often than not in a material way (each company’s experience of course will be slightly different), and/or imparted some great learnings and experiences for the participants (either for this start-up or one later down the road), the program graduates should say that the small equity dilution (if any) is well worth it (if they even bring it up at all).  

Now, it can be hard to assess program track record for new accelerators such as these new healthtech ones.  For Health Box and Rock Health, you should of course ask current or past program participants if they got value out of the program and their experience.  But absent an established program track record, you should move to diligence the track record of the program’s people.  As most who’ve been involved with early stage start-ups and investing know, when push comes to shove, team is usually one of the most important, if not the differentiating factor.  Now no one single person makes a company and can do it all themselves.  And while the people involved with the program won’t do your job for you, it is important to determine their track record.  Find out who is involved, day in and day out, as the program’s directors and staff and find out what their backgrounds are, i.e. do they have relevant experience in health or technology start-ups, investing, and innovation?  Determine if they possess not just deep and relevant domain expertise, but what their reputations are in terms of other start-ups, investors, and thought-leaders in the industry.  Finally, figure out if they are well connected within the industry’s innovation community (the types listed above, but also including customers and media).  You should also diligence who is part of the program’s surrounding ecosystem and community, in terms of the sponsoring companies, mentors, and investors.  Ideally get in touch with a few, and ask them why they are involved, what is their understanding of the program, and how/what they will contribute.  Ask them frankly if they are in it for the long haul and believe in the space (or is this just a short-term and “hot” area they want to be involved in).

3) SUBSTANCE: Determine what the program will offer you, in terms of structure, resources, and content.  There is no secret sauce to what ingredients are necessary to bring together to result in a big and successful company, but relevant topics and experts include: legal, marketing/PR, programming, UI/UX design, business and revenue models, HR/team building, ops/real estate, finance/investing, and customers.  Y Combinator clearly states what happens in their program and what program participants can expect.  Be sure to determine whether it is a program of substance instead of flash.  The track record of the program and the main people involved will help determine whether an accelerator might be a worth applying to.  A way of helping determine a program’s substance is finding out what their philosophy or mission statement is (or if they have one!).  

Finally - the ultimate consideration is whether you believe a specific accelerator can help speed up your NewCo’s growth and development in three intense months as opposed to figuring it out on your own.  An analogy might be continually running the football to advance your company down the field versus trying pass plays.  Running the football can get you down the field eventually, but you can cover more ground quicker by airing it out and throwing downfield.  A start-up accelerator can help with the latter, but it’s certainly not for everyone. While applications to these accelerators can vary in terms of length and complexity, it’s worth it to do your homework and diligence whether the Fit, Track Record (of the program and it’s people), and Substance are worth applying to.  Applying and enrolling certainly shouldn’t be done haphazardly!  But if, for whatever reason, you don’t think you are ready now for a program’s class, take time to think about it and compile some more diligence, and consider applying for the next program class as hopefully these healthtech accelerators (and others) will be around in the years to come! 

As always, I welcome any thoughts and comments!  Especially if there are other established healthtech accelerators out there!

-cch

Below is my guest post on Pulse & Signal (a public health blog) from Sept. 14, 2011 as part of the 2011 Data, Design, Diabetes (DDD) Challenge which I was a mentor for.  The post was originally written in advance of the DDD demo day, after which two of the five semi-finalists were selected as finalists to continue with the Challenge with the chance to win the main prize (the winner will be announced in the next few weeks).  The post is meant to crystalize and explain the experience of the DDD incubator, which was in many ways similar to some of the tech accelerator/incubator programs out there, but in other ways different.  In any event - it was a fantastic program and all five semi-finalists had great ideas for innovation in diabetes involving design and data.  Congrats to all, and good luck to the remaining two finalists for the $100k prize: Chewable and Ginger.io.   And stay tuned for more exciting things in health & technology innovation through incubators and accelerators this winter, with the launch of Blueprint Health’s and Startup Health’s 1st program classes in New York in January, along with Rock Health’s 2nd program class in San Francisco.  Oh - and it should be noted that all of these health & tech organizations (including Startup Health thanks to a friendly reminder from Unity Stoakes) have some tie to Boston/New England, mainly through the great universities there.  Just sayin. :)

-cch 

It  is an exciting time to be an entrepreneur these days.  President Obama earlier this year launched aStartup America initiative to promote entrepreneurship in America, citing the need for the US to maintain its competitiveness in international business through tech innovation and superiority in particular.  For those that are tech enthusiasts, i.e. those in Silicon Valley, the importance of technology start-ups and entrepreneurship isn’t a new fad.    Start-up technology accelerator and incubator programs, such as TechStars and Y-combinator, have been around since the mid 2000’s to help entrepreneurs grow businesses from ideation to product development and launch.   Thanks to President Obama and Congress, who passed the HITECH Act in March 2009 and Affordable Care Act in March 2010, there is now also great interest in the intersection of health and technology innovation, aided by the billions of dollars earmarked for technology adoption by health care providers and health insurance companies.  This interest in “healthtech” is further evidenced by the recent creation of health technology specific incubators all across the country such as New York’s Blueprint Health, Chicago’s Healthbox, and San Francisco’s Rock Health.

It should be noted that established health care and life science companies are also re-thinking how they innovate beyond their own four walls to better leverage technologies that aren’t native to their industries, such as mobile, digital and social media, the Internet, cloud-computing, etc.  The 2011 sanofi-aventis U.S. Innovation Challenge: Data, Design, Diabetes (DDD) is such an example of a life science company spurring innovation through a public and crowd-sourced challenge with financial rewards and a virtual incubator that was previously introduced here.  The challenge was announced on June 9, 2011 in DC, and has a Demonstration Day for five semi-finalists in New York this Thursday, September 15 in NYC (anyone interested in health and technology innovation, particularly diabetes, is welcome to attend the DDD Demo Day, as it is free and open to the interested public).

 There are seven core components of these start-up incubator programs:

1. Application
2. Guaranteed fixed funding (for those start-ups who are accepted)
3. Physical co-location
4. Limited program timeframe
5. Rapid iteration and innovation
6. Close mentorship and guidance
7. Demonstration (“Demo”) Day upon program culmination

I will touch on each of these seven components as it relates to DDD, but will expound a bit deeper on the last three components, which I would argue are the more exciting elements of the program (in particular the upcoming Demo Day). The DDD challenge incorporates virtually all of these elements with one exception outlined below.   Regarding the first component, the competition accepted applications via its website July 1 through July 31, and five semi-finalists were chosen from the pool of applications and announced August 5.  The second component (fixed funding) of DDD is explained simply here on the DDD homepage, but the total prize money to be awarded is $210,000. The third component is the only element not fully incorporated within the DDD challenge, as the program is a virtual incubator and did not provide physical office space nor require that the five semi-finalists be co-located together in New York.  A limited time frame, or the fourth component of incubator programs is an attribute of DDD, as the five semi-finalists and mentors collaborated from August through September in the virtual incubator, and a detailed timeline of the overall challenge can be found here.

Rapid Iteration and Innovation: Any accelerator or incubator program encourages very rapid development of product or service prototypes.  This is partly because these programs are a fixed and limited duration (i.e. typically 12 weeks from program start to demo day).  Teams therefore need to work long, hard, and fast to get to Demo Day.  While start-up life truly is a marathon, these programs are intended to be sprints and as anyone knows, you can’t sustain sprints for a long duration of time.  Therefore, rapid development of prototypes is encouraged.  Perfection isn’t always achieved nor desired within this complex time frame – but quick trial and error is a goal.  This core tenant of lean start-ups is endorsed by Eric Ries, who has written several books around “Lean Startups”, as evidenced by a recent blog post of Eric’s called “The Power of Small Batches” (which is borrowed from his most recent book).

The DDD teams I’ve interacted with over the past few weeks as a mentor all have a fairly robust and long product development wish-list or roadmap.   What they have all had to do throughout this program is:

• Determine which core product features they could reasonably develop  for their platform or service offering in the time available prior to Demo Day
• Prioritize those core features
• Rapidly develop those core features
• Test those features

Close mentorship and guidance:  It is true that the barriers to starting a company, particularly a technology based company are very low these days.  Not only is it financially easier to say, start and launch a business website and build mobile apps, but there is an abundance of free or low cost knowledge and resources such as coder and hacker communities, seed/angel/VC investors, entrepreneur/start-up communities that can be accessed in real life or online by leveraging the Internet. As a result, there are those that question the value of start-up accelerators, but to be clear – they are not intended for every entrepreneur, they do not guarantee overnight or ultimate success for the start-up, and aren’t required to launch and grow an innovative and meaningful company.  Most incubators are intended primarily for young or first time entrepreneurs.   However, it should be noted that the DDD challenge and its virtual incubator model is slightly different than pure tech accelerators, in that it was constructed to encourage broad innovation in diabetes through the combination of data and design, and encourages all entrepreneurs, young and old, to endeavor in this important area.   What the DDD challenge and tech accelerators do share is the reliance on a strong mentor community to help nurture the start-ups in the program. The quality, accessibility, and diversity of mentors define and distinguish how valuable an experience is going through one start-up accelerator versus another.

David Tisch, the Managing Director of TechStars NYC and I have shared conversations around what is the right metric of success for Managing Directors or Partners of accelerators – and ultimately it’s whether the entrepreneurs think they got value from the program, not so much in terms of the actual financial capital they received (and whether it was dilutive or not from an ownership perspective), but from the guidance they received from mentors, from the development and growth of their start-up during the program, and whether it was simply time well spent.  Mentors can’t and won’t do everything for your start-up to succeed, but can help you think through the pros and cons of business or product strategy, link you up with other domain experts and potential investors, and push you and your team to work smarter and faster.  At the end of such an accelerator program, if the program has been developed thoughtfully by its managing directors or partners (usually these accelerator programs are run by seasoned entrepreneurs with significant domain expertise and/or early stage investors) and the assembled cast of mentors do their job right, the graduating start-ups will provide testimony to the benefit of the accelerator; they should be fanatical ambassadors for that program’s brand and attest to its value.  They and their business will have found their way in a much shorter period of time than if left on their own to figure things out.

Demo Day: This is the graduation ceremony for the start-ups of an accelerator program.   It is the culmination of weeks of hard work and long hours.  It is a celebration, whereby the companies show the world the progress they have made in the past few months of the program.  An audience of journalists, investors, start-ups, and other people and companies interested in start-ups and innovation will be in attendance to learn more about these start-up companies who up until that point, might have been in stealth mode or have been figuring out the right product mix, business partnerships, go-to-market (GTM) strategy, and business model.  Each company gets a few minutes (5 to 15 minutes typically) to present to the audience, and share two main things:

• Business plan: this should be similar to the quick elevator pitch or investment deck as if the company were pitching seed, angel or VC investors.  It is not intended to be an exhaustive fifty page opus in Word, but a quick summary presentation around:
  • Team
  • Market/Problem
  • Solution/Value proposition
  • Competition
  • Business model
  • Launch/financing plans
• Demo of their actual product: ideally there will be a live product demo shared at Demo Day.  Think of it as a show & tell from your elementary school days, but in reverse.  At Demo Day – you typically tell first what you’re working on, but then you should follow-up and show.  Most tech investors (VCs primarily, but also super-seed and super-angel investors) typically won’t invest with just only a business plan, formally in Powerpoint or written on the proverbial cocktail napkin.  Proof of not just a business opportunity, but in product development and traction typically are table-stakes these days when a start-up is raising a serious round of financing (loosely speaking, anything above/over $150 – $200k).  If a live demo can’t be shown, at least a staged demo should be provided so people can get an appreciation of what the technology and product looks and feels like from a design, UI/UX perspective.  If neither a live or staged demo can be shared, some proof that there isn’t a significant technical and engineering hurdle can help assuage investors.  Or in other words, some testimony that the “D” associated with R&D can be completed.  It’s easy to tell a story and present a business case, but if you’re planning on raising more financing to support your company, build a team, and launch and develop a robust product, investors will want assurance that there isn’t technical risk (i.e. is it theoretically possible) risk or engineering risk (i.e. it’s not just theoretically possible, but this team or resources assembled can make what is theoretically possible into reality in a given timeframe with finite resources).   Usually for popular tech accelerators, Demo Day is a frothy period of time where investors and journalists alike attempt to woo the hottest start-ups and build exclusive relationships, particularly in sexy verticals such as (for now) “social” or “deals” or “photo or video sharing”.   It can be a long day for start-ups, as they prepare and rehearse their Demo but also longer story to be shared with the outside world, but it should be a celebration and a public announcement that they’ve made it through the program, and are ready to take on the world…. And who knows, perhaps raise a Series A(wesome).

While Demo Day typically marks the end of typical accelerator programs, DDD is slightly different in that it is primarily a challenge first, and then an incubator second.  The challenge doesn’t stop on Thursday 9/15 at the DDD Demo Day in NYC.  Judges at Demo Day will pick two finalists from the five current semi-finalists who will then each receive an additional $10,000 to help pilot their prototypes in community uptake exercises in October.  This will be a great opportunity for the finalist companies to not just talk the talk, but walk the walk in terms of actual live implementation of their product or service in the field so that they can continue iterating and enhancing their value proposition.  A final challenge winner will be selected after the community exercises are conducted and receive the $100,000 final grand prize in November to further accelerate their company’s growth.  They will also have an opportunity to further incubate at the Rock Health health technology app accelerator for a month.   I am sure I speak for not just myself, but all the DDD mentors in that we are impressed in how much has been accomplished in a short period of time, and eagerly await not just Demo Day this week, but the further development of several health tech companies this fall.