T. A. McCann

The (Healthcare) Ground Beneath Our Feet… This year it is likely that over $10 billion will be invested in the digital health sector – a robust amount, no doubt, but inconsequential when compared to the amount of capital tied up in healthcare real estate assets, which is estimated to be $1.2 trillion by Jones Lang Lasalle. Of that amount, approximately $790 billion is in the hospital sector while the remaining $490 billion is in medical office assets. It is estimated that there are 48.6k facilities with 3.4 billion square feet of healthcare real estate, 42% of which are owned by REITs and another 33% held by other private investment vehicles. Much of the digital health investment is meant to make the physical healthcare infrastructure more productive: greater operating efficiencies, greater patient throughput, more relevant personalized care models with better outcomes. As the healthcare system is being pushed to be more distributed to lower cost sites of care, accelerated now by the rapid proliferation of automation and AI capabilities, the potential impact on healthcare infrastructure assets will be profound. Thoughts on what that might look like... https://lnkd.in/eTfAdUbS #digitalhealth Flare Capital Partners

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One of my proudest moments as an investor occurred today as Alaffia Health announced its series A because it shows how the Aperture® Venture Capital vision of multi-level, multi-generational #impactinvesting is succeeding in the marketplace. Here’s the model in its most basic form : ✅As diverse fund managers with meaningful capital to allocate, we are changing the VC landscape every day just by doing our day jobs. ✅As Black/Brown investors with ~40 years experience collectively, Aperture GPs have access to talent /excellence that others do not, so our portfolio *organically* is more inclusive by race, gender and geography even while optimizing for financial outcomes (all about the alpha). ✅Our most successful portco’s are using financial #innovation to solve market problems that impact underrepresented demographics and underserved communities. Alaffia Health is a shining example of the impact portion of our overall fund thesis, and we couldn’t be prouder of TJ Ademiluyi and Adun Akanni, MPH, PMP - the dynamic brother-sister founder duo whose vision we have steadfastly supported on their journey. Congratulations to TJ and Adun from William Crowder and myself, as well as the whole Aperture team- Marjorie King Philip McKenzie Yves Louis-Jacques Tanvi Lal Michelle Dhansinghani Lisha Bell Katie Kelly Amy Chung Cindy Chong, CFA Brian Fernandes-Halloran Monroe France Jayden Pantel Darren Herman Evan Wladis Neal Triplett Thomas Scriven Peter Ammon Irina Bit-Babik Tim Milanich Rob Rahbari

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Excited to announce Frist Cressey Ventures' investment in Qualified Health and privileged to partner w/ SignalFire, Healthier Capital, Town Hall Ventures and others!   Healthcare costs are increasing at a faster rate than ever before, with the US spending nearly twice as other wealthy countries and still ranking bottom in outcomes. It's a story you've all heard - - US healthcare is known for astronomical inefficiencies, waste, workforce supply constraints, fragmented access, appalling patient experiences, and driving patients and businesses into debt.   Yes these problems present opportunities. But opportunities are limited to the system's appetite for change, desire and incentive to try something new and the innovation available. At FCV we believe we've hit the trifecta with Generative AI. Generative AI has given us truly transformational tools in the toolkit and the healthcare ecosystem is demanding to absorb its benefits. This perfect collision of supply and demand means healthcare is poised for big change.   Generative AI is everywhere, it's buzzy, it dangles hope and opportunity. But many things need to be true for the Gen AI transformation in healthcare to take hold, such as but not limited to:   💡 Patient lives and data need to remain safe: We believe in a highly regulated and human life-touching sector such as healthcare we must ensure Gen AI can drive to unrivalled savings and improvements in the quality of care WHILE not putting patient lives or data at risk.   💡 Systems need to own their utilization of Gen AI: We believe systems will use some hybrid of external partners and homegrown solutions but importantly will want full control of data provisioning and utilization as well as the ability to solve an unlimited number of nuanced issues and not cookie cutter algorithms.   💡 Costs need to be looked at on an enterprise level: We believe the speed of innovation in Gen AI means costs will continue decreasing dramatically but at an enterprise level this will still not be a small detail. Systems will want the ability to understand costs and delegate as needed for the outcomes desired at the organizational level.   Enter Qualified.   We knew when we met Justin Norden, MD, MBA, MPhil and team we were standing in front of changemakers. These individuals have lived and breathed the true application and implementation of Generative AI far before we were asking ChatGPT to write our emails. In fact, if you’ve ever driven in a Waymo you’ve benefited from past products this team has built.   Qualified Health is on a mission to enforce governance in Gen AI, allow systems to rapidly build for their needs, monitor and make decisions for all GenAI (homegrown and external) and accelerate the value the sector can glean from these new technologies.   Huge shout out to William T., Tommaso Auerbach and Jamie Kuntz for their hard work!

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Hot take on a lot of early-stage digital health companies out there: You're not a tech company. Most tech-enabled care companies I've seen over the past two years are only tech-enabled in the sense that they use telehealth as their delivery mechanism for care. There are exceptions to this, of course - companies who build computer vision and applied AI tools to better the doctor-patient experience, companies who build tooling around risk scoring and stratification to enable more personalized medicine, companies who build truly novel intakes to better route patients to the appropriate care, etc. These companies have real technology chops and, if they sell it right to the market, can get credit for this from investors. But if you're truly a telehealth provider, you need to realize now that the goal post has shifted dramatically from 2021 and you're going to be valued at maturity at something like 3x EBITDA. That's profit. Not revenue. Throw a revenue multiple out the window. That's not the world we live in if you're a virtual doctor's office. Think of how that impacts venture math. If you're raising a seed round at $15M post-money (or $12M pre-money), it means you'll have to generate something like $150-200M in annual EBITDA to be a fund returner for your seed investors. Maybe even more with dilution, since telehealth businesses are not traditionally capital efficient and will likely need to raise material additional capital to reach that scale. You need to be ridiculously profitable (probably on $800M-$1B in annual revenue since you're likely going to be a 40% gross margin business). Here's the good news: you can set yourself up well (and probably be a contrarian founder relative to your peers), by talking about EBITDA growth and how you can grow into a fund-returning outcome based on realistic mature market comps. This will stand out for the investors you're pitching, even at the early stage. This is how you can beat the malaise of the tech-enabled care market. Focus on the right metrics and the right type of growth. You don't have to have all the answers (no founder does), but you need to make sure the ship is headed in the right direction. A focus on profitability for "tech-enabled care" (*ahem* telehealth) businesses is a good first step.

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DeepCast shipped a number of really cool new features recently in advance of a broad outreach push to podcast listeners. One new feature is our new Daily DeepDigest tool that sends you a concise daily email including any new episodes from the trailing 24 hours from any podcasts you Subscribe to (on DeepCast). Think daily podcast cliff notes or podcast news ticker tape, with a hint of Morning Brew various brews or PitchBook News—it's increasing information throughput when you're pressed for time. And this feature is rapidly evolving to distill other key extractions from shows you're already interested in, but also exposing you to other shows you might be unfamiliar with that also have nuggets to share—and thus increasing your aperture yet still conscious of your time. Want to go deeper on any given episode? Click the episode detail and you're off to an episode on DeepCast, where you can subsequently read a longer form distillation of that episode or go straight to the source and listen to the episode. (And podcaster friends, these pages are definitely increasing indexing and thus Google entry points to your shows!) I'm loving this feature as a user, personally. Can't wait to see what others think! #BuildingInPublic #Podcasts #AllTheWorldsInformation #HowYouWantIt

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And my second investment at defy is in 🐶 zeroETL puppies 🐶... I mean PuppyGraph, which is all the beauty of a graph database, none of the data migration or continuous upkeep of a graph database. Sounds like magic? So are puppies 🐶 . Puppygraph is NOT a graph or a database. It is graph analytics engine that answers graph questions on your existing data warehouses, whether that is a Databricks datalake, Google BigQuery or postgres. Compared to SQL, it's faster, handles way more complexity, scales and has almost no upkeep. How did I get to conviction? 1. Tailwinds - 🌊 Lakehouses 🌊 have helped enterprises put all their data in one place, enabling Puppygraph to unlock insights previously unavailable. - 📚 LLMs! 📚AI and RAG cannot easily traverse fragmented data. Puppygraph's Graph RAG unlocks insights with their Knowledge Graph and spoonfeeds to the LLMs. 2. 👯 Team 👯 We have graph experts from Google, LinkedIn, Databricks, Tigergraph, and Instacart who are uniquely able to build this solution. 3. 💸 Customers 💸 . My alma mater Coinbase is a proud user. The feedback from my former colleagues was off the charts! A blockchain is very much a graph database and Puppygraph tracks down fraudulent transactions that go through mixers and helps identify patterns. Huge congrats to Weimo Liu Danfeng Xu Lei Huang Zhenni Wu Gary Hagmueller, defy.vc is proud to be an investor!!

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118 VCs (one hundred eighteen!) are gathering in San Diego next week - to meet with 30 SD startups. But it's so MUCH bigger than just those 30 co's. It brings VCs back - when they see quality companies. It helps those who are next-in-line and adjacent. It enables us to send deal flow all year 'round. It attracts talent and other companies. It inspires entrepreneurship. Connect is working for SD. Together, we're building the best damn innovation ecosystem on the planet. Year over year. Five.Ten.Thirty.

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An interesting article below, that demonstrates out how San Diego is punching above its weight.  And how Connect's strategy and execution over time, contintues to be central to that success. The article describes the current state of the market in Seattle.  (And i love Seattle.) It's a market that we tend to track with relative to venture fundings.  They used to kick our butts, we outraised them each of the last three years.  This despite the fact they have 3x as many funds there, and 9x the amount of resident capital there. (per pitchbook) Some key takeaways:  * They continue to compare themselves to SIlicon Valley. Instead, we leverage our proximity. *They whine there's not enough local investors (see note above - they have more than us). We bring over 200 VCs to SD annually! * They say founders are not connected with one another. We bring CEOs together regularly, in a variety of ways - private dinners and through our Springboard program. * They say they need to elevate their image on a national & international stage. Why we created and continue to build Five.Ten.Thirty (aka Inno Day).  * And the last paragraph - they need to concentrate on making their region a great place to live. Our mantra: "It's about Better, not Bigger." (See XEO, TL Fund). THANK YOU FOR ALL OF YOUR SUPPORT. WE ARE ON A MISSION TOGETHER!!!  (Comments, whining, suggestions on SD always welcome.) https://lnkd.in/g6Rq_f2Y

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Want a front-row seat to the frontier of tech? We’ve got the role (or two) for you! We’re expanding our frontier-tech team at Blackbird by hiring a Frontier Tech Investments Associate and Foundry Fellows! Got questions? We've got answers... 1️⃣ What are the roles? 🧪 Associate = a full-time VC investment gig in our Blackbird Investments team, working directly with me. We’re looking for someone with a science and/or engineering background and more curiosity than they can handle. You’ll grow your own investment brand and practice, support our portfolio founders, and will help build Foundry, our early-stage frontier-tech accelerator. ✨ Foundry Fellow = a casual/contract gig in our Blackbird Investments team, ~15h per week for 3 months. The Fellowship is ideal for PhD students and ECRs who want to learn more about startups and VC. You’ll go deep on emerging areas relevant to your expertise (or curiosity!), get a front-row seat to groundbreaking companies in those areas, build out your non-academic network, and develop a solid writing practice. 2️⃣ Why are you hiring? We love frontier tech, and we’re ready to grow our team. 3️⃣ Wow, it’s so great that you’re starting to look at deep tech! Look, we get it: we don’t make a lot of noise about our frontier tech investing. Buuuut we’ve been deep-tech investors since we backed Tim Kentley-Klay to found Zoox back in 2014—we’ve been on incredible journeys with PsiQuantum (building the world's first utility-scale quantum computer right here in Australia!), Inventia Life Science (transforming drug discovery with high-fidelity cell models), Remedy Robotics (surgical robots for remote endovascular procedures), Opto Biosystems (minimally-invasive neural implants to treat cancer), and more. We believe that frontier technologies, and great frontier-tech investing, will be part of the solutions to the greatest problems humanity faces today. 4️⃣ When do applications close? May 31st at 11:59pm AEST. 5️⃣ I have more questions! I’m sure you do! Clare Birch and I are hosting an AMA to answer any and all questions about these roles. Want to know what a week in the life of our team looks like? What’s keeping us up at night? What our ideal candidate looks like? Come along and find out - registration link in the comments 👇 Apply for these roles: Associate - https://lnkd.in/gCfj4EUJ Foundry Fellowships - https://lnkd.in/gj6ATZVZ If you know anyone that we should meet, send me their details! Cameron Elise Ben Andrew Robin Joseph Adelaide James Olivia Lucinda Raghav Jesse Christie Mohamed Tom Amee Pablo Haya Loong Hon Joshua Benjamin Megan Harry Denzil Matthew Diana Daniel Tom Deanna Justin Amar Lilly Stone Thomas

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Exciting news! We just sent out the inaugural newsletter for Future Frontier Capital, our pre-seed venture fund backing frontier tech startups. As I hit "send," I realized how launching FFC parallels the path of the founders we support. Starting FFC has required the same passion, perseverance, and self-belief that drive entrepreneurs. Just like a startup, getting a VC fund off the ground demands relentless hustle—building the brand, perfecting the pitch, and networking tirelessly. There are constant challenges that test your resolve and endless hours of unglamorous work behind the scenes. And perhaps most daunting - the self-doubt, wondering if you're crazy for attempting something so bold. Pushing through that negative self-talk requires unshakable faith in your mission. Raising this VC fund reminds me of starting our IP strategy and patent analytics firm two decades ago. It’s a powerful reminder of the perseverance, creativity, and resilience needed to turn an ambitious idea into reality. This experience makes us more empathetic partners, ready to support the founders we back. Our work is just beginning, and this inaugural newsletter underscores our commitment to supporting frontier tech startups every step of the way. #startups #VentureCapital #EmergingManagers #Entrepreneurship #InnovationMindSet

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I really enjoyed recording this episode of The Digital Industrial Podcast with Ty Findley. We talked about common misconceptions for deep tech, the "Why Now" for the category, and differences between investor diligence for deep tech and traditional tech. https://lnkd.in/eKtwjauu

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I enjoyed going on Nick Telson-Sillett’s podcast, Pitch Deck by Forward Pursuit. Nick is a serial founder and investor (founded and exited DesignMyNight) so knows both sides of the table which always makes for an enriching chat. Some things we discussed: - The perceived power dynamic between VCs and founders can hinder productive conversations. - A compelling product demo can significantly influence investor interest. - Founders must focus on solving real customer problems to succeed. - Hiring standards are crucial for building a successful startup team. - Behavioural roadblocks can prevent the adoption of new solutions. - Validation from potential customers is key for pre-revenue startups. - The early-stage funding landscape has become more efficient and selective. - Pace of execution is a critical factor in attracting investment.

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📈 Demand for fertility services is rising -> 💼 PE recognizes this and wants in -> 🏜 but opportunities are scarce (https://lnkd.in/g6zXEVZh). Highly recommend anyone who wants a deeper understanding of what's going with fertility and fertility tech read Aya Spencer's *2024 State of fertility tech report* (https://lnkd.in/gVjK_UpX) - it's a great summary

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It was wonderful to be in conversation with Madison Mills of Yahoo Finance at their annual Invest conference earlier this week. We covered everything from the venture outlook for 2025, impact of elections on women's health investing and innovation, and more. Full clip and summary below 👇 https://lnkd.in/gS67sc2Y

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I believe two of the big winners over the next 10 years in the SMB category will be PE who are rolling up the businesses and GenAI powered software that makes running these businesses significantly more turnkey and/or profitable. Thanks for having me on Jay Kapoor. If you want spicy takes fast forward to 25 min mark. If you want to get deep in market analysis buckle in for the whole thing. https://lnkd.in/d8M7Jyrx

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#thisisnotadvice Day 384 Today's question: “What is the best way to give feedback?” Michelle Volberg is the founder and CEO of Twill, a venture backed technology platform that makes hiring easier by allowing talent to recommend their peers & friends for open roles. Previously, Michelle founded and ran a nationally recognized executive search firm recruiting talent for startups and public companies. She started her career in sales working at The Daily Beast, Digitas, NBC, etc. We're here on #thisisnotadvice to answer all your questions about how to thrive at work. If you have any questions you want us to answer next time, drop us a comment below or on X (formerly known as Twitter). For more, check out our community-edited, comprehensive reference guide on how to work: www.thisisnotadvice.work.

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To my amazing network - I am thrilled to announce the launch of Pave Health Ventures, an early-stage venture fund dedicated to broadening access to healthcare and improving the overall well-being of our communities. I’ve been very fortunate in my healthcare career. As the Founder & CEO of MedPilot, we capped off a seven-year journey with a successful exit when we were acquired by Vytalize Health. For the last three years, serving as Chief Innovation Officer, I’ve had the honor to contribute to the remarkable growth at Vytalize, impacting the lives of hundreds of thousands of patients by enhancing the quality of care they receive. I am immensely grateful to Matt Buder Shapiro, not only for being the perfect partner and co-founder but also for being an incredible friend. Additionally, I extend my heartfelt appreciation to Faris Ghawi, Amer Alnajar, and Jordan Brown for their outstanding leadership and for broadening my perspective on the significance of value-based care. This journey has not only provided me with industry expertise but has allowed me to cultivate invaluable relationships and an incredible network. As I embark on this new chapter, I am profoundly grateful to be supported by top executives and thought leaders in the investment, wellness, and healthcare industries. Within the healthcare ecosystem, we are represented by key stakeholders from health systems, insurers, governmental organizations, retail health businesses, provider groups, and value-based care organizations. At Pave Health Ventures, we believe the timing couldn't be more opportune to help support health-focused startups. With the growing prevalence of illness and chronic health conditions impacting our communities, consumers and key Healthcare Stakeholders are increasingly prioritizing proactive and preventative care. This shift in focus is fueling demand for technology, products, and services aimed at improving health outcomes, unlocking trillions of dollars in growth potential within the healthcare landscape. Pave Health Ventures is all-in. We are actively seeking solutions that tackle the root causes of illness, manage chronic conditions, and optimize care and care teams. Please support us in our mission by opening your networks and introducing us to amazing founders and entrepreneurs. Together, let's help pave the way to a healthier tomorrow. Jacob Myers

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Someone broke down the estimated costs of a $15 Sweetgreen salad. We need these cost graphics for digital health to help future founders. Especially for tech enabled cos, the greatest cost is labor. Much of the "value created" is in curation and matching, which means the gross margins are reliant on labor arbitrage. Pay someone $X, but get paid $X+Y% per visit. The challenge with healthcare is that you often have to pick one of two business models: 1. specialized, low volume, high cost, low gross margin % 2. generalized, high volume, low cost, high gross margin % I'd argue founders should focus on gross dollars over the lifetime of the customer (like Jeff Bezos said) instead of gross margin %'s, but we'll leave that for another time. The challenge is that many tech enabled digital health cos have high cost of goods sold (labor) and moderately high product, design, and engineering budgets. We must build differentiated solutions for patients, clinicians, and clients to be out incumbents, however, we're realizing that companies are ultimately valued on the discounted value of future cash flows. And the high SG&A costs at most organizations might be inbalanced to the unit economics of the business. I'm not sure the math pencils out for everyone unfortunately. But I'm just a guy on the internet, would love to hear the thoughts from those smarter than I (you!). Comment below. --- p.s. I have no idea the accuracy of the graphic and not an investor in Sweetgreen. Cheers. Credit: David Crowther

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Exciting news from Techstars for our #Colorado ecosystem! Thanks, Nicole Glaros, Natty Zola, and David Cohen, for your collaboration in reimagining how best to support founders in #Colorado. #startups #entrepreneurship #ecosystem #innovation

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