What Does HIMSS15 Tell Us About Venture Investment In Healthcare IT?

[Contributed by Mike MacKeen, originally published on Raising the Next Round]Over 20,000 people will gather next week in Chicago for this year’s HIMSS conference. This nexus of the digital health world is a must-attend event for HCIT vendors. The attendee list allows us to get a snapshot of how the venture industry is impacting healthcare technology.VCs should be attracted to improving healthcare delivery. Big returns come from solving big problems. The cost, availability and quality of healthcare are big problems. The Kaiser Foundation reports US healthcare costs have expanded from 7.2% of GDP in 1970 to 20% of GDP in 2015.  Venture returns are created when large existing systems undergo change.  US healthcare is a trillion dollar system with core drivers in place for change.  Many hospitals are operating with tech infrastructure that is a generation behind and implementation of the ACA is disrupting the system in ways both intentional and unexpected.We analyzed the 6,100 companies participating officially in HIMSS15 against financing data from CapitalIQ and Crunchbase. Our analysis reveals that 326, or only 5.4%, are currently venture backed.  That number seems surprisingly low, particularly when contrasted with the percentage of venture-backed participants in an important horizontal tech event such as Dreamforce.  Our denominator – attending companies – is admittedly skewed.  There are attending companies, such as investment firms (including ours) and others from the ecosystem, that are not HCIT vendors.  There are healthcare providers, some for-profit that may be funded by private equity, but also not-for-profit hospitals that aren’t candidates for venture funding. However, even excluding half the attendees from our calculation, it still seems surprising not to see a higher percentage of venture-backed, disruptive HCIT vendors.HIMSS 2015 Venture Activity: Total Funding Rounds and Total Growth Rounds What does the venture-backed HIMSS attendee look like?  The median venture backed HCIT vendor at HIMSS has raised only $14.4 million across two rounds of capital. The companies are also longer in vintage than typical tech vendors with a median time since founding of 11 years.  Funding for HCIT does appear to be better distributed across geography than that for horizontal tech.  The California bias that distributes 30+% of overall tech venture money to Golden State companies is not present in HCIT where only 15% of the VC backed HCIT vendors at HIMSS15 are from California.The HIMSS15 venture backed attendees raised a collective $3.2 billion last year, but much of that went to horizontal vendors such as Cloudera raising $900M.  2014’s famed unicorn rounds seem absent in HCIT.  Genome database company Human Longevity’s $70 million raise was the largest among the dedicated healthcare IT vendors during 2014’s private bull market.NEA tops the list of HIMSS most active venture investors with 27 current portfolio companies represented at this year’s conference.  Corporate venture is prominent across the top investors with Intel, Qualcomm and the Partners Innovation Fund each invested in a dozen or more HIMSS attendees.HIMSS 2015 Venture Activity: Most Active Investors and Best Funded CompaniesHIMSS as an organization is learning to embrace start-ups.  The Sunday pre-conference menu includes the Venture+ Forum with panel discussions and 14 HCIT start-ups pitching their business plans.  Last year’s winners were medication optimization vendor ActualMeds and connected patient platform CareSync.  ActualMeds closed a seed round two months after winning Venture+ and CareSync closed a $4.3 million Series A financing six months later.  I am looking forward to seeing the pitches from this year’s presenters.There are venture-backed success stories at HIMSS15.  99 of the publicly traded tech vendors attending HIMSS, who have a collective market value of $739 billion, were venture-backed previously.  Those names however include horizontal vendors with a presence in healthcare like Intel, VMWare or Tableau.  While there are dedicated HCIT vendors at HIMSS that validate the venture investment opportunity, including athenaHealth, Merge Healthcare, MedAssets and Myriad Genetics, the list is shorter than I expected.Our analysis has me reconsidering venture funded innovation in healthcare tech. Are entrepreneurs building enough scalable companies targeting the shortcomings of healthcare delivery? Should hospital CIOs be demanding more innovation and be more willing to switch to disruptive vendors that leverage mobile, cloud and big data? Do enough VCs understand that business models in healthcare tech should not be benchmarked against metrics from horizontal enterprise applications? Is our economy’s innovation engine impacting healthcare to the degree it could?I am going to also post this to the HIMSS attendee news feed where I hope others will share their views on these questions.

Posted on April 13, 2015 in Capital Markets, Insights, Private Equity, Technology Industry