Yuechen Zhao

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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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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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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AI memory is fundamental for conversational AI and AI agents. It is critical for building personalized experiences and improving reasoning. Check out Letta’s course to understand how to use AI memory to enhance the customization and quality of your AI app.

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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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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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Open-source models can be a strong lever for increasing gross margins at AI companies, especially those that have hefty cost structures (e.g., enterprise sales orgs that require significant customer success or implementation resources, as well forward-deployed AI services models common in healthcare and life sciences). One of many reasons to maintain a modular and flexible stack with minimal dependencies when building an AI company. More on the importance of flexibility in the AI stack: https://lnkd.in/eA2XATRk h/t Delip Rao #ai #artificialintelligence #generativeai #healthcare

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In vertical SaaS, the very best companies landed with a product solving a specific, burning pain point that horizontal solutions solved badly and then became broad product suites over time (ServiceTitan, Veeva Systems, Doximity, etc). My partner Gordon Ritter calls this “layering the cake”. In vertical AI, the landing wedges are much more brittle. While the painpoints they solve are very real (and often unaddressable by SaaS alone), they’re also much more likely to commodotize in the near term as the tech advances. 👀 Therefore, the need to layer the cake in vertical AI is much more urgent than in vertical SaaS. 👀 The best vertical AI CEOs not only recognize the dynamic, but talk about it openly. Helps those around them keep up the speed of innovation and their eyes on the bigger prize.

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🚨🚨 🚨 Unlocking Innovation: The Power of the Adjacent Possible Innovation programs can stall when the team tries to ideate way beyond their collective perspective and frame of reference. Like a software engineer brainstorming genetic modification of mycelia, or a senior executive ideating process improvements which they haven't been participated in for decades. It's challenging, exhausting, and ultimately self-defeating. Enter the concept of the "Adjacent Possible" - a game-changer for innovation. What is it? The Adjacent Possible, coined by Stuart Kauffman, represents the realm of new ideas within reach based on our current knowledge, resources, and capabilities. Why it matters: ➡️ Realistic Innovation: it focuses on achievable advancements, not far-fetched concepts. ➡️ Incremental Progress: each innovation opens doors to new possibilities. How to leverage it: • Constantly explore the boundaries of your adjacent possible. What's in your line of sight is what you know best. • Combine existing ideas in novel ways. Even small perturbations from status quo can generate large innovation leaps. • Stay curious about developments in adjacent industries. Cross-domain patterns create fresh sources of ideas, while also expanding the adjacent possible. Most of all, it takes the 'genius' pressure off the team. No one knows everything, but each one of us knows a lot about something, and we can all drive plenty of innovation potential by focusing on the spaces we know best. Are you exploring your Adjacent Possible? Share your thoughts below! 👇 #Innovation #innovationsystems #AdjacentPossible

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Presenting at the Senate as part of the Coalition for Health AI (CHAI) "Day on the Hill" wasn't on my 2024 bingo card, but I'm feeling energized by the bipartisan discussions on healthcare AI. The numbers tell a compelling story: while nearly 2,000 healthcare AI startups have received funding over the last two decades, only 1 in 20 provider-facing companies reach late-stage maturity. Beyond natural market dynamics, two critical barriers are holding back AI's full potential in healthcare: unsustainable payment models and inadequate evaluation infrastructure – only 5% of research studies on LLMs in medicine utilize real patient care data, and studies advancing our understanding of performance beyond medical licensing exam benchmarks remain anemic at best. At CHAI, we're advocating for essential foundations: • Rigorous technical model performance evaluations • Comprehensive bias assessments across diverse patient populations • Thorough pre-deployment simulations and prospective studies • Robust ongoing local monitoring The path forward demands strong reporting infrastructure, advanced healthcare AI benchmarks, and meaningful public-private partnerships to drive real-world AI deployment in healthcare. Stay tuned for CHAI's upcoming initiatives in 2025 as we expand our engagements with the startup and investment ecosystem. https://lnkd.in/enw-GQcA

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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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Non-Engineering Roles at Early-Stage Startups Offering $120K+ Base Salary with Meaningful Bonus and Equity: Chief of Staff @ Milo (Consumer), Remote Biz Ops Lead @ Fractal Agriculture (FinTech), Remote; Backed by Virta Ventures Chief of Staff @ CakeAI (AI SaaS), NY; Backed by Primary Venture Partners Demand Generation Specialist @ Rootly (Consumer), Remote; Backed by YC, 8VC, Gradient Ventures Account Executive @ CommandBar (Enterprise SaaS), Remote; Backed by Soma Capital, YC, Insight Partners Product Marketing @ Slope (Enterprise), Remote; Backed by YC, Union Square Ventures, Liquid 2 Ventures Supply Planning Manager @ PROVEN Skincare (Consumer), Remote; Backed by YC, FJ Labs, Soma Capital, Social Capital Account Executive @ Accrue Savings (Consumer), NY; Backed by Ground Up Ventures, Tiger Global Chief of Staff @ UNIGRID Battery (Climate), CA; Backed by Union Square Ventures, LiquidMetal Ventures Job details and the full list (40+ opportunities) are in the comments below. If you're interested in non-tech jobs focused on specific industries like HardTech, HealthTech, Climate, etc., then DM me or let me know in the comments.

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At Forum we look at thousands of deals each year across our Accelerator and Pre-Seed funds but only end up investing in a little over 1% of those startups.  As an early stage VC, I am in the business of saying no to nearly every startup I meet, and while there is nuanced rationale for many of the startups I pass on, a vast majority of businesses that don’t meet the qualification to get funded typically fall into one of two buckets. ▪ First time founders have a tendency to go out to market too early to raise pre-seed capital ▪   I’m sure most founders have heard some iteration of this from VCs that ultimately pass on their business.  In some cases it's a blanket excuse covering up for other pass reasons- perhaps a VC doesn’t believe in a team or isn’t bullish on the market opportunity - but in many cases founders simply haven't proven enough to the market to warrant an investment. I meet many teams with an articulate vision for the product that they want to build, but they either haven't performed enough customer discovery to prove demand for their initial wedge product, or need to raise pre-seed capital to build out an MVP.  In those cases, pre-seed investors are unwilling to underwrite those risks.  To be default fundable, teams need to be able to keep costs low, perform extensive customer discovery, and ship some version of an early product - pilots and early paid customers are key. A huge piece of this is having founding engineering talent on the team. ▪Not every startup is a venture opportunity ▪ By definition, a venture backed business is solving a problem within a market opportunity so massive and so desperately needed, that its growth rate is off the charts.   It spreads like a weed, absorbing almost unlimited amounts of capital to fulfill demand within its customer base.   Each year there are maybe 20 companies launched that ultimately have venture scale outcomes. The bar to reach this rarified air is unfathomably high and the reality is the vast majority of founders simply aren’t building for opportunities that have the potential to be one of these generational companies. Many startup founders view VC as the only viable option for capitalizing their business, but not every great business is a venture business, and most successful founders never take VC dollars.  In order to reach an IPO/acquisition large enough to generate venture returns, a startup needs a credible path to $100s of millions in revenue. This is the standard by which early stage opportunities are evaluated. The flip side to this, and I share this feedback often with founders I meet that are building interesting business in non venture markets, if you are able to scale to $10- $20M in revenue that can be a massively successful outcome for a founder.  There are investors who focus on these type outcomes, namely lower middle market PE shops, and the typical path to those deals is a bootstrapped business or a friends/family capital raise.

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What a week this has been for innovative companies in Seattle (first Smartsheet and now OctoAI). Today NVIDIA made public the news that they have acquired Madrona portfolio company OctoAI. Partnering with the founders since Day 1 (ok Day -1) has been one of the greatest experiences of my life. Luis Ceze, Jared Roesch, Tianqi Chen, Jason Knight, Thierry Moreau and Carlos Guestrin were all involved in the research and insights that helped create the TVM open source technology at the University of Washington computer science school and then the creation of OctoAI back in 2019 to drive commercial impact with this technology. From sorting out the terms of the original "pre-seed" round over a bottle of Caymus Vineyards wine to helping Amazon Web Services (AWS) understand the dynamics around the open source movement in Applied AI to learning our way in to product-market fit with the BEST inference optimization service available (OctoAI can help customers find their optimal fit of performance, customization, and cost), OctoAI has been the best! The company has helped set the table for AI-driven innovation for the years ahead and they will be a perfect compliment to the many capabilities at Nvidia. Luis, his leadership team, the board (including Carlos Guestrin Lip-Bu Tan and Mike Dauber) and so many "friends of OctoAI" know what a motivated, talented and authentic group of people are associated with this company. It is inspiring to see an acquisition at a total deal value of over $250 million in this highly dynamic and fast-moving phase of AI disruption. It is even more exciting to anticipate what will be possible with innovations powered by AI models and related technologies in the years ahead. Madrona has been investing in Applied AI for over a decade and we truly believe that we are just getting started! One of the hardest judgement calls as an investor and board member is to assess the benefits and risks of selling a company at a key inflection point in the journey. Nvidia made a compelling case that the impact for the OctoAI team and technology would be maximized within the market leader for AI infrastructure. I will be rooting every day that they all maximize this impact in the months and years ahead!

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Next one up, Flagler Health! In an attempt to demystify some of the non-obvious elements we found when we first met the founders of our fastest growing portfolio companies at 186 Ventures, here is the third edition of the "idiosyncratic phenomenon". This highlight will be on Albert Katz, Leon Anijar, and Will Hu and their journey building Flagler Health to bring unprecedented AI enabled patient care to the world of musculoskeletal (MsK) providers. As the healthcare industry shifts to a value based care paradigm, there will be increased pressure on the entire industry to ensure patient outcomes improve, all the while helping providers generate more revenue / become more cost efficient. Since we co-led their March, 2024 seed round with Streamlined, the company has rolled out some of their newest remote therapeutic and chronic condition management features to many patients and providers alike, experiencing high revenue growth in such a short period of time. The company continues to face unmet customer demand as it continues to scale its expansion into 2025. https://lnkd.in/exesTcmC

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Collate is emerging from stealth with $30 million in seed funding led by Redpoint that values the fledgling business at more than $100 million, a significant number for such an early-stage company. VC firms First Round and Conviction Partners also participated, as well as Y Combinator. https://lnkd.in/ey4mjHy2 #startups #venturecapital #fundraising #artificialintelligence #ai #biotech #lifesciences

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Instacart is a market leader when it comes to leveraging AI tools to boost productivity at work. I had an amazing conversation with JJ Zhuang, Instacart’s Chief Architect, who has shepherded over 50 AI-driven initiatives to market across the org. We explored what catapulted Instacart to the forefront of AI integration, supporting radically diverse use cases across various functional areas. One striking insight (echoed by Ethan Mollick and others elsewhere) is that you often don't need specialized tools for specialized work. Frontier models like GPT-4 can seamlessly adapt to a wide range of functions and use cases. They're not just for engineers; they're incredibly versatile tools used by marketing, comms, and legal teams. From generating code to proofreading and ideation, GPT-4 empowers every department to leverage AI for enhanced productivity and innovation. By integrating LLM’s like GPT-4 into their workflows, teams can streamline processes, automate repetitive tasks, and unlock bandwidth for new creative possibilities. How can you harness the power of AI in your own work to boost productivity? Share your thoughts below 👇 Want to hear more insights from JJ? Check out the full podcast episode by clicking the link in the comments.

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