Q&A: KeyView’s Holistic Stance on Fostering Health IT Startups

One week after unveiling itself as a new player in the health-investing landscape, New York-based KeyView Partners is releasing today a guide for entrepreneurs who want to succeed in the booming health IT startup space. The report—which is called iHealth Ecosystem and has an accompanying website—identifies six major trends driving change in the health care industry. It also spotlights companies that KeyView’s investors believe are doing a good job capitalizing on those trends.

KeyView’s CEO David Shrier says his new firm is just starting to look for investment opportunities across the medical-technology industry and has entered into a term sheet with its first portfolio holding (which he can’t name just yet). The iHealth Ecosystem report reflects KeyView’s approach, which is not just to support startups financially, but also to actively assist entrepreneurs in navigating an increasingly complex health care system.

Shrier recently spoke with Xconomy about opportunities in health technology, and how his new firm will be positioning itself to take advantage of them.

Xconomy: What trends were you seeing that inspired you to start KeyView?
David Shrier: I’ve very interested in the intersection of data, technology and health. I started KeyView with Tom Gardner, who has been a very successful healthcare executive. He was a division president at J&J and ran a number of public and private companies that lived at the intersection between health and technology. My own background also bridges health and technology. I got a biology degree from Brown and did research using computer control systems. Then I became a data programmer on Wall Street. I got into venture capital and technology and was involved in a lot of interesting businesses, including building a data analytics system for Dun & Bradstreet. Tom and I had been talking for about four years about the future of healthcare. More recently we decided we wanted to get actively involved together and started KeyView.

X: How will your investment approach differ from others working in the area?
DS: We are operating investors. Teams work with us because they feel we bring a certain point of view and skills that augment what they’re doing. I distinguish operating investors from what you’d call pure financial sponsors. We at KeyView have all held profit and loss responsibilities, made payroll, been CEOs or functional leaders within our organization. So the fact that we are operators first is a differentiator in the marketplace.

Another differentiator that’s more specific to the opportunity is that we have a particular thesis and point of view on where healthcare is going over the next decade, and we are positioning ourselves to help drive that change. We think that healthcare globally is in crisis. We think for-profit enterprises can take a significant role in fixing these problems rather than waiting for the policymakers to fix them.

X: So what is your prevailing view of where healthcare is going?
DS: The emerging trend we see is interconnected health care. What we found startling when we began doing our research was that we believe there will be over 250 trillion interconnected nodes in the healthcare system by 2020. That is the same number of neuron connections in the human brain. That is a profoundthought. The summary opportunity for us is each one of those connections is going to be generating data, and a number of them will be centering on medical decisions. So the companies that are going to be the big winners will be the ones that help understand, analyze and make useful the data that comes out of these interconnected nodes. And it will be the companies that help providers, patients, and payers make better decisions and deliver better outcomes, are going to be the big winners in the new phase of healthcare as the industry transforms. So it’s all about big data, analytics, and decision support.

X: In the report out today you cite Princeton, NJ-based IntegriChain as an example of a company taking advantage of these trends. What do you like about this company?
DS: It helps make the global supply chain more transparent for pharmaceutical companies. What does that mean? Through the cloud, IntegriChain helps pharmaceutical companies more precisely understand where their products are at any point of time and how they’re selling.

A counter example—and I’ve seen a number of these so I’m not going to name names—would be an electronic health record company that does not integrate with the major health IT platforms. That is not interconnecting, and that does not have a bright future.

Companies listed in the report are there to help people make sense of the chaos. There are some companies where we either have or plan to have business relationships with. As we announce those deals, we will bring that to light.

X: You identify “chaos in data” as a big opportunity for entrepreneurs. What do you mean by that?

KeyView's David Shrier

DS: In the ’90s and beyond, everyone said “we’ve got to invest billions in these giant warehouses in the sky that are filled with data.” But the data quality is suspect, and it’s utter chaos finding information in these databases. A number of electronic medical systems were built and implemented that are optimized for the hospital CFO but not for the care provider. So the care provider needs actionable data at the moment of care, and they’re struggling with a system that was not designed to help them. That’s an opportunity.

X: You also cite “consumerization” and “care site choice” as important trends. Explain.
DS: We’ve read lots about the increasing use of technology in consumer health, and people using technology to get answers about medical questions. What we find interesting is people are now becoming more sensitized to cost, and starting to use technology and tools to better understand the cost and quality of the healthcare that they’re getting. That’s being driven by another trend, which is that more and more of the cost is being shifted to the consumer.

Care site choice means consumers now have more places to get medical care, to make it easier for them to access care. For example, companies are realizing if they have a doctor come to the worksite once a week, employees are more likely to see a doctor for routine care. They end up being healthier, which lowers the cost to the employer of insuring the employees, as well as reducing absenteeism, illness, disability, a number of other costs. Now millions of worksites can become points of care. Another example is the rise of nursing clinics in major drugstore chains. I got my flu shot at CVS MinuteClinic. I didn’t go to the doctor, I didn’t have to make an appointment. I walked in. It took me five minutes. That’s an example of increased convenience and lower cost that is reshaping the landscape of health. Once you find those trends, you now start to look at companies that take advantage of them.

X: One trend we’ve noticed is the growth of health IT incubators such as Blueprint Health here in NYC and Rock Health in San Francisco. How will these initiatives help build a stronger health IT infrastructure?
DS: I ran Ernst & Young’s sponsorship of Blueprint Health when I was Ernst & Young’s first and only Entrepreneur in Residence. We have a continuing informal relationship with Blueprint Health. We think they are a group to watch.

We are starting to see a trend emerge. For example, New York City has an entrepreneur in residence named Melinda Thomas. She is focused on healthcare. That’s an example of the growing awareness of this sector.

X: You have also started a think tank called Camelot Health. What is that group’s mission?
DS: We are trying to come up with ideas about for-profit businesses that reduce health care costs and improve quality of care. We want to give these ideas to incubators or accelerators like Blueprint Health, or to early-stage venture capitalists. Camelot is like Davos meets Idealab for health care. It is composed of 17 health executives who are interested and passionate about solving the problems of global health care using for-profit enterprises, rather than waiting for public handouts. We view ourselves as complementary to the policymakers.

The Chinese ideogram for crisis embeds the ideogram for opportunity. We think there’s going to be tremendous wealth creation for savvy investors and executives who help take aggregate costs out of the health care system while improving quality of care.

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