Ruby Gadelrab
@DivaBiotech
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CEO and Founder of @M_Disrupt , Healthcare Executive #Genomics #DigitalHealth expert, ex VP Commercial Marketing @23andme , advisor, mentor.
Austin, TX
Joined December 2009
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Pinned Tweet
The love and support my team
@m_disrupt
show for each other brings me to tears.
Please check out
@kaydaustin
video as she raises awareness for our colleague who lost his wife to lukeamia on Thursday. Please donate to the
@gofundme
if you can
TikTok
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After a week in San Francisco for
#JPM2023
i have come to the conclusion that its the scariest, dirtiest city I have experienced. I have lived in London, Cairo and Shanghai and SF is where I have felt the most unsafe. Such a shame for a city that generates so much $$$
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Today my beautiful son Lucas turns 8 years old. February 22nd is always a bittersweet day for me, but Lucas has become my why.
8 years ago yesterday I was admitted to Stanford with preeclampsia. 24 hours later I gave birth to my son at 28 weeks. He was born at under 3
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Dear lord... please give me the confidence of a 25 year old tech bro building a health product.
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Yesterday a physician who is in a CMO role and who I respect highly said this:
“Most physicians know medicine but don’t understand the business of healthcare”
Agree? Disagree? Discuss
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I dont understand the start ups in healthcare that are willing to spend 500K on tech and not willing to spend <50K on clinical expertise who can help them build a real solution (and potentially save them the 500K if they are going in the wrong direction)
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My dream investor is a minority investor who deeply understand healthcare and digital health and is mission aligned on bringing health products to market quickly AND responsibly . Who are those unicorns?
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Just spoke to a C level executive at a health system who told me
1) they are being ultra strict about the type of digital health they are willing to pilot
2) they wont pilot unless the innovation shows both clinical outcomes AND ROI
3) the innovation needs to solve a problem
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Loving
@nickjonas
sharing his very poignant story about his diabetes and mental health at
#HLTH2023
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Healthcare is one of the only industries where the consumer (patient) the user (clinician) and the payor (plans and employers) are all different stakeholders with different incentives.
When building new health innovations, who should we prioritize?
Discuss
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I see 100's of digital health companies - have started to see a pattern. Companies that give clinicians a voice in the process and a seat at the table of digital health product development generally do better than those that don't. The best companies have a Chief Medical Officer
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I’m so tired of hearing that the solution to lack of women leadership in digital health is more mentorship programs. Nope we don’t need more mentorship. We need opportunities and space to lead.
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Dear lord, give me the the confidence of a tech bro building in healthcare and raising in 2023 at 2022 valuations.
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About 16 months ago, I met the most inspiring woman who applied for one of our engineering roles.
During the interview she wowed us with her knowledge, skill and passion for what we are building and at the end, she disclosed that she had rare stage 4 kidney cancer.
We hired
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In the future, digital health will just be called healthcare.
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Someone asked me my why for being in healthcare.
My whys:
1) My mother died of liver cancer.
2) I had preeclampsia
3) My son was born at 28 weeks and spent 12 weeks in the NICU
4) My hospital bill was $50K for my c section & $1.2M for the NICU
I want to change all of the above.
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If you are building a digital health product here are the 6 things to answer
1) What clinical problem do you solve
2) Who will pay for it, use it and consume it?
3) Whats your regulatory strategy?
4) How will you generate evidence?
5) Whats the ROI?
6) How will you sell it?
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Cycle of despair in digital health
1) Build awesome health product
2) GTM DTC in patient pay mode
3)OMG CACs are so high & why the hell aren't patients paying?
4) Pivot to B2B2C - divert all $$$ to BD
5) Oops it doesn't fit clinical workflows/payors wont pay
6) Back to step 2.
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In healthcare if you win the woman, you win the household. Women are the chief medical officers of their families, and yet they are so underserved.
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Something is off with the food we eat in america. I have spent 3 weeks in europe and the middle east, vacation eating and drinking everything and haven’t gained a pound. In the US I eat half of what I eat and gain weight.
@chrissyfarr
didn’t you have a similar experience?
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Interesting facts on
#digital
health
- 350,000 Health apps in the market today
- 90,000 Were added in 2020
- 250 new apps are released every single day.
BUT
There are only 2000 publications since 2007 demonstrating clinical effectiveness.
Huge Gap In Evidence
Source: IQIVIA
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This morning in my DMs:
Founder 1: Male just finished a 20M raise for a women’s health company looking for help with health experts
Founder 2: Female building a women’s health company and Investor just pulled the seed stage term sheet because they are freaked out by SVB
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I don’t often share things this personal but here goes.
In 2015, I had preeclampsia.
My baby had to be "delivered now" - there were no options.
My husband was asked "who should we save if we can only save one of them?"
My son was born at 28 weeks. at 2.9 pounds. (Thread)
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Yesterday I spoke to a tech founder who had pitched their healthtech company to an investor. The investor told them that it was a big red flag to build a healthcare company with no clinical skills in the team and to come and talk to
@m_disrupt
. I am so happy that investors are
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@JennSedlerMD
as the mom of a 28week old NICU baby I can’t tell you how much I appreciated the doctors and nurses doing this. This was the most stressful time of my life and these daily tiny victories kept me going. Thank you!
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In the increasingly crowded digital health market, demonstrating clinical outcomes and ROI will be the key differentiator.
Just saying it a little louder for the folks in the back.
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At
#HLTH2022
the conference in Vegas where 10,000 healthtech nerds gather and drink mimosas and gamble before tackling some of healthcare’s biggest challenges
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@ottosipe
Its absolutely heartbreaking for the people on the streets. I saw so much drug use and extreme mental health issues in a city thats so rich and opulent. Why isn't the city taking care of it's people??
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The thing that concerns me the most about our digital health industry is that most of the solutions that are being built today are completely different from the actual REAL problems in the healthcare system.
This means they stand zero chance of adoption or scale within todays
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It's very frustrating that most digital health products are currently made for healthy, wealthy white folks. Just sayin.
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HOT Tip for digital health founders: today a leader at a health system told me that health systems care more about new revenue generation opportunities than cost savings. Which is entirely different than most pitch decks I have seen.
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One of my dream investors just committed today and i am ecstatic
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Today I made 10 intros of seed stage founders to investors. What are you doing to help your fellow founders? We need to help each other because a rising tide lifts all boats :)
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In digital health we need to start thinking beyond the MVP, we need MVE - Minimal Viable Evidence that major healthcare stakeholders will accept.
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@fimazaltsman
I lived in the bay area for 16 years so I know it well. I moved to Austin and have no regrets.
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Saying it louder for the people in the back:
Female founders dont need incubators, accelerators or more mentors. They just need the money.
Write the check.
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There are now two archetypes of people who start healthtech companies
- Techies who are frustrated with the healthcare they received as patients
- Clinicians who are frustrated with the healthcare they are forced to deliver
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I firmly believe that the current fund raising process, destroys some incredible companies. I have just seen an amazing product but the founder couldn't raise to keep going and has shut down.
There has to be a better way.
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@LifeWithArjay
@Airbnb
@AirbnbHelp
@bchesky
Im in austin and if you ever find yourself in this situation again please DM me - i can help you.
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It occurs to me that todays healthcare system has broken up patients into the sum of their parts with each clinician treat only one body part or system and not the whole person.
Don’t we risk doing the same again in digital health by building a plethora of point solutions?
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It occurs to me that Gen X and older millennial women are taking care of the healthcare decisions of three generations: their own, their children’s and their parent’s. Why then did women founders only get 2% of VC money in 2021?
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Heard a really interesting stat recently
In the 90's if you asked kids what they want to be when they grew up - about 20% said a doctor.
If you ask kids today - over 30% said social media influencer.
If we think the physician shortage is bad today think what it will be like
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Reasons why clinicians are a competitive advantage to todays digital health companies
1) They understand clinical workflows.
2) They have experienced the breaks in the system first hand
3) They understand how to communicate the clinical problem and your solution to their peers.
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When the co-founders of two of the biggest digital health companies invest in your round you know its a great day.
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In case you don’t have fomo - this will give it to you, the most awesome gathering of female founders and investors
#hlth2021
@chrissyfarr
@AlyssaJoyJaffee
@thekkchristine
@JessHOwens
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Who are the best angel investors you know investing in Digital health?
I am particularly interested in Angels who are:
- Clinicians
- Women
- Underrepresented investors.
- Operators with digital health or healthcare experience.
Please tag them in so I don't miss anyone.
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My list of fav accounts to follow if you want the latest digital health news
@deenashakir
@chrissyfarr
@SPulim
@AlyssaJoyJaffee
@boltyboy
@erbrod
@m_disrupt
@doc_namrata
@operationdanish
@MattSakumoto
@BenSchwartz_MD
@UliChettipally
@sacjai
@digitald0ctor
@julesyoo
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So to be clear: when i say I’m not bullish on DTC healthcare, I’m not talking about access, or experience - which should be as easy and delightful as consumer products. I am talking about PAYMENT - Consumers shouldn’t have to self pay for their healthcare.
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Today we call it digital health, tomorrow we will call it healthcare.
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Pet peeve of the day: when people assume
#femtech
means fertility. Women’s health is critical to society and goes way beyond having babies - menopause, sleep, nutrition, CVD, endometriosis, mental health just to name a few.
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Who is the Best PR firm or person that you know in digital health?
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As funding tightens in digital health there will be more scrutiny on the evidence of clinical outcomes by the healthcare stakeholders. Invest in evidence generation folks.
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Is EVERYONE in digital health starting a telemedicine company? There are too many Telehealth companies that the market is saturated and there needs to be some consolidation. There are SOO many other problems in healthcare to solve - let's be original. There I said it.
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Lord grant me the confidence of a tech bro associate who has never been an operator and mansplains my business to me.
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The reason companies like Babylon fail, experts say, is simply that it’s hard to replace flesh-and-blood clinicians with an algorithm, and there’s an inherent mismatch between the move-fast-break-things culture of tech startups and that of health care.
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@kellychickadee
OMG - the PTSD is real and no one ever thinks to ask or treat the mother. You are just expected to adjust to parenthood, and get on with it. I am so sorry you experienced this too.
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Is there anyone who has built a mental health for women platform? Specifically with access to therapists who specialize in women's health?
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When I talk about the “Business of healthcare” I am not talking about clinicians running their own practices or starting companies, thats Entrepreneurship and we all learn that on the fly
Im talking about understanding the incentives for each stakeholder in the healthcare complex
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@CarlosdelRio7
Its one of the few “businesses” where the consumer (patient) the user (provider) and the payor (plans and employer) are completely different with unaligned incentives.
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10 Women's health issues that are not fertility:
- Endometriosis
- Depression
- Menopause
- PCOS
- Sleep
- Preeclampsia
- Mastitis
- Breast and Ovarian Cancer
- Fibroids
- Post Partem Depression
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What is happening in digital health? We are being inundated with requests for experts, product, clinical and payor experts.
Its not a side effect of new funding because we all know that has slowed. Maybe because so many layoffs but the projects still need to get done?
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“To really change the healthcare system you have to really get into and understand the healthcare system from the inside unlike how tech is trying to disrupt from the outside.” Sam Hazen CEO of HCA
#HLTH2022
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Another moment of pride as a founder is the moment when you can pay your team full salaries AND health insurance and benefits.
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The number of investors who have added to or changed their investment thesis to include "clinical outcomes" or "health outcomes" is just remarkable. A year ago very few investors cared about this. I wonder how they plan to diligence which companies are demonstrating outcomes?
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I have seen 3 digital health companies in the last week targeting the problem of diagnostic odyssey in Autoimmune disease. All 3 told me that symptoms appear years before the disease and early intervention can completely prevent certain conditions. Next big thing?
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Reunited and it feels so good.
We hugged my dad.
Best Christmas gift ever.
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I am not bullish on DTC business models in healthcare because they don’t scale well.
BUT I am also self paying for an increasing number of healthcare services. I am one of the lucky ones who can afford to.
How do we create DTC models that are financially accessible to all?
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Clinicians are the most undervalued and yet most important part of improving and digitizing healthcare.
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Walgreens’ chief medical officer departs to join MDisrupt
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The number of incredibly talented female execs I have met lately, leaving their tech jobs to build in women's health is astounding. The future of digital health will look very different to today.
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@dodgeblake
@BusinessInsider
“Healthcare moves at the speed of trust” is what a wise man told me. The problem with big tech is that they are not building trust or building community. They are trying to disrupt from the outside.
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I am starting a new medication and I found myself heading to tiktok to learn more about it from the doctors on tiktok and the patients who are taking it. I have access to science but the value to me is the real world view. Is this the future of healthcare education?
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Examples of the sexist VC behavior I experienced yesterday
VC 1: Can I speak to the men in your team about your tech?
VC 2: Why does a woman with a young child (i had mentioned my son) want to build a VC backed company, you are better off as a lifestyle business
The amount of sexism and unsolicited (bad) advice I have experienced just today from VCs is shocking. They don’t even know when they are doing it. The number of times it happens, you would think I would be able to move past it by now. But it hurts every single time.
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This news is of MAJOR significance to the digital health world and it does not bode well. I spoke to a friend at big pharma today who told me that Pharma execs are increasingly frustrated with the lack of evidence and meaningful outcomes of many digital solutions.
Biogen
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The generation of founders who have navigated the past three years have had an intensive bootcamp in every aspect of business:
- surviving a pandemic and furloughs
- building remote teams
- pivots for those who participated in covid responses
- return to work plans
-
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The calibre of the angels coming into my priced round are giving me palpitations of excitement! Today was a 3 "yes" day which is a win in founder world :)
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Metrics for digital health from least important to most important:
- Social media following
- CRM contacts
- Website clicks
- Covered lives
- Utilization rates
- Engagement rates
- Engagement rates + clinical outcomes
- Clinical outcomes + ROI
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Who is coming to VIVE in Miami this year?
@grgyap
from
@MenloVentures
and the
@m_disrupt
team are hosting an awesome afterparty there - who needs an invite?
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Seriously there must be some female MD healthtech founders??
@chrissyfarr
do you know any???
I am looking for examples of Female Physician founded successful healthtech companies - please suggest if you know any thank you!
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In digital health there is tons of technology & technologists that can build products. What’s missing is domain experts that understand healthcare, how to build & commercialize sensible scalable, health products. Wouldn’t it be novel if more health experts were involved?
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OMG - I am RIDICULOUSLY excited to announce this
@m_disrupt
webinar:
Got major FOMO about investing in Women's health?
All star line up:
@chrissyfarr
-
@OMERSVentures
@deenashakir
-
@Lux_Capital
@amydivaraniya
-
@OOVAlife
Neel Shah -
@mavenclinic
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AI in healthcare isn't about tech replacing doctors, it's about data replacing guesswork
"AI won't replace physicians, physicians using AI will replace those who don't"
Catchy, but is a doc who isn't using ChatGPT to craft notes so awful that they'll be booted out?
There are capabilities coming that can save time and make jobs easier.
But why word it as a threat?
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I am looking for examples of Female Physician founded successful healthtech companies - please suggest if you know any thank you!
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Calling all my patient engagement expert friends. I have several digital health clients looking for experts in this area for some fascinating projects.
Please let me know if you have this skill or know someone that does, please tag them in!
#digitalhealth
#patientengagement
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Today I met an AMAZING associate at a VC firm, Not only was he thoughtful and knowledgeable but he went to bat for me and put our deal in front of the partners 15 minutes later, so that the fund could work on our closing timelines. ALWAYS be respectful to the associates, they can
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What A Day!
- Nanny has Covid
- Husband has a mild Fever
- Kid has Strep and Scarlet Fever (Who gets that any more??)
- We bank with SVB and are tracking it closely like everyone else
- I did 4 VC pitches while juggling the above, one of which was to a guy who told me to
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The fundamental problem in digital health is that adoption and reimbursement requires evidence generation, which takes time and money.
Health systems and payors REQUIRE this to engage.
Most start ups cannot generate these with seed funding and are are trying to engage too
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I heard a really interesting stat from a seasoned healthtech investor. Apparently it takes on average of 5 years for healthtech company to find product-market fit!
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Delighted to announce our $3M seed raise lead by
@thecatmiddleton
at the
@hellotvc
And more delighted that
@erinbrodwin
wrote our story this morning at
#HLTH2023
Exclusive: MDisrupt helps health tech founders get clinical
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In healthcare we over emphasize the value of EMR data and underemphasize the value of Genetics, Lifestyle and Behavioral and SDOH data which constitute 90% of health outcomes.
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Wow amazon just delivered my meds - pretty efficiently too. My poor provider had no idea what hit her when i asked her to transfer everything to amazon.
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This is what we are announcing at
#ViVE2022
today in Miami!
Hot off the press!
@m_disrupt
lands $6M in funding to build its Digital Health Intelligence platform!
#digitalhealthintelligence
#digitalhealth
#healthtech
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What does one wear to pitch to 250 investors in time sq? Well sparkly shoes of course!
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How should Digital Health be reimbursed by traditional payors?
One perspective is that if it is a real healthcare product then it should be held to the standards and evidence that real healthcare products are.
Another perspective is that the standards and evidence need to be
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The irony of the funds that passed on me now reaching out to ask if im interested in being an LP on their funds…
When I have the privilege of being an LP, I will invest in those that took a bet on me.
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