We’re Moving On Up!

Hello to all my Subscribers.  I really appreciate your commiting to read what I have to say, or at least to getting my emails and deleting them. To make the blog more readable, I have graduated to a dedicated domain with some better graphics.  You will find the Venture Valkyrie blog now at a new address http://venturevalkyrie.com.

Unfortunately, I cannot just move my subscribers over there.  Each of you has to do this individually.  So, if you are still on board with this whole Lisa Suennen blog thing, please do the following to keep your subscription:

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If you don’t re-subscribe, you won’t get any more notices about posts, so I hope that you will!  I am planning a new post for tonight so stay tuned. 

Best, Lisa

Can You Hear Me Now?

In my last post I talked about robots and other technologies used for remote monitoring of patients who are seeking to lose weight or achieve other healthcare goals. One of the biggest challenges with remote monitoring systems, particularly as it relates to consistently and frequently monitoring people with chronic illness, such as heart or lung disease, is compliance. Even when the technology is sitting right there on their kitchen counter, as the Autom or Health Buddy does, sometimes people just ignore it. If you let the system know you were experiencing shortness of breath or a rapid, irregular heartbeat, your doctor could be on the phone to you in well, a heartbeat. Instead, that fancy remote monitoring device sometimes gets used as a handy dandy towel rack, just like that exercise bike in your bedroom does an excellent job of holding up your clothes.

Health Buddy

Autom the Robot

Of course, we all recognize this is just human nature. Your spouse says to you, “don’t talk on the cell phone while you’re driving, “ and, while you’re responding with “don’t tell me what to do, “ you slam into the back of a Mercedes. Human nature: don’t tell me what to do, don’t make me report to you, even if it’s good for me. Don’t make me take action to take care of myself…I just want some all-seeing force to take care of me while I’m watching American Idol. Pass the potato chips.

So what if such a thing was possible? What if you could truly monitor patients in a completely passive and comfortable way…in a way that they didn’t even know it was happening? Imagine a system that could continuously listen to a patient’s heart or lung sounds or other electric/acoustic signals of the body? Well, granted, there are some monitors that can be worn to listen to heart sounds, for instance, but they are extremely annoying to wear. They wrap around your body, stick to your skin, and generally make you feel like you’re wearing someone else’s bra–not comfortable and not a long-term solution. What I’m talking about is a product that could listen to the sounds of your body 24/7 and communicate irregularities to a medical expert but you would not even feel it at all.

Amazingly, a new breakthrough in materials science out of the Massachusetts Institute of Technology is on the precipice of making this possible. Acoustic fibers—fibers that can  hear, collect data, and communicate it back out—have recently been announced as the most recent technology to emerge from the laboratory of Dr. Yoel Fink, who is one of the smartest guys on the planet and, I am lucky to say, founder and Chairman of one of my portfolio companies, OmniGuide.  A recent article in the Economist discusses this scientific breakthrough.

Dr. Yoel Fink

“What the hell,” you say, “a fiber that hears? What kind of fiber?” Well, I’ve seen them and they look kind of like Rapunzel’s hair, long and silky and fine (1.1 millimeters in diameter), and they are capable of being woven into fabrics or any structure, really. Take that bra, for instance. I mean, you’re wearing one anyway so it’s not as if it’s intrusive. Imagine for a moment that your bra has fibers woven within it that could listen to your heart or lungs and measure the sounds they produce today against the sounds they have produced for the last several months. When they notice a difference, which could be a pre-cursor to an adverse medical event, they send a signal to a cell phone or other receiver that says, “hey, dude, get some medical attention, stat.”

A colored close-up of the hearing fibers, not yet in sock form

We are talking here about the potential of a virtual monitor in the shape of a sock that can listen to the flow of blood in your ankle, compare it to previous measurements, and tell you when the arteries in your feet are becoming occluded and need attention. Pretty damn cool and the clear antidote to the problem of patient compliance. Except when your sock disappears in the dryer. Hey, maybe that’s the solution to missing socks! Fiber-laced socks could call your cell phone and inform you of their whereabouts! Now that’s what I call applied science.

In any event, the process by which these fibers work is beyond the scope of this blog (and my intellect), but you can read about that here. In its simplest form, the technology relies on a material commonly used in microphones and a highly complex manufacturing process much like that already in use for OmniGuide (the medical device company), which produces fibers of another material composition—in that case the fibers deliver laser energy to undertake precision surgery.

For the moment, let me just assure you that the new applications of this fiber technology are real and being perfected and tested for multiple uses, including wearable microphones, biological sensors and large area sonar imaging. The development of these fibers was originally funded by the military, which apparently can think of a myriad of uses, such as listening to soldiers’ surroundings or measuring biological conditions in the battlefield.

But wait, there’s more! What is especially crazy is that these fibers cannot only detect and produce sound, but–brace yourself–they can also detect images. The fibers can sense light and integrate what has been sensed into a readable image. This work is still in progress, but has great promise in both military and commercial applications. One can imagine a military helmet that can see enemies in the surrounding area or a baseball cap that can see the pitch going off the left inside corner of home plate. Maybe there is a virtual umpire in our future who doesn’t make bad calls.

Oh, and in case you are not yet impressed, the next idea for the fiber is targeted to smell. The idea is that smell-sensing fibers would be woven into the fabric of airline seats and/or busses to sense whether someone is carrying TNT on board. Still on the drawing board, the fiber “nose” will make it at least 3 of the 5 human senses that can be performed by a structure that looks pretty much like fishing wire.

Thus, in a perfect world, we will soon have clothing that can hear the baking pans come out of the oven at Krispy Kreme, smell when the donuts are done, and see that your favorite type is now available (chocolate iced, cream filled). Now that is living. Thankfully the fiber cannot taste the donut for me so I am not entirely obsolete.

I am confident that Yoel will make something amazing from these technologies—that they are not just cool ideas without practical applications. Why do I know this? Well, he has been down this road before. His first significant fiber discovery, the “perfect mirror”, has become the foundation for OmniGuide, the laser surgery company previously mentioned. OmniGuide’s laser fibers, channeling CO2-based laser energy, enable minimally invasive surgery to remove tumors and ablate tissue in numerous applications from neurology, otolaryngology, otology, gynecology, urology, even opthamology.

Because of their unique characteristics, these fibers enable surgeons to remove tissue without causing the kind of collateral damage to nearby bodily structures that is so often the case when one uses metal scalpels or other kinds of lasers to perform surgery. Today, OmniGuide’s products are used in more than 1000 surgeries a month and that number is growing fast. These fibers may not see or hear, but they save lives every day and also reduce the cost of treatment by shortening surgical time, mitigating negative side effects and reducing post-surgical pain. So far the fiber has not been able to scrub in on its own and replace the medical staff, but Yoel is young and he has a lot of years of discovery still in front of him.

“Just what do you think you’re doing, Dave?”

For those of you not quite old enough to remember it (or who aren’t movie buffs), that was a quote from HAL the robot in 2001 Space Odyssey. HAL is a robotic/computer system that communicates with the crew, expressing emotions both positive and negative.

In a story that ran July 20, 2010 in the Wall Street Journal, I learned that Hong Kong-based Intuitive Automata has developed a robot designed to help individuals combat obesity by actively communicating with them.  The product is a cute little robot that looks the spawn of a talking ET and the iPad.  HAL is back, but hopefully this time he is on a mission for good.

Known as Autom, the little dude (or should I say dudette…they say it’s a girl) is meant to sit on the kitchen counter and track your eating and exercise behavior, but also give you tips on how to improve compliance with diet and exercise plans.  It communicates with the user literally by talking.  According to the article, these conversations are formulated after users input information about their diet and exercise regimen that result in prompts from Autom to make good choices.  I’m guessing she doesn’t say  “hey, what do you think you’re eating Dave?” or “have you seen yourself from behind lately?” but she might think that really loudly.

Zac Efron..too bad he's not a robot

The WSJ reports that Autom also “uses social cues to seem more lifelike, a big psychological difference from working with a static computer screen. She blinks her eyes, turns to look at who she’s talking to (in the future she will apparently have facial recognition capabilities), and ends conversations by saying, ‘I hope we can talk again about your progress,’ in a female voice.”   I am guessing that they have to use someone that sounds more like Angelina Jolie than Fran Drescher to get you to actually listen (it isn’t going to get your attention if it sounds like your mom, right?), but you have to love the concept.  It’s basically a techno-conscience with big puppy dog eyes.   I can think of a number of product extensions that could really expand their market opportunity….I’ll be the first in line to buy the one that tells my teenager to set the table, do her homework and feed the dog, all in Zac Efron’s voice.   But back to the subject at hand.

According to Intuitive Automata research, users adhere to their diets longer when using Autom.  This is not really surprising to me, as there have been many demonstrations of the power of daily remote monitoring for the effective management of chronic diseases, obesity, and even certain mental health conditions.  My firm, Psilos Group, was the lead investor in a company called Health Hero Network, now a division of Bosch, which sells a remote monitoring product called the Health Buddy.  While it doesn’t have cute little eyes or a voice like Christina Aguilera, the Health Buddy is used for remote monitoring in the home for patients with chronic diseases.

Health Hero has shown time and again that when you regularly and frequently (daily) engage on a personalized basis with a patient, you can make a major material difference in health outcome and health cost.  For instance, the US Department of Veterans Affairs recently published four years of data showing a reduction of 19 percent in hospitalizations and 25 percent in bed days of care among a population of 17,025 veterans enrolled in the VA’s Care Coordination and Home Telehealth (CCHT) Program, where the Health Buddy is a central feature. In January of last year CMS extended an existing 3-year pilot of the Health Buddy as a result of similar outcomes.

If it’s so great then, why isn’t tele-monitoring used everywhere throughout our healthcare system?  Shouldn’t everyone over 65 have a Health Buddy or Autom in their home?  The biggest challenge in getting adoption of these programs has been a fundamental lack of reimbursement by insurance carriers, both public and private.  It has been a serious challenge to get carriers to pay the cost of the devices, even though the return on investment has been demonstrated many times over.

Norman Rockwell, sans robot

A second and related challenge is ensuring that the patient’s primary care physician is fully engaged in looking at the data that comes out of these systems.  While the patient’s engagement with the system is, of course, essential, the positive effect of remote monitoring is significantly compounded when the patient’s physician is part of the team and actively reviewing the data to ensure that appropriate interventions occur before the patient enters a high-risk state.  By and large, the physician won’t practically engage in the process unless they are reimbursed for the time they spend on data review and patient outreach, but when they are motivated to participate with the patient in the tele-monitoring process, it can be a powerful partnership.   Patient+physician+robot:  not exactly a Norman Rockwell painting, but it seems to work.

It appears that, after a solid 12-15 years of trying, the opportunity to foster a true market for remote monitoring may slowly be arriving.  The recently passed Accountable Care Act calls out remote monitoring as a core methodology to improve Medicare performance and is starting path down a road of more consistent reimbursement for this valuable approach to patient care.  As there is greater discourse about Accountable Care Organizations and a move to adopt global payment structures that bundle payments around chronic conditions, the return-on-investment for remote monitoring becomes crystal clear.  As always, it is “follow the money.”  But that’s human nature and that’s business and in the end, the opportunity to meaningfully engage the consumer through the application of this proven technological approach will play a part of the salvation of our ailing healthcare system.    No doubt when that happens, remote monitoring devices everywhere will look up at us with their big blue eyes and say, “what took you so long?!”

The Shaman will see you now….

Each day I receive a compilation email from the NY Times that lists all the articles about healthcare and medicine that are included in that day’s edition.  I know, pretty lazy, but at least it enables me to stay up-to-date on the latest and greatest medical topics deemed worthy of coverage by the Times without having to go through the laborious task of unfolding it myself.

Today’s email had seven healthcare articles listed, a pretty typical number.  But what struck me about today’s list was that 3 of the 7 articles dealt with issues that are clearly outside of what would be considered mainstream medicine.  The first article, entitled Weekdays, the Adman Worked. Sundays, the Shaman Healed, is about a guy who is an advertising executive by day and who, in his free time, practices shamanistic healing for all manner of chronic illnesses and other serious conditions.  For those of you unfamiliar with the practice, Shamanism encompasses the belief that Shamans are intermediaries or messengers between the human world and the spirit worlds; they treat ailments/illness by mending the soul.

My favorite part of the article:

“…Itzhak Beery began seeing clients about a decade ago, and gradually moved into teaching courses on shamanism, creating a New York association of Shamans and building a Web portal for Shamans worldwide. “

The Shaman will see you now

I checked out this portal and it allows you to locate the perfect Shaman, matched by geography and specialty (with or without animal healing?!). Impressive.  We haven’t managed to get Western medicine physicians that organized.  You can go to what is, for all intents and purposes, shaman.com and find an appropriate practitioner in seconds, but if you need to find the appropriate cardiologist or neurologist in America, there is no such central authority.

There were 2 medical marijuana articles, but the one that drew my attention was entitled V.A. Eases Rules for Medical Marijuana.  This article discusses how hospitals and clinics in the Department of Veterans Affairs  (VA) system will now formally allow veterans to use the drug in states where it is legal, though they will not prescribe it.  Apparently, it has heretofore been the VA’s practice to deny prescription painkillers to patients who admit to using medical marijuana even in states where it is deemed legal to do so.  The VA is now recognizing that medical marijuana may be an appropriate treatment alternative or at a minimum, should not be denied.  Best line in the article:

“Veterans, some of whom have been at the forefront of the medical marijuana movement, praised the department’s decision. They say cannabis helps soothe physical and psychological pain and can alleviate the side effects of some treatments. “

Grateful dead fans everywhere have issued a collective, “Duh.”

Millions of people in the U.S. are firm believers in what is generally lumped into a single category called “alternative medicine.”  Alternative medicine is used as a moniker to encompass everything from well-accepted treatment interventions, such as chiropractic care, to treatment approaches that are accepted some places, questioned in others (e.g., acupuncture) to interventions that are considered well outside the mainstream.  I’ll go with Shamanism as my example here of a quintessential example of seriously alternative medicine.

It just struck me as interesting that the country’s most recognized news authority (unless you are a fan of Glenn Beck) spent so many of their column inches on this topic in a time when reform of the “establishment” medical system seems to suck up even more press resources than Brad and Angelina’s marriage.  I had a sudden realization that none of the discourse on health reform so far, at least that I have seen, has incorporated any thought about how to improve quality of care or reduce cost of care through the adoption of alternative approaches to treatment not currently in the mainstream.

There is no question that the current health reform efforts have within them an undercurrent of intention to reduce the numbers and types of available covered treatments in an effort to reduce healthcare costs.  The concept of comparative effectiveness is rooted in that idea.  Funded to the tune of $1.1 billion by passage of the American Recovery and Reinvestment Act (ARRA), the newly created Patient-Centered Outcomes Research Institute is charged with figuring out precisely what is worth paying for based on clinical efficacy (and maybe cost-efficiency too).

It is certainly possible that opening the discourse to include “alternative” treatment modalities could expand costs further by adding more things to pay for, particularly if such treatments do not come packed with evidence of their efficacy–not a whole lot of randomized clinical shaman trials out there today.  There is also a lack of available evidence about the efficacy of medical marijuana, which is generally ascribed to barriers to performing studies due to the inconvenience of the drug being illegal.  Anxiety is one of the primary diagnoses for which both medical marijuana and shamanism are used.  Now there’s the comparative effectiveness study I want to see.

But seriously, the idea that there are valid and valuable alternative treatments that should make their way into the mainstream is definitely not going to go away and perhaps it is something that should be more openly examined.  There are many examples of interventions once thought impossible or even silly that are now part of mainstream medicine.  Once upon a time, if you told a cardiac surgeon that you were going to treat heart disease by punching a hole in a patient’s groin, threading a tube with a balloon in it up into the heart, blowing the balloon up, deflating it and then pulling it all out, voila!, the surgeon would have had you locked up for being insane.  Today, that is pretty much the definition of modern angioplasty and there are over 2 million of them done each year.

In fact, in my favorite recent history example, in 2004 the FDA approved leeches for use in treating wounds.  Yes, those leeches.  The ones you see in movies about 19^th Century doctors where they are dressed in potato sacks and working out of dark caves using leeches to “bleed” people out of their illnesses.  Turns out that that whole bleeding thing doesn’t work, but leeches have a real utility, even today, in cleaning particularly difficult wounds.

Take two leeches and call me in the morning

Even better, maggots were approved for similar use, also in 2004 (a good year to be vermin).  Monarch Labs touts itself as the country’s “exclusive provider of medical maggots.”  I guess I am not surprised that there isn’t a rush of competition.

So where does alternative medicine fit in our new healthcare paradigm?  It has traditionally been paid for by patients themselves, who willingly expend more than  $34 Billion per year on a variety of alternative medicine therapies (while complaining about paying $10 for a physician visit copayment to their internist).  To put this in perspective, some estimate that the amount paid directly by patients to “alternative” practitioners adds up to nearly 25% of those same people paid out-of-pocket to see their regular doctors.

Under the recently passed Affordable Care Act, there are many provisions that suggest that patients must get more engaged in their own healthcare and must be encouraged to take responsibility for their own health.  If that is the case, we are likely to see even more demand for alternatives to generally accepted medical interventions when traditional medicine doesn’t do the trick.  I am curious to see how this is integrated into the discourse about comparative effectiveness as the landscape evolves.  Will those engaged to oversee what will and won’t be covered in our healthcare system represent a broader perspective than what tends to come from a room full of traditionally trained physicians?  Maybe there should be a Shaman in the mix.

Girls Rule: Amy Belt and Beth Falk

Back to my women in venture capital focus for a moment, as I want to promote the efforts of two colleagues to create very professional and useful venues for people who happen to be women (as opposed to women who need to make a big deal out of it) to connect around issues that matter to us in health care and finance.

Amy Belt, currently a Vice President at Advanced Technology Ventures (and a fellow UC Berkeley grad, Go Bears!), is in the throes of organizing a conference for women in medical technology.  The conference, which is in the formation stage but is likely to occur in September of 2011 in Northern CA, will be focused around key issues in the med tech sector in the post-health care reform era.  I like her focus here, which will be, essentially, “alright already, med tech people; stop talking about the damn lemon and let’s get to figuring how we make lemonade.”

The planned conference will be targeted towards women (VCs, entrepreneurs, representatives of the med tech industry and other healthcare executives with an interest in medtech) but not about women, which is an important distinction in my view.  In other words, much like the Women’s Private Equity Conference, most everyone in the room will have lipstick in their purse but will be there for serious professional discourse, not to compare colors.  Amy is welcoming input on ideas for panel topics and also creating a list of people interested in attending.  Contact her at abelt@atvcapital.com.

And speaking of good conferences, on Wednesday I saw Beth Falk, who produces the conference, and she told me that their 2nd Annual Women’s Alternative Investment Summit will be held in New York on November 4-5, 2010.  Last year at this conference there were over 250 senior women executives in private equity, venture capital, hedge funds, and real estate investing from both the LP and GP side.

I have been three times to the Half Moon Bay version of this conference called the Women in Private Equity Conference, and it is one of the best things I attend all year.  Lots of serious, professional women gathered to discuss issues of the day and network and hear high-value content.

I have to say, it is refreshing to go to a meeting such as this where you are not the only one who forgot to show up in a gray suit and red tie.  It is also refreshing to attend an event that is intended to enrich the knowledge and careers of women attendees by bringing new speakers and topics to the fore, rather than rehashing the same old thing.  I don’t think that this creativity is specifically the result of the audience being female.  Rather, I think it is because it is different people organizing, different people setting the agenda and different people speaking than the usual fare.  As such, you get to hear different perspectives, which is great. Plus, social activities occur in the spa rather than the golf course, which is good for me since my only useful golf skills are driving the little cart or coming in under par when there is a windmill or castle drawbridge between me and the hole.

Government as an Engine for Innovation

I’ve been thinking a great deal about the newly formed Center for Medicare and Medicaid Innovation. (CMI). This entity was established as a result of the Affordable Care Act (the new healthcare reform legislation) and its purpose is to “research, develop, test and expand innovative payment and service delivery models that will improve the quality and reduce the costs of care for” patients covered by CMS-related programs.  The legislation gives this entity over $10 billion dollars initially and broad authority to figure out new ways of doing things better and differently than before.   What is great about CMI is that they have the authority to run their programs much more like a business would without many historical governmental constraints.  That’s great news for innovation, which is sorely needed in the U.S. healthcare system.

Among the key objectives that the administration has discussed is how to transition the collective mindset from one of healthcare to one of health.  In other words, if a person is healthy, they do not need health CARE.  This is a very important distinction; it puts the emphasis on prevention and wellness as opposed to what you do when somebody is already sick.  In order to affect such a transition, there must be an emphasis on innovation to change the way we have traditionally looked at the healthcare world.

This is an interesting challenge and one that requires a great deal of thoughtfulness in how to approach the universe of innovation opportunities. As venture capitalists, I and my colleagues vet, select and monitor deals and specifically focus on how we pick winners and avoid losers.  It’s a little like being asked to handicap who’s going to win the World Series, but then again, that is pretty much our job as VCs:  to act like Billy Beane and pick those most likely to succeed in a capital efficient way based on detailed analysis of trends and meaningful data, not solely based on experience.

For those of you who don’t know him, Beane is the General Manager of the Oakland A’s baseball team and is known as the guy who introduced “sabermetrics” to baseball, which is the science of using detailed analysis of objective player statistics, instead of relying on conventional wisdom/traditional scouting to identify the best players.  He was famous for being able to identify nascent baseball superstars who he could hire very cheaply by comparison because they didn’t fit the traditional mode. Beane was profiled in the truly awesome book, Moneyball, by Michael Lewis, in which Beane is famously described for drafting a short, fat catcher who nobody wanted based on his statistically-proven ability to draw walks.

Beane’s is in many ways a great model for venture capital in healthcare, in particular, because his goal is to find the best value in baseball—in other words, the highest quality players who could produce a winning season at the lowest cost.  Sound familiar? This will be the same challenge our government officials will face as they think about all of the options available to them in order to identify which of those crazy caterpillars is going to actually turn into a butterfly.

This will be interesting, because many of the potential areas of improvement may be in organizations that don’t yet exist, such as specialized new health plans, provider organizations and payment structures that have been much discussed but barely tried in practice. This effort will require a broad range of public and private views, including that of entrepreneurs who have those “not yet existing” ideas, to be considered.

We need to nurture companies that come out of left field with disruptive ideas that blow up conventional wisdom and replace it with completely new ways of doing things, particularly thing that impart convenience, personalization, health-optimization and cost-effectiveness into the healthcare equation.  Will today’s healthcare giants be tomorrow’s healthcare leaders?  Good question, but not likely unless they are willing to reinvent themselves completely—something very hard to do.  It’s a little like shooting your dog because he’s ugly, even though he gave you years of companionship.

World's Ugliest Dog Contest Winner

It appears that CMS and their colleagues are seriously committed to innovation and to doing the work to find great new ideas.  What they do and the money they can bring to bear can make a big difference, particularly since VCs have underfunded healthcare services and IT for eons.  I saw an article today that said VC funding of healthcare IT almost doubled in Q2 2010 as compared to Q2 2009 to $157 million.   Healthcare services consistently takes less than 1% of VC money that goes to the healthcare sector; in Q2, total healthcare venture funding was $2.7 billion so services probably got about $27 million, if I did my math right.  $27 million sounds like a lot when you are talking about buying a house (actual cost of recent house bought by Charles Schwab), but its downright microscopic when you are talking about healthcare system innovation.   It will be interesting to watch the progress in Washington as it unfolds.

Antidote to the Baconator: Apps for Healthy Kids

A quick antidote to the Baconator post:  Tim Marklein at Weber Shandwick sent me an article about a cool competition now underway in which GE, the USDA and Michelle Obama have created a challenge to motivate American entrepreneurs, software developers, the public, and students to create an on-line game or tool that can use “fun” to teach kids and/or their parents about how to get kids to exercise and eat healthy.  I have to admit–kind of a cool idea that manages to combine health and entrepreneurship. I like it.

I’ll pause for a moment to allow you to digest the irony that today’s method for engaging kids in exercise and healthy eating is to keep the kid sitting in front of their screen even longer.  The sound of a kid’s joy long ago metamorphosed from “Wheeeeeeee!” to “Wii!”

Anyhow, the Apps for Healthy Kids challenge was to create either:

• Games that educate through engaging the user in an entertaining experience, or
• “Tools” that empower users to access, visualize, sort, mash, track, or otherwise better understand data in ways that will inform user behavior.

In so doing, the develop must use some basic USDA data about recommended food habits and must incorporate at least one of the following:

• Teaching kids to eat more whole grains
• Increasing fruit and vegetable consumption
• Focusing on consuming more low- or non-fat milk
• Choosing lean sources of protein (meat and beans)
• Making food group education fun
• Understanding calories
• Increasing foods with high nutrition value and decreasing amounts of solid fats and added sugars (“extra” calories), and decreasing amounts of sodium
• Identifying and consuming proper portion size
• Being more physically active
• Balancing physical activity and food intake

The competition is now in the reviewing/voting stage.  95 games were deemed eligible for the final prizes, which include being honored at the White House and some cold hard cash.  Winners are discouraged from using their cash to purchase Baconators.

The 95 finalists were displayed at the Games for Health conference, a software developers conference recently held in multiple cities, and can be seen on line by clicking HERE.  The games will be judged by a list of people that includes Apple founder Steve Wozniak; Michael Levine, Executive Director of the Sesame Street Workshop; guys from Zynga, LucasArts, Google and a variety of others; it is, mercifully, not dominated by government policy wonks.  Kids feed their input into the process at the official website or by casting an on-line vote at Whyville, a virtual world for tweens (kind of like Second Life but with lots of eye rolling and an unhealthy obsession with the Twilight Series). Final judging and the end of voting will take place August 14^th.

I perused the list of 95 applicants and their vote status and it an interesting assortment of ideas.

Your Food Buster Host

Currently number one with a bullet is called Food Buster, which is described as “a game show that asks you to carefully stack food items that don’t break our scale. For each round you’ll try to find foods with the fewest calories, least added sugar, and least amount of saturated fat. The fewer the calories, the more points you’ll get. When you’re done, you can learn about all of the food items you had available, complete with personalized results on how much exercise it would take to burn off each item. Welcome to the Food Buster game show!”  Cute idea, a little scary to further foster our current game show culture featuring obligatory big-haired game show host,  but cute.

Among the lowest vote-getting ideas so far is one wild and crazy entry called:  Food-Fueled Bio-Batteries: How Nutritional Recharging “Makes it Rain” in the Mitochondrial Matrix.  Seriously.  I can hear 7 year olds everywhere saying, “WTF?”  I couldn’t get past the name to learn about what it actually is.  Maybe it just suffers from poor marketing.

Mercifully, none of the games are called “Conquer Mount Baconator”.

Anyway, I like this idea of fostering both entrepreneurial spirit and the creation of real products and services that have a known appeal (games) to kids for a noble and important cause.  Hopefully it will turn virtual exercise into some actual physical activity and be the scourge of Baconator lovers everywhere.

Scale Mount Baconator!

Baconator? Make Mine a Triple!

So I was sitting here on the couch watching Tim Lincecum, Cy Young-award winning pitcher, throw a full game shut out against the NY Mets (Go Giants!) and along comes a Wendy’s commercial for (dramatic pause)….The Baconator.  I was so amazed by the grandiosity of this thing that I looked it up on-line at Wendys.com and lo and behold, not only is there a Baconator (it is really hard to type that without hearing Arnold Schwarzenegger’s voice in my head) but there is an honest-to-god Baconator Triple!  Somewhere in Washington, D.C., Michelle Obama, who has made healthy eating her personal political platform, is reaching for a stiff drink.

Wendy’s Baconator Triple is about the size of Marge Simpson’s hairdo on a humid day and boasts the following features:

• 3 one-quarter-pound beef patties
• 9 slices of bacon
• 3 slices of American cheese
• Mayonnaise
• Bun
• Ketchup
• Tomato and lettuce available so that you can say you had a vegetable
• Pickles are optional (oh no, I couldn’t possibly)

This gourmet delight has—brace yourself—1360 calories, 820 of which are from fat.  The current dietary guidelines suggest that the average adult should eat roughly 2000 calories a day, of which no more than 30% should be from fat.  That’s 600 allowable fat calories, so this bad boy has almost 1.5 times the recommended allowance. And that doesn’t even include the fries or gratuitous Diet Coke.

Chihuahua=5 Baconators

The Baconator weighs 424 grams.  For those of you who have forgotten your middle school weight and measure equivalents, that is almost one whole pound of food.  In my house, that 424 grams equals 20% of our pet Chihuahua.  I do not think that she has the surface area to support 9 strips of bacon.

The good news:  2 grams of fiber!

Wendy’s promotional notes on the website say that the Baconator is, “…enough to make your mouth water.”

Mouth water?  Are you kidding me?  It’s enough to make your arteries slam shut so loud that the neighbors call the police to ask you to quiet down the party.

Maybe I should be happy, as I am Chairman of the Board of a highly successful cardiology company, AngioScore, whose mission in life is to open the clogged arteries that develop in people’s hearts, legs and elsewhere due to the build-up of arterial plaque.   Hey, maybe AngioScore should start giving away free Baconators to juice up the sales channel?  But I digress.

The reason I bring this up is that there has been a great deal of ranting and hand-wringing about the “criminal behavior” of the health insurance companies.  They are often written about as the bad guys of the American healthcare system, withholding care from those in need.  I’m not saying that never happens; in fact I’m sure it sometimes does.  But the insurance carriers are at the end of the food chain, literally.  If you are going to be pointing fingers at Aetna or HealthNet for their actions, you have to save at least one finger (I’m not saying which one) for the people at Wendy’s who dreamed up the Baconator Triple.  I can see them now at the brainstorming table:

Marketing Director:  “How can we make the Baconator Double even better?”

Customer Service Director:  “I know!  Make it a triple!”

Marketing Director:  “Damn, you are so creative!”

And while these gourmands are dreaming up their next culinary wonder (“I know, how about the Octo-Baconator!”), there are also good people in the insurance carrier world trying to undo this damage.

A Psilos portfolio company called SeeChange Health, in conjunction with United Healthcare, is now offering a specialized diabetes insurance plan designed to encourage those who are developing or who may already have Type II diabetes, a disease that is largely acquired as a result of years of poor diet, to take good care of themselves.  The program rewards those who agree to engage in a widely accepted diabetes treatment regimen:  regularly checking their glucose levels, seeing foot and eye doctors annually, taking prescribed medications and getting annual blood tests.   The reward to the patient, in addition to better health, comes in the form of zero out-of-pocket costs for most or all of these activities, meaning the patient pays nothing or nearly nothing for the office visits, medicines, diagnostic tests and other medical actions required to ensure that your diabetes is under control.  This is very meaningful for people in the program, as it can put as much as $500/year in hard cold cash back in their pockets.  The bottom line:  an insurance program that pays you to be healthier.

Why do they do this? Well it turns out that when people with Type II diabetes are diagnosed early and managed effectively you can treat them for a lot less money because their complications are less serious to manage.  What complications you may ask?  Well, heart disease for one.  See Baconator above.

This preventative approach to healthcare is good for the patient to be sure, but it is also good for the insurance company because they don’t have to spend as much money to pay your claims, and that is more profitable for them.  In the end, it is a win-win situation and the end result benefits the U.S. healthcare system as a whole.  We should all be delighted to see insurance carriers who provide products like this and wish them well.  If they can profit by making Americans healthier, well it’s hard to feel bad about that.

I find it not just ironic, but somewhat disturbing that so much of the health reform dialog has focused on how to fix the system that takes care of people after they are already sick.  Remember, between 70% and 80% of all medical costs are expended to treat people with chronic illnesses, not on prevention.

I am glad to see that Michelle Obama has taken up the healthy eating cause, but it seems to me that this effort should be far more integrated into the health reform discussion right up front.  The government is planning to regulate everything from how often doctors must prescribe medication electronically to how much profit insurers can make.  They are establishing a research center to decide which treatments work better than others according to clinical trials of their own design.  While there will undoubtedly be some positive outcomes from this effort to establish “comparative effectiveness” metrics, many fear this effort may also lead to the elimination of insurance reimbursement for legitimate and possibly more effective treatment approaches simply because they cost more or might serve the needs of only small groups of individual patients.

If the government can go to this effort to manage the treatment end of healthcare–those things that are oriented to fix, in part, the damage we have done to ourselves, they can surely take a look at the legitimate role of the Baconator in American society.   If the new healthcare reform law can mandate a 2.9% tax on revenues for all medical device companies, even those young, entrepreneurial companies that are not yet profitable (e.g., including cardiology companies like AngioScore that are making a positive difference in the lives of patients by cleaning out their cheddar-filled arteries) surely they can sleep better at night knowing there is a companion Baconator tax.  I think that 2.9% per bacon slice sounds about right.

U.S. Medical Innovation: Win the Pennant or Strike Out Looking?

Yesterday I attended a meeting of a group of venture capitalists and NVCA representatives who came together to discuss the formation of a new industry group focused on preserving the spirit and business of medical innovation that has for so long been the unchallenged purview of the United States.  The group is tentatively to be called MedIC , which stands for the Medical Innovation and Competitiveness Coalition.  Notably, the group’s Chairman is Dr. Beth Seidenberg, a life sciences partner at Kleiner Perkins, and the lead organizer is Kelly Slone, Director of Federal Life Science Policy of the National Venture Capital Association.  Great to see such a show of gal-power driving the effort to address such a critical issue for our industry.

The U.S. healthcare ecosystem, to use a trendy VC word, has long been notable for its global leadership in the development of new drugs, new medical devices, and other healthcare products and services.  Despite its limitations and challenges, our medical industry has for decades been the go-to incubator of a seemingly boundless array of new medical inventions that spread throughout the world.  Bash America all you want, but when you need surgery, you’re heading straight to New York or Cleveland or Rochester (MN) to get the brand new whatchamacalit that will save your life.  Saudi princes may go to Monaco to gamble or Tokyo to shop, but they fly here to get the latest and greatest that the world’s healthcare system has to offer.   With all due respect to the great nations of the rest of the world, we have been sitting at the top of the totem pole on this particular front for a while.

And yet, our culture of innovation leadership is definitely in peril.  There has been a cascade of economic occurrences, public policy decisions and regulatory actions over the last year or two that collectively put the U.S. at serious risk of losing our innovative medical edge.   These have come in the form of tax policies (such as the highly punitive taxes on medical device and pharmaceutical products in the new healthcare reform legislation and efforts to increase capital gains taxes in ways that will discourage investment in young companies); increasing complexity and decreasing transparency at the FDA and other regulatory agencies, which raises the cost and risk of bringing new products to market; and declining access by entrepreneurs to venture capital due to everything from Limited Partners’ curtailing investment in venture funds to the currently dysfunctional IPO market.  Venture capital funding for young companies in the life sciences and healthcare market declined approximately 29% between 2008 and 2009, according to research done recently commissioned by the Council for Medical Innovation, which also claims we have already begun to fall behind other nations in investment in new medical innovation.  Yikes.

The biggest challenge to U.S. medical innovation may well be the law of unintended consequences—the unexpected but very real collective negative impact of a myriad of independent actions and policies that, together, create an environment hostile to the small companies that rise up out of garages and Starbucks to create cures for cancer, restore eyesight to the blind and enable infants born with defective hearts to live to put their parents into old age homes.  It is worth noting that venture-backed (read: small, entrepreneurial) healthcare companies represent more than 50% of the new jobs that are created in the healthcare field, according to NVCA in their report entitled Patient Capital.

We like to think of America as the land of the brave, home of the new, new thing, but our culture of healthcare innovation is at risk of becoming our father’s Oldsmobile if those of us who swim directly in the entrepreneurial stream don’t rise up and take action.  At this very moment, China is busily acting on a goal to become the world’s leading medical device market at a time when our government appears to be Charlie Brown at the plate.  In my last post I talked about how U.S. healthcare quality has fallen to number 7 among a list of developed countries.  If we aren’t careful, the U.S, will become the Baltimore Orioles of medical innovation.

This makes so little sense in light of the goal we have set for ourselves to provide high quality healthcare to all Americans and stop the epidemics of chronic illness that are driving our nation to the brink of bankruptcy.  Only innovation in healthcare delivery will fix these problems.  While acknowledging that on the one hand in the new health reform legislation, we are busily tying the other hand behind our back with counter-productive policies.  It is going to take a serious public-private partnership and increasing, not declining, public and private capital investment to maintain our innovative edge and ensure our nation’s ongoing leadership as pioneers in the development of products and services that keep our nation healthy and prosperous.

So back to MedIC.  Their goal is to engage VCs, entrepreneurs and patient advocates in this effort through lobbying, public relations and industry education to help preserve and nurture what we have long valued.  If you are an entrepreneur and or venture capitalist in the healthcare and life sciences field, please take a moment and read up about MedIC.  They are still in the formative stage but are looking for members–both venture firms and young companies–who will work together to spread the word about how to keep America at the vanguard of medical innovation.  Companies focused on pharma, medical devices, healthcare IT and healthcare services are all welcome.  Information about MedIC will shortly be forthcoming from  NVCA and I will post the link to it when it arrives.

Women who seek to be equal with men lack ambition

I love that Timothy Leary quote (the title above).  And in a time when venture capital fundraising requires nerves of steel and the patience of a saint, we welcome the news from San Francisco’s DBL Investors that they have closed approximately 2/3 of the $150MM target for their 2^nd fund.  DBL’s two managing partners are Nancy Pfund and Cynthia Ringo.  Of the team of 5 at DBL, 3 are of the XX-chromosome variety, making them a highly unusual group.  Gotta love a VC fund where there is a line for the ladies’ room.

DBL expects to complete the fund by year-end and continue their focus on investing in healthcare, IT, consumer products and clean technology companies in the Western U.S. Key to their strategy is DBL’s focus on the “Double Bottom Line” to which their name refers.  It is intended to guide their portfolio selection towards companies that can deliver top-tier venture capital returns while enabling social, environmental and economic improvement in the regions in which they operate.  DBL’s team spends time thinking about things like how the companies in which they invest can positively impact their communities on a micro and macro level in the areas of education, wage fairness, support of minority and women businesses and environmental improvement, among others.  Worked for Ben and Jerry; no reason it can’t work for Nancy and Cynthia (and their partners).  Clearly their LPs like it, enabling them to put some serious points on the fundraising board at a time when it is challenging for anyone with any chromosomes to raise a fund.

The DBL gang was involved, in fact, in the hot deal of the moment, the IPO of Tesla Motors.  It’s been a while since an IPO got people excited and this one definitely revved Wall Street’s engines.

Congratulations to DBL and good luck driving that last fundraising mile…I hear the Tesla is a pretty smooth ride.

We’re Number One! Er, I Mean Seven!

A report just released compares the performance of the American health care system with those of Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom.  This report, which was issued by the Commonwealth Fund, a Washington, D.C.-based private foundation focused on improving healthcare, says the U.S. ranks seventh out of seven in overall healthcare system quality and efficacy, despite spending the most per capita. 

Despite having the costliest health care system in the world, the United States is last or next-to-last in quality, efficiency, access to care, equity and the ability of its citizens to lead long, healthy, productive lives.  According to the report, the U.S. spends the most on health care, at $7,290 per capita per year (in  2007—it’s gone up since then). That’s almost twice the amount spent in Canada and nearly three times the rate of New Zealand, which spends the least.  The Netherlands, which has the highest-ranked health care system on the Commonwealth Fund list, spends only $3,837 per capita.  The Netherlands?  Isn’t that the place with the wooden shoes?  The average person can’t even locate that on a map.  And yet they are cleaning our clock.  It’s like the World Cup, where the U.S. is consistently beat by countries we wouldn’t even save a seat for at a U.N meeting.  Hell, Avis can claim it is number two for trying harder.  The U.S. isn’t even showing up in uniform.

It isn’t that surprising that we rank low on access to healthcare since we do not have mandated universal coverage as many of these countries do.  However, here’s a stark statistic for you in the land of the brave and the home of the most sophisticated technology on earth:  In 2008, 14% of U.S. patients with chronic conditions had been given the wrong medication or the wrong dose. That’s twice the error rate observed in Germany and the Netherlands, according to the Commonwealth Fund’s study authors.  The rates at which adults reported delays in notification about abnormal test results or were given the wrong results were three times higher than in Germany and the Netherlands.  Go team!  We win the gold for being the worst country for patient safety.

What is especially sad about this is that we have the means to address this problem right now today.  It may be difficult to expand access to all, impossible to perfect efficiency, etc., but there is literally no reason we should have the worst patient safety record in the world.    Numerous technologies exist today to eliminate patient errors in the hospital and at home. There are surgical sponges with RFID tags so we don’t leave them inside patients; there are checklists and processes (not even high tech ones) that dramatically reduce hospital acquired infections; in our own Psilos portfolio we have a company called Patient Safe Solutions that reduces medication errors in hospitals from 19% (19%!) to near zero, saving the healthcare system millions of dollars in the process.  Would you go back to Starbucks if they screwed up your Frappuccino order 19% of the time?  I don’t think so. 

The problem with safety in the healthcare world is twofold:  1) many of the errors are cloaked in silence; we have to engender a culture of healthcare provider transparency and consumer engagement in order to change the status quo; and, 2) we have a healthcare system that has traditionally rewarded the commission of errors by paying again to fix the mistake.  Again, would you pay for that defective Frappuccino?  No, I thought not.  And Starbucks would willingly replace it for free.  And apologize. Maybe offer you a free muffin.  Yet hospitals have routinely been reimbursed for the extra days of stay they cause by committing a medical error.  We removed the wrong leg?  Oops, sorry, enjoy your extended stay…ka-ching! 

Fortunately, the federal government has started promulgating regulations that will prevent mistakes in hospitals from getting reimbursed.  Kind of sad that’s what’s necessary, but at least it’s a step in the right direction.  We have no such incentives yet in the outpatient side of treatment

What we really need is to summon some of that old-fashioned American chest-thumping competitiveness we apply to sports to drive us from number seven to number one.  The same fanaticism that leads us to glory in the Olympics and to dominate the world in basketball, baseball and bowling could really help us out if applied to the medical side of things.  Maybe we need a mascot or a theme song or a special healthcare jersey to foster that team spirit, but we should not condone a world where we are miserable when we lose in Olympic figure-skating but indifferent when we don’t make the cut in healthcare.  If this were tennis, John McEnroe would be throwing his racquet across the court. 

Patient safety and healthcare quality improvement (not just expanded health insurance access) must become serious public policy goals if our world is going to change for the better.   We need active consumer education and expanded media coverage around this issue to drum up some serious national pride or we are going to continue to sit this one out on the bench. Number seven doesn’t make the play-offs, but this is a game we should win.

I’m just a person trapped inside a woman’s body. -Elaine Boosler

So yesterday I decided to send a quick email out to all the women VCs I know (probably about 40) to ask them to send me input for my blog, specifically ongoing reports of great accomplishments by their female VC brethren.  I got a lot of nice notes saying they will keep it in mind, but only one note with an actual “input”, which was from Heidi Huntsman, now of Portola Street Advisors and previously of Utah Ventures.  Heidi’s note to me said, in a nutshell, that the blog is going to be hard to fill with stories since the only story that came to her immediately was that 8 different women she knew had left the VC world in the last year.  Thanks Heidi.  Not.

We all know about how the field of venture capital is contracting generally (estimates are 15%-30% declines), but I hadn’t really stopped to think about how this is likely to disproportionately impact female partners, since so often they are at newer, less established firms, which are unfortunately the ones closer to the abyss.  For those older, more established firms that decide to downsize, the newer partners (as in some chance they might be female) are often the first to go.  In 2008 the NVCA did a survey that found that 14% of VC partners are women, but I bet that if they did that survey again today the number would have declined.

It’s a funny thing, since we have also recently had a huge leap forward in chick power in the VC world with the election of Kate Mitchell as Chairman of the NVCA.  Serving alongside her are two additional female board members, Diana Frazier of FLAG Capital Management and Theresia Gouw Ranzetta of Accel Partners.  That’s only 3 of 28 Board and Executive Committee members, but it’s a step in the right direction.

Also, I have recently been to the Women’s Private Equity Summit, held annually in Half Moon Bay, CA, and it is a veritable sea of smart women, probably over 350 in all, from venture and private equity.   There was a pretty funny moment at that conference where I was sitting in the giant ballroom watching a panel and I realized that literally the only man in the room was the event photographer.  Considering the composition of the typical meeting I attend, it was kind of surreal—a bit like going to Nordstrom on women’s shoe sale day and seeing that one pathetic guy sitting, sad and lonely, in the gratuitous husband chair.

After many years publishing their Midas List of the “best global investors in tech and life sciences,” Forbes did not publish one for 2009. In 2007 and 2008 there were 5 women out of 100 on the list.  It will be interesting to see what the list looks like if they do one for 2010.

In any event, I am going with the Scarlet O’Hara “tomorrow is another day” approach and hoping to soon see an email box overflowing with evidence of the exploits of my y-chromosome-challenged colleagues.  If you are reading this, please remember to pass along the stories you hear so I can include them.

Life, Do You Hear Me?!!

In May 2010, Craig Venter and his team at the J. Craig Venter Institute (JCVI), a not-for-profit genomic research organization, announced that they had successfully constructed the first self-replicating, synthetic bacterial cell.    To grossly oversimplify it, what they did was take a series of computer-generated DNA sequences, stitch them together into a genome (the genetic instruction set to create life) and stick the genome inside an essentially empty cell.   I’ll be damned if the thing didn’t start reproducing and creating a new “living organism” that was derived from the genomic “instruction set” that had been implanted.

The result, according to Venter, is, “… the first self-replicating cell on the planet to have a computer for a parent.”

I can see it now:  MacBooks everywhere are preparing themselves to ring out with a hearty chorus of, “no you can’t borrow the car” and “clean your damn room.”

This story has amazing implications scientifically, ethically, and in every other adverbial sense.  If we can design genomes to create new life forms, we can, theoretically, develop organisms that will cure disease, solve the energy crisis and establish a whole new next generation of horror movie protagonists.  The Blob that Ate New York?  Yeah, I made that.

While the story is epic in its scientific possibilities, the part of the story that somehow most grabbed me was this press release excerpt:

As in the team’s 2008 publication in which they described the successful synthesis of the M. genitalium genome, they designed and inserted into the genome what they called watermarks. These are specifically designed segments of DNA that use the “alphabet” of genes and proteins that enable the researcher to spell out words and phrases. The watermarks are an essential means to prove that the genome is synthetic and not native, and to identify the laboratory of origin. Encoded in the watermarks is a new DNA code for writing words, sentences and numbers. In addition to the new code there is a web address to send emails to if you can successfully decode the new code, the names of 46 authors and other key contributors and three quotations: “TO LIVE, TO ERR, TO FALL, TO TRIUMPH, TO RECREATE LIFE OUT OF LIFE.” – JAMES JOYCE; “SEE THINGS NOT AS THEY ARE, BUT AS THEY MIGHT BE.”-A quote from the book, “American Prometheus”; “WHAT I CANNOT BUILD, I CANNOT UNDERSTAND.” – RICHARD FEYNMAN.

For some reason that whole concept struck me as incredibly funny.  Here you had some of the greatest scientists of our time creating new life and they had to stop to have a meeting to figure out what were the ideal quotations to encode into their new organism.

My first thought was that this is really taking that whole tattoo craze just a little too far.  Everywhere you go you see teenagers with more ink than a Hells Angels’ bar and now we are just pre-tatting life forms before birth to save time.

But that aside, I would love to have been a fly on the wall in the lab as they debated what would be just the right oratorical imprint to capture their scientific leap forward.

You can assume they would have quickly dispensed with “Dude, where’s my car?” But did they stop just for a minute and contemplate whether they should go the Field of Dreams route with, “If you build it, he will come”?

Was there a Monty Python fan among them that lobbied for “What is your name? What is your quest? What is your favorite color?” so those who decoded the phrase would also have to provide a specific response? “My name: Craig Venter. My quest: to create new life.  My favorite color:  blue….no, yellow…aaaaaaggghhhh!”

Maybe a Woody Allen look-alike scientist advocating for: “I don’t want to achieve immortality through my work. I want to achieve it through not dying. “

You know that one guy just had to suggest the immortal words of Dr. Frederick Frankenstein: “LIFE! DO YOU HEAR ME? GIVE MY CREATION… LIFE!”

I realize that this digression from the profundity of the discovery might trivialize what may turn out to be among the key life sciences breakthroughs of our time, but in the immortal words of Yogi Berra, “Most of our future lies ahead,” and hopefully I’ll have time to make up for it.

Girls Rule: Karen Talmadge

Saw today that my colleague, Karen Talmadge, has been given the Charles H. Best Medal for Distinguished Service in the Cause of Diabetes.

I am really happy for her.  Karen is a first-class professional and brilliant and I have the honor of working with her as a fellow Board Member of Veralight, a non-invasive diabetes screening company in which we are also fellow investors.  She was the founder of Kyphon, which is a major success story in the medical device world.

I love working with Karen because she is no-nonsense, smart and experienced, and has a great sense of humor.  Congrats to Karen on the well-deserved recognition.

So it turns out “blog” is a verb….

The final straw was Jeff Bussgang’s article in PE Hub today encouraging more healthcare/life sciences VCs to blog (see link below).

More VC Bloggers Needed (Seriously)

I’ve been thinking about this whole blogging thing but desperately trying to stay out of the way of the Facebook/Blog/Twitter information superhighway in an effort to remain firmly aligned with the ghost of Internet past.  I know, I know, it’s lame.  But this whole digital thing kind of gives me a rash.  If everyone wanted to hear what I had to say, they would ask me, right?  Twitter?  Seriously.  I don’t even care what I’m thinking minute to minute.

But it was kind of a harmonic convergence thing.  First I saw the Bussgang post, then I clicked through to this: Global Venture Blog VC Directory Ranked by Monthly Uniques which is a list of purportedly all of the VC-authored blogs out there in the universe today.  I’m sure it is not a complete list, but it does include 137 VC blogs and, of those, only 3 (!) are authored by women.  For you math fans, that’s less than 2%, which is roughly equal to “can’t even see it with the naked eye”.  I went over to BlogHer to see if there were any current female VC blogs and there was really nothing that was recent at all.

And, in one of those strange time and place coincidences, I moderated a panel at the Red Herring 100 Conference in San Diego yesterday.  There were exactly 3 (!) women in the room of about 60 or so participants when I was up on stage, including me.  Apparently there is some law somewhere that says no more than 3 women can congregate in a business setting–perhaps people are worried that knitting might break out or something.  Anyway, of the three women, one was the CEO of BlogHer (Lisa Stone), who was super cool and very encouraging of the blog thing.  So I guess I already had it on my mind when I saw the article and lists this morning.

And thus, a reluctant blogger is born.  I am definitely not one of those feminazi types who is all about estrogen power, but there is clearly a void in the universe if there are almost no healthcare VC bloggers and even less than that in the way of female VC bloggers (much less some unwritten law that only 3 women can be in a room at any one time).  Plus, my partner, Steve Krupa, started this cool blog recently and it made me kind of envious in that he seemed to be having a lot of fun with it.  So here I am.

Don’t worry, it’s not going to be all chick-lit whining about why it’s hard for a girl to be a VC.  Life is hard, wear a helmet.  Plus, I don’t want to be the blogging equivalent of a chick-flick where all the guy VCs’ eyes glaze over because I am out here saying, “hey, does this blog make my butt look big?” Hopefully this will offer just a different point of view that happens to come from someone who willingly contributes a meaningful portion of her take-home pay to make-up and shoes instead of beer and BBQ equipment.

Thanks for reading!