In the last few years, we have seen custom-built software for digital health become increasingly widespread. Previously, founders calculated how quickly and cost effectively they could build their entire tech stack. Today, we believe founders consider what pieces to buy vs build, and increasingly the number of choices available to buy prove daunting.
While others have aggregated the resources available for founders today (a16z’s helpful list here for example), we thought a curated post might help founders start wading through their options. We’ve compiled our “getting started” guide for digital health founders below.
But first, a big caveat: This list isn’t exhaustive and isn’t updated daily! If you’re a builder in one of the categories below and would like to be added, send us a note. Additionally, the categories below are rough and imperfect buckets. We recognize each vendor’s use case isn’t as clear cut. Like you, we’re also learning daily about the emerging field of digital health infrastructure!
Last, we want to share our thesis on all buy-vs-build decisions: we strongly believe that every digital health company should have their own “secret sauce” in a piece of their tech stack. We’ve seen many successful builders begin by identifying and focusing engineering resources on this proprietary insight or process, while utilizing vendors to fill in other pieces of the tech stack. As the company scales, it may make sense to bring more pieces in house, but it does not need to start that way.
Our ultimate goal in sharing this piece is to help founders accelerate getting to market. We hope you find it helpful!
1. Clinical Staffing
The limited supply of clinical staff has been well documented throughout the pandemic. But for digital health companies, the problem is often more complex than simply meeting demand — coordinating a diverse team that meets a population’s needs across geographies is a dynamic and complex challenge even for scaled care teams. We’ve seen a few approaches: while many opt to hire a portion of their clinicians full-time to handle the majority of patient volume while utilizing contractors to dynamically manage excess volume, others have fully relied on contractors or scaled their own in-house care teams. Here are some solution providers in the space:
2. Provider Management, Licensing & Credentialing
As more and more digital health businesses deploy a reimbursement model, the payor credentialing process can often be a massive hurdle for scaling businesses. Ensuring clinicians are licensed across states and in-network at payors can take months, leaving clinician capacity unutilized or delaying expansion into new states entirely. Several startups have jumped in to alleviate this pain point with SaaS solutions:
3. Modern EHR
While many builders at the earliest stages tend to run pilots on a frankenstein of Google spreadsheets and airtables, many care delivery businesses quickly reach a point where an EHR vendor is necessary. Fortunately, today’s founders don’t have to build their own from scratch. There are several options:
- Broad-use EHR: Canvas Medical, Zus Health, Healthie, Akute Health, Elation Health, DrChrono, AeroDPC
- Behavioral-Health Specific: Simple Practice, Therapy Notes, Theranest, Osmind, Valant
- Established: AthenaHealth
4. Patient Experience
Designing the front-end of your patient experience is daunting, particularly at the earliest stage. Several businesses have built low-code / no-code solutions with API-functionality to scale alongside your business. Notably, these patient experience tools often include EMR-lite capabilities and also offer integrations into other EMRs. See examples below:
5. Payor Billing
Moving beyond a cash-pay model is often table stakes for today’s digital health businesses. Yet handling the piles of paperwork and red tape associated with payor billing is almost never a core competency of early-stage businesses. Several tech-forward businesses have emerged in the space which are distinct from bundled EMR offerings:
6. Patient CRM & Communications
Maintaining a central record of a patient is critical for continuity of care, particularly as care models become increasingly complex. We see some digital health builders build this in-house while others utilize well-known horizontal solutions for healthcare-specific use cases. While CRM solutions focus on enabling continuity of care for virtual and hybrid models, these offerings also have EMR-lite capabilities. See examples below:
- CRM: Phase Zero, Welkin, Tellescope
- Communications: Pair Team, Spruce Health, NexHealth, Twilio
7. Pharmacy Fulfillment
As a virtual or hybrid care delivery model, many will extend to prescribing and fulfilling drug prescriptions. A founder’s vision of a great patient journey likely doesn’t include the hassle of going to a brick-and-mortar pharmacy but most early-stage startups do not have the resources to build a script fulfillment service.
8. In-Home Care Enablement
As in-home care models have gained more traction, a suite of white-labeled on-demand services for in-home care enablement has come to market (longer discussion on this trend here). Founders today can partner with solutions that enable lab-testing and remote patient monitoring.
- Lab testing: Ash, Sprinter Health, GetLabs
- In-Home medical equipment: Equipt Health
- Home Visits: Axle Health, Workpath, MedArrive
- Remote Patient Monitoring: Validic, Terra, Impilo, Spren
9. Patient Data Access
Though admittedly a larger and more nebulous category, digital health builders who seek medical or payor data can now consider several potential vendors. Companies like Flexpa are utilizing recent changes in interoperability rules to develop a federated identity layer for patients, while others like Ribbon and Redox provide easier access to provider network data. These solutions unlock previously siloed data and connect user experiences in ways that we have come to expect in other sectors but has been difficult in digital health. Examples below:
10. API Integration Management / Data Normalization
With the influx of API-first solutions in digital health, managing integrations and normalizing data flowing across the tech stack is difficult for early and growth stage businesses alike. Companies like Morf are focused on integration management to free up developer hours from establishing and maintaining the ever-increasing number of digital health integrations. Gaze Health provides a platform to help normalize data and analyze it in an effort to improve care delivery. Other businesses have gone even deeper into the stack, such as Develop Health, which provides a full backend for folks to build on top of (like a firebase for digital health).
11. HIPAA / SOC-2 Compliance
We believe building a consumer-friendly experience in digital health relies on a foundation of trust. While we always recommend builders consult with a lawyer and consider all compliance-related risks, there have been several businesses that now assist with the HIPAA and SOC-2 compliance:
We hope you’ve found this guide helpful in thinking through buy-vs-build decisions and identifying potential partners. If you’re building a digital health business or would like your company to be added to the list, we’d love to hear from you — we love ideating with founders on day 1. You can follow us on social media (Ellie Wheeler, Sharla Grass, Massimo Pennisi, and Tyler Olkowski) or reach out directly at tyler.olkowski@greycroft.com!
Last, we’d like to thank those who helped us iterate on this piece, particularly Andrew Arruda, Maitreyee Joshi, Jan-Felix Schneider, the Gordy Health team, and others building in stealth (you know who you are!) for their suggestions and insights.
Disclaimers: Companies noted throughout are not all Greycroft portfolio companies or affiliates and are intended as a curated list of providers in the relevant spaces.
The portfolio companies identified and described herein do not represent all of the portfolio companies purchased, sold or recommended. The reader should not assume that an investment in the portfolio companies identified was or will be profitable. A full listing of investments can be provided upon request. Past performance is not indicative of future results. This is not a solicitation of an offer to purchase securities and may not be relied upon in connection with the purchase or sale of any security.
This publication has been prepared solely for informational purposes. The information contained herein is only as current as of the date indicated and may be superseded by subsequent market events or for other reasons. The information in this document has been developed internally and/or obtained from sources believed to be reliable; however, Greycroft does not guarantee the accuracy, adequacy, or completeness of such information. Greycroft does not assume any duty to, nor undertakes to update forward looking statements. Nothing contained herein constitutes investment, legal, tax or other advice nor is it to be relied on in making an investment or other decision.
