US Gateway – alternative routes for a Finnish

Healthtech startup to get to know/enter the US market

Findings from OWI field trip in Silicon Valley in 12 Sept. – 10 Oct 2010

Presented at OWI Startup Week 3.11.2010

Eeva Kiuru

Oulu Wellness Institute

Content

1. Health tech business trends, interesting new startups

and giants’ activities

2. Silicon Valley innovation ecosystem (and funding for

health)

3. US Gateway options

4. Closing: Homework to OWI, to our startups, to

universities and schools

1. Health tech business trends

1. Web, social media and mobile technologies gain ground

2. iPad, smartphones (android, iPhone), and enthusiastic developer community

3. Huge level of activity in the community, business outcome yet to be seen, vc’s

careful

4. ”Hacking for health”, rich data mining, mashing geodata and local data with

government data.

5. US government supports heavily this development by releasing public health

data – new apps -> new innovations to handle health related data -

>awareness - > new health behaviour

6. Gamification of health

7. Online patient communities

8. Health services -> competed services business

• The U.S. market for wireless home-health technology is projected

to soar from just $304 million last year to $4.4 billion by 2013.

And based on the amount consumers are willing to pay for some

of these services, the potential market is estimated to be between

$7.7 billion and $43 billion annually. -PwC.

• Helping to meet this demand, venture capital investment in

wireless health and mHealth companies totaled $85 million in the

second quarter of 2010, which was double the investment of the

preceding quarter. - MobiHealthNews.

Interesting new startups

• Sharecare in co-op with Dr. Oz, Discovery, Harpo and Sony

• Changing the way consumers are empowered to make informed health

care shopping decisions Castlight Health

• Changing the way we manage our health data ourselves -

Google Health

• Changing the way we communicate remotely with your doctor online -

RelayHealth

• Changing the way we make appointments online - Healthleap

• Changing the business model for building Electronic Health Records -

Practice Fusion

Interesting new startups

• Streamlines everything from daily patient appointments to

medical billing and e-perscriptions by bringing an iPad into the

exam room. - Dr. Chrono

• Helps to find the right doctor - Vitals

• Health education platform for iPad - Unity Medical

• Healthcare data protection – Diversinet

• Management of patient populations - Phytel

• Medical database of objective patient reports -

First Life Research

Patient/disease communities

• PatientsLikeMe

• IWantGreatCare

• MeYou Health

• First Life Research

• Diabetes: – dLife

– SweetSpot Diabetes Care

– TuDiabetes' HealthSeeker

• Cancer:– Navigating Cancer

• Weight management– TweetWhatYouEat

• Exercise:– iMoveYou

Tech and retail giants growing their presence in health care1. Wal-Mart with Dell and eClinicalWorks: to sell an EMR from its Sam’s Club

stores.

2. Dell plans to expand to non-invasive Blood Clucose Monitoring.

3. Google: personal health records allowing patients to store their own health

data

4. Microsoft: personal health information system, HealthVault, that can connect

with medical devices.

5. UnitedHealth insurance company with Cisco product HealthPresence to

develop a national program to allow doctors to treat patients remotely, also

building an in-home system.

6. Intel and GE: system that allows doctors to monitor patients at home.

7. Google and IBM: in-home system that could electronically relay data from

devices such as blood-pressure cuffs and glucose meters.

2. Silicon Valley Innovation Ecosystem and funding for health

The entrepreneur community

Business angels

• 30-70 pitches/month, 1000/year

• Invest 100.000 – 500.000 usd

• Harvard Angels

• Angels Forum

• Band of Angels

• Keiretsu Forum

• Sand Hill Angels

Typical questions from angels to entrepreneurs:

1. How much revenue are you going to make in the first year?

2. How much are you burning money right now, and how much over the coming

3 years?

3. What is your team’s background?

4. How much competition you have?

5. Do you have a finished product?

6. Why you, what’s your key differentiator?

7. Competition is already getting traction – how are you going to get traction?

8. What kind of investment you need to be able to market yourself?

9. Who is your customer, individuals or corporation?

10.What is your business model?

11.How do you make money ?

VC’s (funding for health)

• EDventure Holdings

• West Wireless Health Institute

• Psilos

• Three Arch Partners

• Longitude Capital

• Latterell Venture Partners

• Charter Life Sciences

• Khosla Ventures

• New Enterprise Associates

VC’s (funding for health)

• VC’s advice for med tech:

– Therapeutic device preferred

– Clear regulatory path must be planned

– Existing reimbursement code preferred

– Operations as virtual company is a must (often several

locations)

– Private pay market / consumer challenging and noisy market,

hard to build distribution

– Fill unmet need/ reduce the cost of healthcare

Events

Pitching

You are expected to provide:

• What is the “problem”

• Give an answer to it with Your product.

• What is the new / innovation in Your product.

• Why You are different from the previous products /

innovations).

• What is the exit plan?

Basic format of a 2 minute pitch

• Mitä tehdään

• Mitkä edut

• Minne myydään

• Minkä kokoinen markkina

• Mitä hyötyä rahassa

• Mikä tiimi/yrittäjä ja tausta

• Paljonko haetaan rahoitusta

• Mitä rahalla tehdään (testit, protot, partnerit, tk, avainhenkilöt)

• Mitä sen jälkeen tapahtuu

Questions from VC’s after a pitch

1. Who is your customer?

2. What is the pain point of your customer that you are fixing?

3. Who are you selling to?

4. What is your plan to protect this?

5. Who has the IP on the content?

6. What is the reaction of your early pilot customer regarding your pricing?

7. What is the regulatory landscape and path?

8. How are you going to monetize this?

9. What makes you better than competition? THIS IS VERY IMPORTANT

10.What is the special magic in your product?

11.Why would a customer want to use your product?

12.Are you building a company or a product?

3. US Gateway options

1. Finnode, Tekes/Gaselli, GAP

2. US MAC

3. Right-hand partners

4. Astia

5. Plug&Play Tech Center

6. Garfield Innovation Center

7. Venture Capital firms investing in healthcare

8. Vigo/ Lifeline Ventures

Know your geographic selection:

• Web -> Silicon Valley

• Med tech -> Boston, San Diego

• Canada: – Canada Health Infoway

– Pre-Qualified Vendor -status

Know your category:

Infoway Canada categories:

1. Diagnostic Imaging

2. Drug Information Systems

3. iEHR

4. Laboratory Information Systems

5. Public Health Surveillance

6. Registries

7. Telehealth

8. Benefits Evaluation

9. Business Analysis

10. Change Management

11. Enterprise/Solution Architecture

12. Health Care Standards

13. Privacy and Security Architecture

14. Project Management

Know the stage of your business -> your readiness1. Startup - conceptual phase, product development has not begun. Seed financing.

2. Product Development - developing one or more products, but have not yet begun

shipping. Any number of venture capital rounds or public funding.

3. Product in Beta Test or Clinical Trials - For IT companies: product develompent

ongoing, a prototype is being tested by select customers prior to market introduction. For

medical device companies: the product is out of development and has progressed to

human clinical trials.

4. Shipping Product - At least one revenue-generating product is being shipped, although

other products may still be in development or beta test. For service companies, this

stage indicates that the company is providing services to a customer base and receiving

revenues for those services.

5. Profitable - Company is shipping products or providing services from which it receives

revenues, and the company has reported that it is profitable.

6. Restart - Change in business direction or a dramatic shift in marketing strategy

Source: Venture Source

Analysis per product category

• Value chains, main events, conferences, tradeshows,

competitive environment, analysts, points of contact,

identified channels to validation process, gathering

price information, experience on possible bottlenecks,

gatekeepers, key players, identification of opinion

leaders, different hospital’s business models, identified

routes to markets, different geographical routes.

Finnode, Tekes/Gaselli, GAP

Plug&Play Tech Center

USMAC

• US Affiliate Office package

• Soft Landing programs

• Go Global: Silicon Valley competition

• Regional Go Global programs

• US market acceleration program. The program includes

an intensive boot camp, one-to-one mentoring and

focused business development activities.

Astia

Garfield Health Innovation Center

• Part of Kaiser Permanente (35 hospitals, 15.000 Physicians,

164.000 employees, annual sales 42 mrd USD)

• Facility to test run new innovations

• Innovation zones: home, clinic, hospital and prototyping

OWI: US Gateway program

• Goal: 2-3 med tech entrepreneurs to USA in 2011

• Early market assessment

• Learning the ecosystem, the rules, getting to know the

vc’s, business angels, partners, competition, market

= name of the game.

Go-to-market –model (example)1. Gain market understanding: spend time in Silicon Valley, attend tradeshows , events and

observe. Google a lot.

2. Define target market, ideal customer profile and goals for the market entry.

3. Prepare domestic example showcases, that resemble the US/Canada target customer profile

case/situation.

4. Create contact with local spokesperson and present your business case.

5. Identify key as Beta site candidates for implementing product and conduct validation sites i.e.

University Hospital/Medical School testing or to serve as proving ground.

6. Create contact with the chosen Medical Schools and their key person through the local

spokesperson’s personal network.

7. Prepare the business case with the spokesperson.

8. Present the product with the spokesperson to the Medical Schools’ key person. Target: Trial

project with the Medical School.

9. In Canada create contact with Infoway with the local spokesperson and start the approval

process. (Get started early, duration less than a year)

10. In USA create contact with FDA/NIH with the local spokesperson and start the approval

process. (Get started early, duration xx months.)

Go-to-market –model (example)11. Run the local validations/tests.

12. Establish a local presence with U.S. office and executive team.

13. Recruit regional or national “Guru”. A physician or scientist who is well published, able to

conduct speaking engagements and publish white papers utilizing Company offering.

14. Establish key customer sites in each geographic region in the U.S. market to leverage

future sales and create site visit protocols.

15. Establish membership and attend national tradeshows and participate as exhibitor.

4. Homework

• What is our offering ?

• What are our deliverables ?

• How do we match the trends ?

• What are our competitive advantages ?

• Do we have traction/first customers in Finland ?

• Market assessment as early as possible

• Learn to pitch !

Thank you – let’s keep in contact

• eeva.kiuru@owi.fi

• eeva.kiuru@gmail.com (private)

• +358-40-5886237

• LinkedIn

• Facebook