Apr
12
2021
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Microsoft goes all in on healthcare with $19.7B Nuance acquisition

When Microsoft announced it was acquiring Nuance Communications this morning for $19.7 billion, you could be excused for doing a Monday morning double take at the hefty price tag.

That’s surely a lot of money for a company on a $1.4 billion run rate, but Microsoft, which has already partnered with the speech-to-text market leader on several products over the last couple of years, saw a company firmly embedded in healthcare and it decided to go all in.

And $20 billion is certainly all in, even for a company the size of Microsoft. But 2020 forced us to change the way we do business from restaurants to retailers to doctors. In fact, the pandemic in particular changed the way we interact with our medical providers. We learned very quickly that you don’t have to drive to an office, wait in waiting room, then in an exam room, all to see the doctor for a few minutes.

Instead, we can get on the line, have a quick chat and be on our way. It won’t work for every condition of course — there will always be times the physician needs to see you — but for many meetings such as reviewing test results or for talk therapy, telehealth could suffice.

Microsoft CEO Satya Nadella says that Nuance is at the center of this shift, especially with its use of cloud and artificial intelligence, and that’s why the company was willing to pay the amount it did to get it.

“AI is technology’s most important priority, and healthcare is its most urgent application. Together, with our partner ecosystem, we will put advanced AI solutions into the hands of professionals everywhere to drive better decision-making and create more meaningful connections, as we accelerate growth of Microsoft Cloud in Healthcare and Nuance,” Nadella said in a post announcing the deal.

Holger Mueller, an analyst at Constellation Research, says says that may be so, but he believes that Microsoft missed the boat with Cortana and this is about helping the company catch up on a crucial technology. “Nuance will be not only give Microsoft technology help in regards to neural network based speech recognition, but also a massive improvement from vertical capabilities, call center functionality and the MSFT IP position in speech,” he said.

Microsoft sees this deal doubling what was already a considerable total addressable market to nearly $500 billion. While TAMs always tend to run high, that is still a substantial number.

It also fits with Gartner data, which found that by 2022, 75% of healthcare organizations will have a formal cloud strategy in place. The AI component only adds to that number and Nuance brings 10,000 existing customers to Microsoft including some of the biggest healthcare organizations in the world.

Brent Leary, founder and principal analyst at CRM Essentials, says the deal could provide Microsoft with a ton of health data to help feed the underlying machine learning models and make them more accurate over time.

“There is going be a ton of health data being captured by the interactions coming through telemedicine interactions, and this could create a whole new level of health intelligence,” Leary told me.

That of course could drive a lot of privacy concerns where health data is involved, and it will be up to Microsoft, which just experienced a major breach on its Exchange email server products last month, to assure the public that their sensitive health data is being protected.

Leary says that ensuring data privacy is going to be absolutely key to the success of the deal. “The potential this move has is pretty powerful, but it will only be realized if the data and insights that could come from it are protected and secure — not only protected from hackers but also from unethical use. Either could derail what could be a game changing move,” he said.

Microsoft also seemed to recognize that when it wrote, “Nuance and Microsoft will deepen their existing commitments to the extended partner ecosystem, as well as the highest standards of data privacy, security and compliance.”

Kate Leggett, an analyst at Forrester Research thinks healthcare could be just the first step and once Nuance is in the fold, it could go much deeper than that.

“However, the benefit of this acquisition does not stop [with healthcare]. Nuance also offers market-leading customer engagement technologies, with deep expertise and focus in verticals such as financial services. As MSFT evolves their industry editions into other verticals, this acquisition will pay off for other industries. MSFT may also choose to fill in the gaps within their Dynamics solution with Nuance’s customer engagement technologies,” Leggett said.

We are clearly on the edge of a sea change when it comes to how we interact with our medical providers in the future. COVID pushed medicine deeper into the digital realm in 2020 out of simple necessity. It wasn’t safe to go into the office unless absolutely necessary.

The Nuance acquisition, which is expected to close some time later this year, could help Microsoft shift deeper into the market. It could even bring Teams into it as a meeting tool, but it’s all going to depend on the trust level people have with this approach, and it will be up to the company to make sure that both healthcare providers and the people they serve have that.

May
14
2020
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Why we’re doubling down on cloud investments right now

Years from now, people will look back on the COVID-19 pandemic as a watershed moment for society and the global economy.

Wearing a mask might be as common as owning a phone; telework, telemedicine and online education will be more of a norm than a backup plan; and for the global economy, the cloud will have transformed the underlying infrastructure of businesses and entire industries.

COVID-19 is a turning point for the cloud and cloud company founders. For its computing power and as a delivery model of software, the cloud has been embraced as a solution to many challenges that businesses face during today’s economic downturn and recovery. Not only is the cloud industry more resilient than other industries, but the cloud model offers businesses a promising future in the age of social distancing and beyond.

We believe that once founders find shelter in the cloud, they’ll never go back.

Cloud’s resiliency amid historic volatility

Over the past decade, there’s been a massive market shift from on-premises to cloud, as 94% of enterprises use at least one cloud service today. 2020 was already a milestone year for the cloud industry, as aggregate SaaS and IaaS run-rate revenue each crossed $100 billion, and the BVP Nasdaq Emerging Cloud Index (^EMCLOUD) market cap crossed $1 trillion in early February. Yet in a matter of days, as the COVID-19 pandemic spread, fear tore through financial markets.

In early March, public markets experienced the steepest crash in history with volatility we haven’t seen since the Great Recession. The cloud index market cap dropped to ~$750 million and cloud multiples returned close to their historical averages of ~7x while the VIX volatility index spiked to the mid-80s. Both at global highs in February 2020, the ^EMCLOUD and the S&P 500 traded off by roughly 35% by mid-March. Over the next two months, though, the ^EMCLOUD recouped those losses, charging to a new all-time high on May 7.

The cloud index has continued its rise since then, and as of the close on May 11 has a market cap above $1.2 trillion and has returned to the lofty 12x forward run rate revenue multiples from 2019. Similar to Adobe in 2012, we expect many enterprises to transition over to the cloud model, and the index will continue to expand. As we predicted in this year’s State of the Cloud 2020, by 2025 we expect the cloud to penetrate 50% of enterprise software.

Apr
21
2020
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Will China’s coronavirus-related trends shape the future for American VCs?

For the past month, VC investment pace seems to have slacked off in the U.S., but deal activities in China are picking up following a slowdown prompted by the COVID-19 outbreak.

According to PitchBook, “Chinese firms recorded 66 venture capital deals for the week ended March 28, the most of any week in 2020 and just below figures from the same time last year,” (although 2019 was a slow year). There is a natural lag between when deals are made and when they are announced, but still, there are some interesting trends that I couldn’t help noticing.

While many U.S.-based VCs haven’t had a chance to focus on new deals, recent investment trends coming out of China may indicate which shifts might persist after the crisis and what it could mean for the U.S. investor community.

Image Credits: PitchBook

Apr
16
2020
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Verizon is buying B2B videoconferencing firm BlueJeans

US carrier Verizon* has splashed out to buy veteran B2B videoconferencing platform, BlueJeans Network — shelling out less than $500 million on the acquisition, according to the Wall Street Journal which first reported the news.

A Verizon spokeswoman confirmed to TechCrunch that the price-tag is sub-$500M but did not provide a more exact figure. Videoconferencing platform Blue Jeans has raised ~$175M since being founded around a decade ago, per Crunchbase, with US investor NEA leading a Series E round back in 2015.

In a press release announcing the deal, Verizon said it has entered into a definitive agreement to acquire the enterprise-grade videoconferencing and event platform in order to expand its “immersive unified communications portfolio”.

“Customers will benefit from a BlueJeans enterprise-grade video experience on Verizon’s high-performance global networks. In addition, the platform will be deeply integrated into Verizon’s 5G product roadmap, providing secure and real-time engagement solutions for high growth areas such as telemedicine, distance learning and field service work,” it wrote.

“As the way we work continues to change, it is absolutely critical for businesses and public sector customers to have access to a comprehensive suite of offerings that are enterprise ready, secure, frictionless and that integrate with existing tools,” added Tami Erwin, CEO of Verizon Business, in a supporting statement. “Collaboration and communications have become top of the agenda for businesses of all sizes and in all sectors in recent months. We are excited to combine the power of BlueJeans’ video platform with Verizon Business’ connectivity networks, platforms and solutions to meet our customers’ needs.”

The acquisition comes at a time when videoconferencing is seeing a massive uptick in usage as white collar workers around the world log on to meetings from home during the coronavirus pandemic.

Although it’s BlueJeans’ rival, Zoom, that’s been the most high profile name linked to the viral videoconferencing boom in recent weeks. The latter recently revealed that daily meeting participants on its platform jumped from a modest 10M in December to 200M in March.

However such booming growth and consumer usage has brought increased scrutiny for Zoom — leading to a spate of warnings (and even some bans), related to security and privacy concerns. And earlier this month the company said it would freeze product dev to focus on the laundry list of issues that have surfaced as users have piled in and kicked its tires, taking a little of the shine off of surging growth. 

On the sheer usage front BlueJeans is certainly small fish in comparison to Zoom — having remained b2b focused. A BlueJeans spokeswoman told us it has more than $100M ARR and over 15,000 customers at this point. (Some notable users include Facebook and Disney.)

But it’s paying users that are likely of most interest to Verizon, hence talk of telemedicine, distance learning and field service work — areas ripe for coronavirus-accelerated digitization. Carriers generally, meanwhile, haven’t been able to translate increased usage during the pandemic into a revenue growth story — as a result of a combination of fixed costs, debt and market disruption that’s been hitting their shares during the coronavirus crisis, per Reuters. Bolting on more b2b tools looks to be one way of growing network revenues.

“The combination of BlueJeans’ world class enterprise video collaboration platform and trusted brand with Verizon Business’ next generation edge computing innovation will deliver highly differentiated and compelling solutions to our joint customers,” said Quentin Gallivan, BlueJeans CEO, in a statement. “We are very excited about joining the Verizon team and we truly believe the future of business communications starts today!”

Verizon said today that said BlueJeans founders and “key management” will join the company as part of the acquisition, with BlueJeans employees set to become Verizon employees immediately following the close of the deal — which is expected in the second quarter, pending customary closing conditions.

BlueJeans co-founder Krish Ramakrishnan has a history of exits, selling a couple of his previous startups to networking giant Cisco — where he has also worked, in between spinning out his own companies.

*Disclosure: Verizon is also TechCrunch’s parent company

Sep
24
2019
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Amazon launches Amazon Care, a virtual and in-person healthcare offering for employees

Amazon has gone live with Amazon Care, a new pilot healthcare service offering that is initially available to its employees in and around the Seattle area. The Amazon Care offering includes both virtual and in-person care, with telemedicine via app, chat and remote video, as well as follow-up visits and prescription drug delivery in person directly at an employee’s home or office.

First reported by CNBC, Amazon Care grew out of an initiative announced in 2018 with J.P. Morgan and Berkshire Hathaway to make a big change in how they all collectively handle their employee healthcare needs. The companies announced at the time that they were eager to put together a solution that was “free from profit-making incentives and constraints,” which are of course at the heart of private insurance companies that serve corporate clients currently.

Other large companies, like Apple, offer their own on-premise and remotely accessible healthcare services as part of their employee compensation and benefits packages, so Amazon is hardly unique in seeking to scratch this itch. The difference, however, is that Amazon Care is much more external-facing than those offered by its peers in Silicon Valley, with a brand identity and presentation that strongly suggests the company is thinking about more than its own workforce when it comes to a future potential addressable market for Care.

Screen Shot 2019 09 24 at 4.02.46 PM

The Amazon Care logo.

Care’s website also provides a look at the app that Amazon developed for the telemedicine component, which shows the flow for choosing between text chat and video, as well as a summary of care provided through the service, with invoices, diagnosis and treatment plans all available for patient review.

Amazon lists Care as an option for a “first stop,” with the ability to handle things like colds, infections, minor injuries, preventative consultations, lab work, vaccinations, contraceptives and STI testing and general questions. Basically, it sounds like they cover a lot of what you’d handle at your general practitioner, before being recommended on for any more specialist or advanced medical treatment or expertise.

photo devicerendering.4x 9a453f4c420db36a6d32e73e7e344dec

Rendered screenshots of the Amazon Care app for Amazon employees.

Current eligibility is limited to Amazon’s employees who are enrolled in the company’s health insurance plan and who are located in the pilot service geographical area. The service is currently available between 8 AM and 9 PM local time, Monday through Friday, and between 8 AM and 6 PM Saturday and Sunday.

Amazon acquired PillPack last year, an online pharmacy startup, for around $753 million, and that appears to be part of their core value proposition with Amazon Care, too, which features couriered prescribed medications and remotely communicated treatment plans.

Amazon may be limiting this pilot to employees at launch, but the highly publicized nature of their approach, and the amount of product development that clearly went into developing the initial app, user experience and brand all indicate that it has the broader U.S. market in mind as a potential expansion opportunity down the line. Recent reports also suggest that it’s going to make a play in consumer health with new wearable fitness tracking devices, which could very nicely complement insurance and healthcare services offered at the enterprise and individual level. Perhaps not coincidentally, Walgreens, CVS and McKesson stock were all trading down today.

Aug
24
2016
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Customized online prescription acne treatment provider Curology raises $15M

curology David Lortscher was one of a few dozen people practicing dermatology in New Mexico when he realized a huge problem in the field: There weren’t enough dermatologists, and people were skipping out on visits because they thought it was for more affluent people or took too long. So Lortscher decided to start Curology, which provides acne and anti-aging treatment and prescriptions through… Read More

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