Krishna Yeshwant, general partner, GV
Perusing the life sciences and health portfolio of GV (formerly Google Ventures), one thing is clear. The venture capital arm of Alphabet (you can’t call GV a strategic VC in the way JJDC is of Johnson & Johnson given that Alphabet is not a healthcare company) has a wide-ranging interest in healthcare companies. Portfolio companies span everything from therapeutics, biotech, healthcare delivery, health IT, medtech, to even insurance.
“In our lingo, we would talk about working across the stack of healthcare,” said Krishna Yeshwant, general partner at GV, who heads up the fund’s life sciences team in a recent phone interview. “We are fundamentally looking for transformative companies. Everybody says that and looks for that. What we mean by that is that in the future, ‘What should all this look like and what are the things that are missing from here and there?’ More often than not those are not a particular therapeutic, a particular payer, a tool or thing. More often they are things that fall in between the sectors and don’t entirely respect the boundaries or the silos that exist in the system.”
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That abiding philosophy hasn’t yet found anything interesting in the consumer wearable arena to consider supporting. And so not surprisingly, consumer wearables as a group is rather conspicuous by its absence from GV’s portfolio.
By contrast, GV has invested in so-called clinical wearables: Element Science, which GV co-founded with Third Rock Ventures is building a therapeutic wearable for people at risk of sudden cardiac death. It has also invested in Cala Health, which is developing a wearable for people with essential tremor, pointed out Yeshwant, who spends Wednesday and Friday mornings seeing patients as a part-time physician at his clinic in Brigham and Women’s Hospital in Boston.
But there appears to be a rationale for why GV hasn’t funded a Jawbone or Fitbit or numerous other consumer-facing wearables.
“It’s not that we wouldn’t. It’s just that the bar is quite high for us in that realm,” Yeshwant said. “I think we have all the [same] questions that most people have in the space — it’s really less about the technology and more about, ‘Why would somebody wear this?’ ”
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Yeshwant doesn’t have a good answer for that question and not for lack of trying.
“I have had every one of the wearables out there at one point or another and I’ve worn them all and they all end up in a drawer because at some point they just don’t have sufficient reason for me to keep charging them, keep remembering where they are and keep using them,” he said.
In a Q&A, Yeshwant attempted to explain just what that bar is and what kind of company and entrepreneur would win backing from GV.
MedCity: When you say the bar is high, are you looking for more data, more use cases?
Yeshwant: It’s use cases both from the consumer and from the medical perspective. Why is somebody going to wear this? Let’s look at Afib [atrial fibrillation] as a classic one. Where’s the company that would sit between a Fitbit or an Apple Watch, or an Android wearable, and an iRhythm? (iRhythm Technologies makes the Zio wearable patch that’s worn on the chest for a few weeks to detect irregular heart rhythm). There’s people in our team whose kids have used it. So we very much buy the utility of iRhythm and their product. Things in that genre definitely make sense to me. I see how that works.
But it’s prescribed by a physician. It doesn’t really draw in very much of the consumer component. It definitely touches on the patient need. Why would anyone wear this patch on their chest for a few weeks? They will because they are having symptoms and they are trying to figure out why and they don’t want to die. As a physician, I feel very comfortable with that use case.
But let’s ask another question. Five percent of the population is walking around with afib right now, maybe more. And there is a relatively large percent of those who are cryptogenic who don’t know that they have afib. These are people who are at risk of stroke. That’s not a person who is going to their doctor and asking for a Holter monitor or an iRhythm patch.
It would seem to me that there’s an opportunity with all the people walking around with watches to identify irregular heart rhythm. What happens when you can detect arrhythmia on your Apple Watch?
Maybe there is an array of companies or one large company that could be started there as an example of a company that has probably a little more consumer dynamic than iRhythm but isn’t a Fitbit or an Apple Watch.
We are looking for that kind of company. Frankly, I might even argue the right entrepreneur. We like to invest in-between areas – the interdisciplinary arenas and to do that it’s really helpful to find an entrepreneur who can go into both of those areas and that’s just rare. It’s rare to find somebody who can understand both the healthcare world and the consumer world.
It could even be a consumer person who we might help spend a year or two years to get up to speed on the healthcare side as we conceptualize a company.
But we haven’t seen a lot of companies organically form at that particular consumer healthcare intersection that’s been a great fit for us yet, but it’s not because we wouldn’t invest there. It’s just that we are looking for the right entrepreneur, the right company or set of companies to invest there.
We are raising our hand and saying we’d like to help find entrepreneurs who might have one part of that skill set and help really construct the other part of it. We think there’s real opportunity there …
Up until that company is created by that special entrepreneur, with or without the help of Yeshwant and GV, he is quite content to sit on the sidelines.