Subscribe to the OVP Blog RSS Feed: Enter your email address:

Delivered by FeedBurner


Hospitals Are Still Stuck In An Analog Age

Recently my wife and I welcomed our first child into the world.  In addition to the general excitement (if not frequent bewilderment) that comes with being a new parent, his birth of course led me to spend a few days in the hospital, a place I typically try to avoid.  During our stay, we were served with the highest care by a dizzying number of nurses, aides, and doctors who were constantly checking in on us, which naturally led to the need for a lot of patient handoffs and communication about what had transpired during the latest shift. 

Throughout the many doctor visits during the pregnancy, I actually had been impressed with the way the hospital system had integrated technology into its workflows.  I know that it had recently undergone implementation of a new electronic medical records system, and the doctors and nurses always had our latest information - including lab results - at their fingertips, had seemed quite comfortable taking notes directly on a computer, and fed that information quickly to the front desk for checkout or to send electronic prescriptions to our pharmacy.

Once in the post-delivery ward, however, it felt like we had stepped back in time.  While each room contained a very nice new computer screen and keyboard connected to a remote desktop, during our time there it served little more purpose than as a nightlight.  Doctors and nurses carried around index cards or scraps of paper with a confusing set of notations about each of their patients.  Often nurses would take several seconds of flipping the cards over and turning them around until finding the corner relevant to Sam's last feeding time or when Tracy was due her medications, with each nurse employing a unique organizational system that only she seemed to understand.  During each shift change, the outgoing and incoming nurse would then take up to 10 minutes to share what happened during that shift; while the outgoing nurse read off her paper, the incoming nurse furiously transcribed the information onto her own notecard. 

As a healthcare IT investor bombarded with entrepreneurs touting the digital transformation underway in our healthcare system, our son's first few days in the hospital provided a sharp reality check about how much further we have to go to realize the full potential of that transformation.  I asked one of the nurses, who had been at the hospital long enough to have cared for multiple generations of children in the same family, about her feelings toward the new electronic medical records system, and why she doesn't use the computer.  She replied that she isn't comfortable typing directly into the computer because it prevented her from fully engaging with her patients, in large part because she is an inefficient typist.  As a result, she would spend up to 15 minutes per patient (and cared for 3-4 patients each night - so up to 8% of her working hours) during every shift going back to the computer at the nurse's station to translate her handwritten notes back into the EMR, which she found highly frustrating and not enjoyable. 

For the most part, the antiquated pen and paper approach seemed to work well, as each nurse and doctor had his or her own method to the madness.  Yet the prevalence of handwritten notes to manage our care remained just that to me - madness.  Hospitals and EMR vendors must work to leverage the advances in smartphones and tablets to enable more efficient data collection during patient interactions.  Each nurse already carried a mobile phone for us to reach her; why not make those devices also able to run a set of well-designed apps to replicate the notes the nurses take with pen and paper?  One of our portfolio companies, Canvas, has a platform that would allow hospitals to do just that - and even provide the flexibility for each nurse to design her own app to capture the necessary data in whatever way she found most helpful.  At the same time, our experience in the hospital also reminded me of the dangers of becoming too enamored with technology.  Our nurse would likely have felt just as, if not more, uncomfortable entering data into a tablet or her smartphone than on the computer already available to her.  So, while I hope that my next experience in the hospital offers a bit of progress toward a more digital age, I will temper my expectations as we meet with entrepreneurs because it will be a slow journey away from good old pen and paper.


Two CEO Letters (Plus a Corollary)

There is a story full of business wisdom that is one of my favorites.   It has many variations but a common one goes something like this:

A new CEO walks into his office for the first time and finds two sealed letters on his desk.   One has written on the envelope: “open on your first day on the job.”  The second envelope has written: “open on your last day on the job.”  The CEO opens the first letter and printed there were the simple words “blame everything on your predecessor.”  The CEO takes the advice, gets off to a strong start and has an extraordinary run as CEO, taking the business through a multi-year period of high growth, an IPO, and an industry consolidation.  On the day he retires as a company legend and an industry icon, as he packs up his office and desk, he comes across the second letter, opens it, and reads “write two letters.”  He does just that, leaving them on the desk for his hand-picked successor.

Having been a new CEO and an ex-CEO, I can say with certainty that there is a lot to this story.  It suggests a new CEO is really a restart in so many ways.  Old traditions can be put aside.  “This is the way we do things” stops applying.  Hard decisions can be made because no one will hold the new CEO accountable to previous bad decisions or bad investments or bad hires that now need to be unwound.

The corollary is that Letter 1 has a statute of limitations.  Blame everything on the previous CEO – but do it quickly and move on.  Blame is about “they” and leadership is about “we” – so make the changes fast, dump the baggage, reset the financial expectations for the board, and embrace the company as its leader.  Six months into the role it really needs to feel like and be your seat.  Twelve months in and no one remembers the old CEO’s name.  Your name is on the door and the company’ past, present, and future are now your responsibility and the responsibility of the team that supports you.  Remembering this will help keep the second letter in the drawer for a long time to come.


They Are Coming to Philadelphia

We recently invested in Sidecar, a Philly-based e-commerce marketing solutions company.  Great company, great team, and an awesome CEO.  While the company is note-worthy in its own right, it is also noteworthy for being located in downtown Philadelphia (near 13th and Sansom).   Until about a year ago, we had one portfolio company with a Philadelphia presence – now we have four.    Our first was InstaMed, which has been downtown for close to ten years.  We invested in InstaMed in 2008 and have seen its staff grow more than 10x in Philly to well over 120 people in the city by year end.  PeopleLinx, in which we invested in 2013, was our second.  SevOne, a Wilmington-founded tech company in which we invested in 2007, this year established a large development satellite on South Broad Street in order to attract talent.  Is this just serendipity and the law of small numbers or have things changed?

From 2002 to 2008 when I was running Verticalnet , which was originally founded in Horsham and then later moved to Malvern, I only went downtown to see our lawyers or for a rare social dinner.  I technically live in the city (if Chestnut Hill counts) but it was clear when I moved to Philadelphia in 2000 that the technology community that existed here had its nexus in Wayne around the 202 corridor and the Safeguard campus.  Technology companies were in office parks.  There was also a brain drain with a constant complaint that we had great universities but that we were training people in order for them to graduate and move elsewhere.  The reputation for the Philly region was that it was a great place to raise a family (which it still is), but the converse of that reputation was the difficulty in attracting and retaining young people. 

So what’s happening?  I think it is a lot of small things that have come together to begin a groundswell.  Urban renewal of some vibrant neighborhoods has been successful, with West Philly, Northern Liberties, Fishtown, and other neighborhoods offering affordable options with a restaurant, bar, and activity scene that is much more appealing for the recent graduate (and tech entrepreneur).  Philly’s start-up scene is real and growing and more fuel is being added to the fire, while an increasing number of Route 202 corridor companies are building satellite offices to attract tech talent in Center City.  What was the catalyst?  Was it Mayor Nutter? John Fry? Stephen Tang at the Science Center?  Was it Philly Start-up Leaders?   Was it Ben Franklin Technology Partners?  Was it DreamIt, GoodCompany Ventures and other incubators? VentureForth and other shared workspaces?  Was it fueled by Philly Tech Week and PACT with its IMPACT and Phorum conferences?  Frankly, I think it was an environment that was ready for this and a lot of visionary people contributed to the momentum we now feel.

The other sub-trend that has been emerging is that the types of businesses being started have changed.  Six years ago as the Philly revival began, the companies being started were consumer facing – mobile apps pursuing the next social, mobile, texting, location based ideas.  Today we are seeing strong business-facing solutions emerging with greater frequency from Center City.  These are companies with sustainable business models and experienced leaders.  These are companies that are recruiting talent in Philly and drawing experienced people into Philly from outside.  

I am not proclaiming that Philadelphia is the next Silicon Valley.  It doesn’t need to be.  What I am saying is that Philadelphia is a city that is going to be increasingly hard to ignore when looking at cities on an upswing or cities where strong investing opportunities exist for angels, venture investors, and private equity firms.   At Osage, we certainly have an eye on Philly and we look forward to seeing our number of Philadelphia investments continue to grow and our current investments continue to thrive.


Congratulations to 2014 PACT Enterprise Awards Winner Bill Marvin of InstaMed and Finalists SevOne, PeopleLinx, and Tim Kowalski of Halfpenny Technologies

On May 8th, the Philadelphia Alliance for Capital and Technologies (PACT) held the 2014 Enterprise Awards, their annual black-tie awards gala to honor the region’s top companies, executives, and entrepreneurs in the technology and life sciences sectors.  Once again, the Osage Venture Partners portfolio was well represented.  The event recognizes three finalists and crowns an ultimate winner across eleven total categories, six of which focus on technology, corresponding to different stages of business maturity.  OVP was proud to have four finalists and one winner within the portfolio. 

  • Bill Marvin, InstaMed -  Technology CEO of the Year Winner
  • Tim Kowalski, Halfpenny Technologies – Technology CEO of the Year Finalist
  • SevOne – Technology Company of the Year Finalist
  • PeopleLinx – Technology Startup Company Finalist

Congratulations to all four companies for being recognized as leaders in their categories, with a special call out to Bill Marvin on a well-deserved win, the second in a row for InstaMed, which won as Technology Growth Company of the Year in 2013.  OVP also recognizes the fact that two of the three Technology CEO finalists were from the OVP portfolio, celebrating publicly what we know privately – that leadership drives success. 

Nate Lentz, Robert Adelson, David Drahms, Sean Dowling


Softening a Startup Crash Landing

In 2003 through 2005, when I was in my pre-investor, CEO role, we bought three companies  and through this process we learned a lot about what to do differently, what to do better, and what just not to do in start-up M&A.  One company in particular taught us a majority of the lessons.  The company was a venture backed business that had raised over $40M.  It received an offer for a large exit that was turned down by the board (because it was 1999 and things only went up).  We bought the business four years later because its technology solution moved us from a point solution offering to a platform, its customers more than doubled our existing base, much of the company’s revenue was SaaS, and because we were able to buy the company with stock and at a value that was a fraction of the capital invested.  One founder planned to leave at the time of the acquisition, but the CEO planned to stay on and was key to our integration plans.  I liked him a lot and really respected him and I was truly looking forward to partnering with him.  It took me by sudden surprise when the former CEO called me two weeks after the deal closed and resigned.  While it blindsided me then, it doesn’t surprise me now.  A pilot who successfully crash-lands a plane is pretty unlikely to want to stay on board for the next leg of the flight.  Walking away from the crash may be the only thing that the pilot or a crash-landed CEO can be expected to do.

When I went through this experience as an operator, I thought it might be a one-off.  What I have seen as an investor is that this situation was not unusual.  There are three types of exits – great ones, good ones, and disappointing ones – and this is especially true for management teams given how committed they tend to be to the start-up effort.  A lot is written about great exits and good exits, but the disappointing ones are often the most difficult and are the exits that require the greatest amount of heroism, fortitude, and personal integrity from the leadership.    Think about it.  People have been with the company for five years or more.  They have worked unusually long hours and often for below market pay.  They started the company with a vision and there was a period of excitement and growing expectation as external capital was raised and expectations rose further.  Then something happened, setbacks occurred, and finally the company was sold with the management team / founders receiving possibly, at best, a percentage of the proceeds in a carve-out.  And they take a job offer that they feel they need to accept because not doing so could kill the deal.

These disappointing exits are often the types of businesses that are targeted by our portfolio companies, which see the opportunity to acquire talent, technology, IP or customers.  So when our portfolio companies are considering “tuck-in” acquisitions what should a they, as a buyer, expect when buying a crash-landed business?  Which people will stay and which will go?  What do we recommend that our portfolio CEOs think about to make the combination successful?

  • First, recognize what the employees of the company you bought have been through.  For you as the buyer, you have worked on this transaction for two to three months, you have a transition team in place, and you are excited about getting the new business integrated and starting to see value.  Be aware that most of the new employees have just finished the equivalent of a business marathon and they are collapsing at the finish line.  Asking them to get up immediately and start running again is not going to be well received.  Acknowledge that you understand how hard it has been.  Give them time to recharge.  Think about ways to personally motivate the key keepers.
  • Second, recognize in most cases that several key employees will leave as soon as they contractually can.  This includes the CEO, other co-founders, and the CFO.  Think about whether you want them locked down and miserable or if it is going to be better for everyone if they leave with a “consulting agreement” to get you access to their historical knowledge if necessary.
  • Be clear to the acquired development team and technical folks about your intentions for the acquired product and the areas of exciting innovation on your own platform.  Developers prove to be the most resilient if they can keep working on projects that excite them or if they can be transitioned to an even cooler technology.

My experience with the acquisition described above turned out to be a great one.  Certainly there were challenges but the technology was solid, the customers were relatively stable, and we got some great talent, some of whom became key members of the leadership team.  There are thousands of distressed venture backed businesses, many of which have some great core assets in terms of technology and people.  The secret is knowing what you are buying and what to expect so you can have a similar experience.

Potential acquirers have the chance to buy something valuable for cheap and to really gain some extremely talented employees.  Startups (and especially distressed start-ups) are often less like jobs and more like tumultuous relationships.  People are emotionally drained and have committed extraordinary levels of effort and mental energy to an idea that has failed.  Often they have also made financial sacrifices that are taking a toll.  Toward the end, leadership teams often work for discounted salaries or defer compensation.  Bonuses most likely have not been paid.  Stress and uncertainty and discussions of the “zone of insolvency” have likely been daily realities.  The key for retaining and motivating these people is to offer them stability and opportunity and over time many will get excited about the new vision.  Remember to be patient and let them recharge their emotional batteries – it takes time but it will be time well invested.  In then end this will buy you the loyalty and passion you are counting on from the new team.  Finally, have a going away party for the CEO and other departing leaders.  Let them leave with pride, but let them leave.  The transition is complete once the CEO has left the building.