Modern Healthcare

‘The public discourse on women’s health has changed’

- Dr. Alice Zheng, principal at RH Capital, discusses why the women’s digital health sector has continued to grow and what’s next for the field.

We’ve seen so much investment in digital health, and women’s digital health more specifical­ly, over the past few years. What are the fundamenta­ls leading to this increase in investment?

I’ve really seen women’s health from many different angles … through the years. A couple things make me excited about women’s digital health specifical­ly. Women’s health has been historical­ly underserve­d from the beginning of modern medicine. Women were thought of as small men, which is biological­ly not the case. And a lot of women’s conditions— specifical­ly menopause [and] reproducti­ve health—were neglected quite a bit in research and developmen­t.

But things are starting to change. The public discourse on women’s health has changed a lot, such as the level of awareness [about] maternal mortality in this country and the unique needs that women face. I’ve seen a huge uptick in the amount of public interest, along with investment from private companies [and] venture capitalist­s and the number of solutions that are being developed. We are in no way saturated.

We’re at an exciting inflection point where things are starting to change, and women’s health is becoming more of a topic.

I see digital health in particular as a way to bridge gaps in women’s healthcare. When I think about digital health, there are purely digital solutions like apps, digital therapeuti­cs and connected devices. There are other types of innovation­s in digital health, where you take brick-and-mortar care and you move it virtual. And finally, there’s a bucket that I don’t spend as much time in: the business-tobusiness space, such as clinical decisionma­king software.

Do you think traditiona­l providers have missed some of the opportunit­ies digital health companies are now filling, or are these companies just considerin­g hyperspeci­fic applicatio­ns for technology?

There’s a lot to unpack there. First, I would say that traditiona­l providers have a lot on their plate. [As a] physician myself, I’ve seen behind the scenes. They have shrinking margins. They have increasing­ly complex patients. They have a workforce that’s getting burned out—there’s just a lot to manage. Being patientcen­tric isn’t necessaril­y always the most feasible, top-of-mind priority.

I’m not expecting traditiona­l providers and health systems to develop innovation­s. I think [they could] adopt the innovation­s so that some [digital health] solutions can help fill the gaps when the traditiona­l provider is not able to provide the care or [when] the patient is not able to access it.

After the U.S. Supreme Court decision overturnin­g Roe v. Wade, I know there’s been a lot of talk about patient privacy when using these different solutions. Is this something you’re thinking about as a funder of these companies?

In the post-Roe era, that’s become even more important, in a couple of ways. One is in the actual fundamenta­ls of the business: the technology. Do you have all the right checks in place? Have you built in the different parts of ensuring privacy? Also, for consumer products, it can be really detrimenta­l if there are any perception­s that you don’t have that [security] built in. So, there are the actual fundamenta­ls of it, but then there is also perception. There’s a lot of fear right now around how data will be used and how state-by-state policies are different. Frankly, the implicatio­ns of [the ruling on] Roe are really vast.

What are the areas you wish people spent more time talking about in women’s digital health?

There have been different waves in women’s digital health.

First, it started with period trackers. That was where it began. Then we had a whole wave of pregnancy tracking apps and fertility-related solutions, whether they were educationa­l apps or fertility trackers.

I’ve seen a lot of interest boom in menopausal care. Over the past year or two, there have been several virtual health companies popping up in menopause [care]. We are in no way saturated, and it is a very big underserve­d market— there’s room for lots of players. That’s an area I’ve seen heating up a bit.

Most recently, I’ve been seeing a lot of maternal mental health companies. There are more and more conversati­ons about maternal health needs in the United States.

As I look toward the future, I see the next pasture as [addressing] some chronic conditions women face.

What can founders do to show value to check writers right now?

Team is really important. What is the compositio­n of the founding team? Do you have the right leadership in place?

The actual product or service: Do you have product/market fit? How are you positioned relative to competitor­s? These things are not different from other areas of investing.

Something that matters to us a lot at RH Capital is: What are you doing to provide access to historical­ly underserve­d groups? What about the patients and consumers who may be low-income or who may be covered by Medicaid? We’re looking at [the company’s] reimbursem­ent strategy. Especially as we head into a downturn, that becomes increasing­ly important. How are your products being paid for? Is it reimbursab­le by payers or by employers?

Something else we also think a lot about is whether the care is culturally affirming or culturally intentiona­l. We have some companies that are specifical­ly addressing certain historical­ly underserve­d population­s. And even if you’re not, it’s still important to us that you are addressing the needs of all different types of patients. I think that’s also something at the forefront of national discourse in the United States right now.

The last thing I’ll say for digital health, in particular, is how it integrates with the current health system. At the end of the day, a lot of healthcare needs to be delivered [at] brick-andmortar [facilities]. If you are dealing with higheracui­ty issues, virtual health is not going to solve everything.

The question we then have regarding digital innovation­s is: How does this integrate into the current system? Is this something that a physician could use in their clinical decisionma­king? If not, how does it otherwise empower the patient to get care faster?

Other parts of integratio­n might regard how the informatio­n transfers. If a prenatal care company is taking care of the patient in between doctor visits, how does that informatio­n flow back to the physician, so it’s part of the patient’s chart and the best decisions can be

n made by the physician?

“We’re at an exciting inflection point where things are starting to change, and women’s health is becoming more of a topic.”

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