1upHealth

Since the mid-2010s we have been able to access banking, credit card, and brokerage information within a single app. But while fintech players like Quovo and Plaid have long undergirded data transfer and interoperability within the realm of finance, healthcare data segmentation has persisted. Patients must often keep track of their medical histories, diagnoses, and treatments across multiple care providers and access portals — if they can figure out how to access it at all. 

 

Change on the Horizon

That status quo began to shift with the 2009 passage of the HITECH act, which encouraged the adoption of electronic health records (EHRs). Later, government agencies mandated data sharing between payers and providers using the Fast Healthcare Interoperability Resources (FHIR) protocol as a common standard. By 2021, more than 96 percent of medical records had been digitized. 

As investors in PatientPing (now Bamboo Health) and Quovo — pioneers in facilitating healthcare and financial data exchanges, respectively — F-Prime Capital’s Carl Byers, Brett Cook, and David Jegen had long believed in the potential of healthcare data interoperability to boost efficiency across the healthcare ecosystem. Through close collaborations between the Heath IT and Services and Tech investment teams, they identified four key pillars for our thesis, including:

1. Successful players would start by serving data-holding providers and payers
2. Aggregators will be essential, but few (if any) would be able to differentiate themselves
3. It is essential to serve well and win the app developer ecosystem
4. Strong network effects are possible

When the right company came along, we were ready. 

 

Healthcare’s Modern Data Platform
Despite initial resistance within the healthcare industry, healthcare payers had begun selecting vendors to help them comply with regulatory changes. The situation created a unique catalyst and opportunity for a company like Boston-based 1upHealth, which had developed a cloud-based platform that helps healthcare companies collect, organize, share, and use their data more effectively. By bringing together patient records, insurance claims, and other types of health data, the company facilitates improved healthcare, lower costs, and less risk. 

We quickly realized that 1upHealth had developed the healthcare industry’s most sophisticated FHIR-enabled health data platform, which supported interoperability across the healthcare ecosystem. The founding team shared a strong skill set across tech infrastructure, healthcare and resource management. From this expertise, they rapidly built a robust platform and fast-scaling sales engine, demonstrating clear product-market fit by the time we led 1upHealth’s Series B in April 2021. 

“1upHealth’s collaboration with F-Prime represented a pivotal step for the company,” Founder Ricky Sahu told us recently. “They have helped us through multiple financial planning and strategic efforts, shared their historical experience working with and investing in companies across healthcare data and adjacent industries, and fostered critical connections ranging from new team members to prospective customers.” 

 

Infrastructure for Impact

Using its platform, 1upHealth customers can streamline the collection of clinical data to power workflows like quality reporting, risk adjustment, care management, and utilization management. Their data is easily accessible and discoverable for all downstream applications and analytics functions, and complies with health data exchange regulations including prior authorization, payer-to-payer, and provider access rules, leveraging FHIR application programming interface (APIs).

Since our investment, 1upHealth has emerged as the leading vendor to tech-forward healthcare buyers seeking a cloud-based solution to support a more interoperable future. We are also excited to see payers and collaborating entities like healthcare providers using 1upHealth’s cloud infrastructure to support the transition of payment models between payers and providers from the predominant fee-for-service model, which tends to misalign incentives, to a value and risk-based arrangement that aligns payers and providers’ focus behind patient health. As investors, we saw PatientPing (now Bamboo Health) help facilitate data sharing for these purposes and looking forward, we see a tremendous opportunity to provide the infrastructure for similar use cases and companies.

 

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