Thesis
The US healthcare system can be confusing and unnecessarily time-consuming to navigate. Patients have to deal with a fragmented network of healthcare providers and ever-increasing costs, while providers must wrangle with archaic technology stacks and large quantities of administrative paperwork. As a result, US healthcare expenditure amounts to nearly a fifth of GDP and yet ranks poorly on measures of healthcare access, quality, and preventable mortality.
Compounding this issue is the fact that patients’ care journeys are often complex, with little support between clinical visits. Patients who have frequent questions and predictable symptoms nonetheless rarely receive continuous, proactive care, and lack of continuity harms healthcare outcome since patients recall less than half of the recommendations they are given by their care providers just one week after a clinical visit.
At the same time, care teams across healthcare organizations lack the tools needed to automate complex care plans for patients, even where periodic touch points with patients are crucial for better outcomes. Care teams therefore often lack an easy way to manage care journeys, monitor progress, and personalize patient support. Yet automation is only becoming more critical in the face of escalating workforce challenges; for example, the Association of American Medical Colleges predicts that by 2034 there will be a shortage of up to 124K physicians in the US.
To address these challenges, Memora Health CEO Manav Sevak told Contrary Research in an interview that “healthcare systems have to figure out how to empower and supercharge the clinician using technology. Memora, at its core, is built to do exactly that.” Memora Health helps healthcare organizations digitize and automate care journeys, striving to make complex care delivery simple for patients and clinicians to navigate. The company uses machine learning to convert fragmented healthcare messaging and workflow data into smart modules that enable clinicians to deliver care more continuously. Memora Health also integrates into electronic medical record and patient management systems, which enables the collection of actionable clinical data outside episodic visits and bridges together patient engagement and administrative workflows into one end-to-end solution.
Founding Story
Memora Health was founded in 2017 by Manav Sevak (CEO), Kunaal Naik (CTO), and Nisarg Patel. Sevak studied biochemistry at Georgia Institute of Technology before researching health economics at Harvard and cancer metabolomics back at Georgia Tech. Meanwhile, Patel had been a research fellow at Harvard Law School and completed his graduate work in computational genomics at MIT and Harvard. Naik did a software engineering stint at Google and was an NLP researcher at Georgia Tech.
Sevak and Patel were childhood friends, while Naik knew Sevak from his undergrad days at Georgia Tech. The trio came together after witnessing a college friend struggling with managing an ulcerative colitis diagnosis. Their friend’s medication regimen was complicated, and they were struck by how little support was available to him in between episodic clinic visits. After setting out to create a solution, the team spent 6 months researching in the field, cold-calling doctor’s offices and health systems to better understand clinicians' pain points in their practices and workflow tooling. They researched new digital health tools and mapped out journeys for patients. Before the COVID-19 pandemic, they learned that healthcare providers wanted to provide more continuous care outside the patient visits, how challenging standardizing evidence-based care delivery was, and that the existing tech solutions were unlikely to learn from patient data on an ongoing basis.
The founding team partnered with Brigham Hospital in Massachusetts and Grady Memorial Hospital in Georgia, where they validated the early product in research settings with the intention of publishing papers on outcomes supported by grants. To get this pilot off the ground, the team spent three to four months getting clinicians to adopt the tool before initiating a formal IRB-approved study on how patient outcomes improved by engaging with their tools. The Memora Health team had the IRB review process fast-tracked across 4-6 weeks and recruited research students to support the recruitment process. Following this proof of concept, the healthcare systems expressed a willingness to pay for its product. Over time, the company expanded its scope to include appointments, symptom management, and other use cases. Memora Health incorporated off the pilot, and the company was launched out of Harvard Innovation Lab in 2017 and entered Y Combinator in the Winter 2018 cohort.
Product
Source: The Health Care Blog
Memora Health works with care teams’ existing technology and processes to create customized workflows for managing complex care. Its provider interface integrates with a health system’s EMR or CRM to facilitate care management, clinical workflow automation, and deployment of value-based care. Memora Health can be embedded into the EMR to make care management unified and intelligent. As CEO Manav Sevak told Contrary Research:
“Memora functionally helps modernize how most health systems operate, building an entire process for asynchronously engaging them, for giving patients a very consumer friendly experience, for giving clinicians tools that focus on the actual process of practicing medicine rather than a lot of the rolling logistics of getting reimbursed for [care].”
The Memora Health platform constantly learns from clinical workflows and enables care teams to use data to inform how they can deliver better care. The platform also seeks to minimize change management by adapting to care teams’ existing workflow through integration and intelligence.
Built with in-house teams and licensed clinicians, its Care Programs are designed to be an extension of care teams of healthcare providers to enable care at scale. Memora Health offers care programs in maternal care, surgical care, gastrointestinal care, cancer care, chronic care management, and population health.
Patients are pulled into the Memora Health platform based on information parsed from the medical records that match the criteria for a care journey module either through diagnosis codes, medications prescribed, or a combination of parameters. Patients interact with their care teams via Memora Health’s chatbot. Patients can text freely or be structured. Before and after a visit with a healthcare provider, patients may be prompted to interact with surveys, intake forms, etc., configured depending on where they are in their care journey.
The dashboard triages patients by most to least active concerns based on the data patients share. The patient profiles within Memora Health show a map of their journey over time, with a history of reported concerns, pending and resolved action items, enrolled care journeys, and a risk assessment based on their medical record and first-party data collected.
Source: Memora Health
Messages collected through the chat are ingested into the platform, triaged, and escalated into the provider system’s EMR. This is meant to allow for easy access for real-time patient engagement. Depending on the escalation and the organization’s preferred pivot points, Memora Health may route a patient concern through its Customer Success team to coordinate needs like patient transportation or directly to a clinic’s front desk, freeing time away from logistics. Memora Health tracks time spent by providers and patients engaging with its tools, which is crucial for provider reimbursement purposes.
Source: The Health Care Blog
Market
Customer
“We focus a lot on academic systems where we know for a fact that the types of clinicians that practice in those systems care about … outcome improvements.” - CEO Manav Sevak
Memora Health sells its platform mainly to health systems. The company has also partnered with digital health and life sciences companies. It enables IDNs, AMCs and community-based systems to deploy remote care initiatives in individual practices or across the entire health system. Memora Health's provider integrations also enable health plans to deploy and track value-based arrangements while supporting engagement initiatives.
The company reports over 50 organizations as customers. Notable partners include Mayo Clinic, Moffitt Cancer Center, Penn Medicine, UP Medical, Edward Elmhurst Health, Virtua Health, and Luma Health.
Market Size
The US Patient Engagement Solutions market size was estimated at $5.4 billion in 2021 and is expected to hit $17.7 billion by 2030. Large hospitals with more than 250 beds spend an average of $26.8 million on IT, indicating that Memora Health’s strategy of selling into large health systems may yield favorable unit economics with meaningful penetration at each account.
Competition
Twistle: Founded in 2011, Twistle is a patient engagement platform acquired by Health Catalyst in 2021 for nearly $104.5 million and an additional $65 million in performance targets. The platform uses automation and artificial intelligence to improve patient engagement and care coordination, supporting remote monitoring, chronic care management, and post-acute care. The acquisition added Twistle's patient engagement capabilities to Health Catalyst's suite of healthcare technology solutions, enabling Health Catalyst to offer a more comprehensive platform for care coordination and patient engagement supported by its flagship structured data and analytics platform. Despite the acquisition, the Twistle brand and team operate independently within Health Catalyst’s multi-brand, multi-product enterprise.
CipherHealth: Founded in 2009, CipherHealth is a digital patient engagement platform. It connects providers with patients and caregivers through personalized, automated communications. The company’s latest round of equity financing was an undisclosed growth round led by JMI Equity in 2018. Notable customers include Mayo Clinic, Banner Health, and Penn Medicine.
Conversa Health: Founded in 2014, Conversa Health is a virtual care platform for automated patient management and engagement. It raised a $20 million Series B round in January 2021, co-led by Builders VC and Northwell Ventures, with participation from UH Ventures, P5 Health Ventures, Epic Ventures, Startup Health and Naussau Street Ventures, Genesis Merchant Capital and J-Ventures. Notable customers include Deloitte, Genentech, and UCSF Health.
Business Model
Memora Health operates on an enterprise SaaS model selling into health systems, charging customers a monthly fee based on the number of sites, seats, and workflows used within a healthcare organization. The company looks to demonstrates value to health system enterprises through optimizing time spent and patient engagement for care teams.
Traction
In February 2022, Memora Health reported partnerships with over 50 organizations across health systems, health plans, medical groups, and life science companies. Notable customers include Mayo Clinic, Moffitt Health Center, Edward Elmhurst, and Penn Medicine. As of 2022, the company reports an average patient NPS over 70 and claims that its digitized care programs reduce care team notifications by 40%. Additionally, CEO Manav Sevak told Contrary Research the company has seen its ARR double over the course of 2022.
Valuation
In February 2022, Memora Health announced a $40 million funding round led by Transformation Capital with participation from Andreessen Horowitz, Frist Cressey Ventures, Edward Elmhurst Health, AlleyCorp, and other investors. Other notable investors include Martin Ventures, Kevin Durant and Rich Kleiman’s Thirty-Five Ventures, Sachin Jain, former Flatiron Health founder Zach Weinberg at Operator Partners, B Capital, early Flatiron Health employee Aaron Szekel, and Contrary.
Public comps include Health Catalyst, which acquired competitor Twistle in 2021. As of February 2023, Health Catalyst traded at a market cap of $764 million, or 2.8x revenue. Teladoc Health also presents a relevant public comp for Memora Health, with a market cap of $4.3 billion on ~$2 billion revenue as of February 2023, which is 60% down from a year ago.
Key Opportunities
Many of Memora Health’s opportunities for growth can be contextualized against the backdrop of the unbundling of Epic. With almost a third of the U.S. hospital market share, Epic dominates health IT alongside Cerner across multiple use cases and workflows. Memora Health straddles the patient experience and clinical workflow spaces with opportunities to move horizontally into more telehealth, RCM, interoperability, and patient flow use cases.
Generative AI
As Memora Health expands its platform to handle more healthcare administration workflows, the company could consider augmenting its existing NLP capabilities with AI-powered use cases outside of patient engagement, looking at reimbursement workflows and cross-provider/health system communications. Memora could integrate with a popular tool, like ChatGPT, for care teams to help streamline their time-consuming administrative tasks, such as drafting and faxing preauthorization and appeal letters to insurers.
Linkability
With more health systems using Memora Health’s platform, the company can look to bridge patient insights between EMR systems, especially for providers in overlapping geographies. Memora could augment workflows to allow providers to request medical records from different health systems and allow patients to more easily authorize transfer for a 360-degree picture of a patient’s history over time.
Key Risks
Scalability
With 626 health systems in the US as of 2016, Memora Health’s white-glove approach to customizing and implementing for providers and disease-specific teams is a go-to-market strategy that may be challenging to scale. While Memora Health’s existing provider-side platform is configurable with self-serve customization depending on the sophistication of the end customer, as the company continues to expand into new health systems and new care workflows it will need to ensure the implementation of additions to the care library remains operationally efficient.
Data Security
As Memora Health expands into new markets and more specific care workflows, the company will need to ensure continued security and HIPAA compliance of patient-originated data, especially as engagement becomes more targeted for patients with increasingly identifiable combinations of data (rare disease patients, oncology diagnoses + genomic data + treatments, etc.).
Summary
Memora Health provides a two-sided platform for healthcare providers and patients that improves patient engagement and communication and enables administrative and care workflows. The company has several tailwinds supporting its business, including the increasing adoption of telehealth and virtual care due to the COVID-19 pandemic and healthcare labor shortage, the growing demand for patient-centric healthcare solutions, and the rising interest in digital health solutions among investors.
The company’s platform is clinically validated and consists of a provider-facing software solution and a patient-facing SMS tool incorporating NLP to ingest patient data and synthesize areas for clinician engagement to improve care outcomes. It addresses the need for better communication and engagement between healthcare providers and patients, which can lead to improved health outcomes and increased patient satisfaction. With over 50 healthcare organizations and systems like Moffitt Cancer Center, Mayo Clinic, UP Medical, and Edward Elmhurst as customers, Memora Health has demonstrated notable traction.
*Contrary is an investor in Memora Health through one or more affiliates.