Health Assurance


From Off-Broadway Pitch Night to Big Time Investment
February 3, 2021
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There’s no place like home. That sentiment can be especially true for patients with heart disease who want to stay out of the hospital and keep living at home. It’s tough enough to “age in place” without a chronic illness but a lot tougher with constant monitoring and medical regimes like those that may be required for complex and chronic heart health issues.

Without a network of care providers living with you, adhering to active monitoring to keep heart health concerns in check is a challenge. Collecting data to share back with a care team is time consuming, it can be confusing, and patients often just can’t or won’t comply with what’s needed. Even with wearables, things go wrong — batteries die, uploads fail, and sometimes they’re just not convenient. This results in adherence rates that are often lower than ideal, highlighting the tradeoff between proximity to care and enabling independence. The team at Casana, one of GC’s newest portfolio companies, believes that sophisticated, passive technologies will be key to bridging that gap in heart healthcare.

More than an Op-pun-tunity
We first met Casana founder Nick Conn, Ph.D., in 2018 around a business plan pitch event at the Rochester Institute of Technology. At the time, Nick was a post-doc fellow focusing on medical device design and biomedical signal processing. More specifically, what he showed to Datto founder Austin McChord and me was the idea of creating an inconspicuous cardiovascular monitoring system for daily use in the home. This monitoring system would be all but invisible to the consumer — as it would be built into a toilet seat.

In Nick’s concept, several important health metrics could be regularly monitored while a person simply went about his or her daily, well, er, business. To be clear, there’s no fluid sampling here, just passive readings. But if key readings are out of a normal range or trending in the wrong direction, care professionals could be notified automatically.

At the time of Nick’s pitch, the “hospital at home” concept had been part of a broader, decade-long future-of-healthcare conversation. Chronic conditions with well-defined treatment protocols such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) were successfully being monitored at home to improve outcomes and increase patient satisfaction rates — all at a lower cost than treating patients in hospital.

Frankly, at first the idea of an omniscient, cloud-connected toilet seat seemed a little far fetched, if not downright intrusive. Admittedly, it also lent itself to some fun wordplay at pitch night, but our curiosities were piqued by the concept and its underlying technology. Austin, an avid tinkerer since childhood, was particularly drawn to the challenges involved with building a multi-sensor, low-power connected product that needed to be reliable enough to collect and transmit critical health data. With Datto, Austin had built products to protect a company’s most critical data and systems, and the parallels were intriguing. The RDV team did not make an investment in Nick’s concept that night, but his idea stayed with us.

From Product Concept to Company Building
Now, a little background on an important coincidence in this story. Austin had also attended RIT years earlier. While still a student there, he’d founded Datto in the basement of his dad’s office in his hometown in Connecticut. After successfully bootstrapping Datto by selling data backup services into the SMB market, he took his first institutional investment from General Catalyst in 2013. GC partner Steven Herrod and I took board seats, and with the fresh funding, Austin grew Datto into a suite of data backup, security, and network continuity products sold exclusively through the MSP channel. The business exploded and Austin, appreciating the talent coming out of RIT, built a key engineering and customer service center for Datto there in Upstate New York. Four years on, the company was acquired for more than $1 billion and subsequently went public in 2020 (NYSE: MSP) after Austin had transitioned out of the CEO role.

While Austin was finishing his tenure as CEO of Datto, Nick was proving out his passive cardiovascular monitoring system for patients living with CHF. He’d taken a big step toward commercializing the idea by forming a company called Heart Health Intelligence (HHI), Inc. The two met again and it was clear there was a chance to build a meaningful business around Nick’s life-supporting concept and research. When Nick looked to raise a Series A to build a new category of failsafe, smart, and easy to use health monitoring devices that can collect the data that’s needed to keep people healthy at home, Austin was ready for a new challenge. We jumped at the opportunity with him.

The Casana Leadership Team

With this week’s announcement of a Series A co-led by GC and Outsiders Fund in the company, now known as Casana, will be led by Austin as CEO and Nick as founder and chief scientific officer. The team is perfecting their design and will soon have working devices for testing in the real world. Sorry for the pun, but Casana will bring new meaning to selling technology “seats.” The team is currently working on a plan to seek FDA clearance for The Heart Seat™, which aims to give doctors better data and a finer understanding of their patient’s chronic conditions. I’ve joined the board of directors along with Dr. Jeff Leiden, cardiologist and executive chairman and former CEO of Vertex Pharmaceuticals, who will serve as chairman of the board for Casana.

Healthcare Landscape
Healthcare is undergoing a profound once-in-a-generation shift. Technologists and care providers are partnering in unprecedented ways to bring true innovation to nearly every aspect of the industry. I’ve been privileged to have a front-row seat to watch this playing out in the fight against COVID-19 as a director of Moderna. At GC, we’re seeing it through care delivery platforms like Livongo, Cityblock, Color, and Ro Health; in infrastructure with companies like Commure and SonderMind; in revenue management with Olive; and in health monitoring with breakthrough ideas and technology like Casana.

We’re backing the trend we’re seeing over and over again — the increasing importance of delivering quality care outside of a traditional hospital setting or a doctor’s office. We believe this is more than a situational trend and that there is an opportunity for continued technological innovation and company building here. We’re honored to be able to back Austin for a second time, and I can’t think of a better group than he, Nick, Jeff and the entire Casana team to take on this challenge. With the best of the tech, biomedical, and healthcare worlds coming together, we’re excited to see all that Casana will accomplish, improving patients’ quality of life and, perhaps, even saving some lives.

— Paul Sagan and Team GC