Digital health investors have missed the mark when it comes to harnessing technology to improve health, as it is broadly defined…and required to improve the human condition. Certainly there have been a number of breakthrough investments that have focused on particular conditions like diabetes, and other solutions that have sought to advance whole-person health with a root-cause resolution approach to care. The concept of whole-person or holistic health recognizes the interconnection between physical, mental, and social well-being. For too long, physical and mental health were siloed – and only recently are providers adding mental health screenings into routine appointments to improve patient outcomes. Similarly, the social determinants of health – the nonmedical factors that influence health outcomes – are increasingly being treated as a necessary component of effective care delivery.
However, we rarely see coordination between medical and dental professionals.They use different electronic health record systems, different billing codes and different insurance coverage. But if we believe that whole-person care should be the norm, it’s increasingly clear that medical-dental integration is a necessity.
The Importance of Oral Health
The World Economic Forum recently reported that the lack of investment in oral health has led to a population health crisis, and a high economic burden felt across the entire U.S. health care system. For patients, financial barriers stemming from insufficient insurance coverage or high costs of services have prevented them from seeking oral care for years. Most individuals on Medicare lack dental benefits because traditional Medicare does not include dental coverage. Dental appointments are the number one medical service skipped due to cost, and with growing evidence of oral health’s connection to other areas of the body – neglecting care can lead to other health conditions that require even more expensive treatment, including diabetes, heart disease, Alzheimer’s disease, among others. We need to address these accessibility issues today, starting with regular care appointments.
Bridging the Gap with Technology
Oral health tech solutions play a significant role in bringing care to the patient. By investing in remote care management, companies can empower providers and patients to prioritize oral care as a pathway for chronic disease prevention, and drive cost savings beyond traditional dental care. Innovations like teledentistry, at-home dental services, and mobile dentistry are already showing promise by eliminating the need for long travel days and time taken off from work for appointments. Addressing access barriers with solutions that enable more convenient modes of care delivery are essential to whole-person health because they enable patients to easily receive care (often at more affordable price points), regardless of their location or economic status.
Integrating Medical Treatment to Consolidate Digital Solutions
Platforms that include dental health status enable a more consistent way for clinicians to personalize care plans based on a patients’ overall health profile. With the mouth as the gateway to the rest of the body, integrated care platforms inclusive of oral health make it easier for clinicians to detect and treat medical needs for conditions like respiratory disease, high blood pressure, diabetes, and more.
We are starting to see dental providers kickstart this through their testing protocols, incorporating measurements like blood pressure into oral health evaluations. Non-invasive testing technologies such as salivary diagnostics are also demonstrating potential to help clinicians address risks for chronic disease in a timely manner.
Next-generation medical devices have entered the mix to provide support at the diagnoses stage of care, as well. For instance, wearable health sensors are collecting real-time salivary data that can be shared directly with doctors, helping detect and track risk for health conditions like diabetes or hypertension. There are also solutions in the sleep monitoring space that identify the early signs of obstructive sleep apnea and guide patients to the best treatment pathway, including oral health interventions. Expanding usage of oral appliance therapy can not only improve sleep, but other health-debilitating symptoms caused by sleep deprivation.
By investing in oral health startups as a springboard for medical-dental integration, digital health VCs can set providers free from the technological burden that comes from the balancing act between separate health solutions, allowing them to tap into other care networks and make unique patient recommendations.
Driving Interoperability Through Patient Data Sharing
There has been much said about the need for data interoperability – and oral health data is not an exception, as it is often kept separate from the rest of the medical system. There is a meaningful opportunity to fill in the missing links and foster more seamless connectivity, as a way to incentivize deeper collaboration between payers, providers, and patients in forging medical-dental integration.
Specialty care is often part of the path to holistic health but is daunting for patients who are tasked with collecting and organizing their personal health information. Modern health care providers are poised to change this with care coordination tools that allow dental professionals to easily make specialist referrals and communicate about oral health-linked conditions on the back end. Similarly, clinical decision support systems that are cloud-based allow dentists to review health information all in one place and enable them to easily create in-depth treatment plans that address multiple areas of their health. Innovation boosting interoperability will serve as the glue needed for optimal patient outcomes.
Put Money Where the Mouth is
As the next generation of founders leans into innovation that unifies medical care, it is the prime time for digital health investors to embrace oral health as integral to overall health. With a shifted mindset, VCs will not only lay the groundwork for a healthier population but forge a new standard for medical cohesiveness that truly puts patients at the center of their care.
Denise Marks
Denise W. Marks serves as chief financial officer, executive vice president of CareQuest Institute for Oral Health. As a member of the executive leadership team, Denise plays an integral role ensuring the financial health and operational success of the organization.
Denise has more than 25 years of experience in senior finance and operations roles. Before joining CareQuest Institute, Denise was chief administrative partner and chief compliance officer at SV Health Investors, a global investment firm focused on the health care sector. Prior to that, Denise held finance, operations, and compliance positions at CMGI, @Ventures, and PriceWaterhouseCoopers.
Lee Shapiro
Lee Shapiro is Managing Partner at 7wireVentures, an investment firm he co-founded over a decade ago. He also served as Chief Financial Officer of Livongo Health until November 2020. Previously he was President of Allscripts from 2001 until the end of 2012. His leadership was integral in the execution of over $4B in mergers, acquisitions, and financings. His responsibilities included the company’s strategy, international operations, business development and partnerships, legal, government relations, and health plan initiatives.
Prior to stepping in as CFO of Livongo and leading its 2019 IPO, Lee served on the board of the company since its launch, chaired the audit committee, and served as a member of its compensation committee. During his tenure as CFO, Livongo also had a successful secondary offering, raised $550M in convertible debt and entered into an agreement to merge at the highest valuation, $18.5B, of any healthcare technology company, based on revenue multiples. The price of $159 per share was over six times the price of Livongo’s shares at the time of its IPO, just 12 months earlier.
Lee serves on the board of Senior Connect, a special purpose acquisition company, served on the board of directors (audit committee and nominating and governance committee) of Medidata Solutions until its sale in 2019 to Dassault Systemes. He also served on the board of Tivity Health until May 2020. There, Lee chaired the audit committee and also served on the compensation committee. In January, 2021, Lee joined the board of Click Therapeutics. He also serves on the board and committees of various 7wireVentures portfolio companies.
For the past 4 years, Lee has been a member of the National Board of Directors of the American Heart Association, where he is currently Treasurer, has chaired the audit committee, and serves on the business operations committee. He has also been part of Strategic Goal Task Forces.
He is a co-founder and board member of The World Innovation Network, the advisory committee of the University of Chicago Innovation Fund, and has served on the Samsung Digital Health Advisory Board, and Qualcomm Life Advisory Board. Based on his industry experience, Lee is a frequent speaker at widely attended industry conferences and is a published contributor to the Forbes Business Council. He has also served as an officer and director of the Gastro-Intestinal Research Foundation (GIRF).
