Nov 14

The nomination process for the 2015 Seattle Health Innovator of the year is open! Now what?

The Seattle Health Innovator Awards are intended as an opportunity to recognize those in the community who are pushing the envelope in health innovation. It’s about asking someone you were inspired by at an event or at a meeting to coffee, to understand more about what they are working on. It’s about acknowledging the work of someone you collaborated with. Ultimately, it’s about building the health innovation community in the Puget Sound area.  Nominate here.

In order to resolve a few commonly asked questions regarding the nomination process, please refer below. 

Q: Does the nomination have to be for something done just in 2015?

Not necessarily – we all recognize innovation can take years of work.

Q: Help! I’m stuck on the nomination form!

Consider using the nomination as an opportunity to go to lunch with someone you are interested in talking to or  someone who inspired you to think a little differently.

Q: Can I nominate a co-worker?

Definitely – in fact, we encourage it! We don’t always have the opportunity to recognize the work of our teams to an outside audience.

Q: As a leader at a small startup, can I nominate anyone on my team?

Yes! Especially in the startup environment, we don’t always have the means to recognize those on our team that drive innovation. This is a great opportunity to do so.


Oct 16

Is the ‘Seattle Freeze” Real?

A common experience among people, especially those new to Seattle, is known as the “Seattle Freeze”. This is what it feels like. You go to a networking event and meet some incredibly interesting, friendly, and apparently receptive people. You follow-up with a successful LinkedIn connection. You feel excited that you’ve found new friends and colleagues. Yet, afterwards, when it comes to building relationships and getting to know people on a more personal level, that is proving more difficult. Would you agree?

This is the 5th in a series about Seattle’s prospects as a health innovation hub from the perspective of health startups. In prior posts we have looked at these criteria:

  • Cost of doing business – Seattle ranks in the middle.
  • Financial capital – Seattle is lowest of the comparison cities in the amount invested in healthcare; 30% of angels are specifically associated with healthcare.
  • Human capital –Highest ranked city in our study with the largest share of college grads[i]; hub for technology and sciences.
  • Health Institutions– Seattle has world-class academic and research institutions, like the comparison cities, but lags Boston, New York, and San Francisco in the amount of funding. Seattle’s healthcare delivery systems are seen as relatively complacent and risk averse when it comes to working with local health startups.
  • Regional culture- this post.

Perhaps one of the more important criteria in deciding where to locate a new venture is a startup-friendly culture. Being in a location where startups thrive and can support each other can be a powerful advantage. How open and friendly is the startup culture in the metro area?  Is it cut-throat competitive? How likely is it that other companies will poach your team? Typically startup entrepreneurs need help or advice when building their company. Quality of life for our teams is critical to being able to recruit the best people. Despite the media hype around startups, it is not all about late night sprints and cold pizza. Living in a beautiful area with diverse cultural resources (museums, concerts, parks) and the ability to maintain a healthy lifestyle and to build relationships all contribute to building a sustainable team and an amazing company.

To answer these and other questions we worked with Amy Young, of ZenCloud Consulting, to conduct a survey of the membership of the Seattle Health Innovators group. With 120 responses we have some interesting findings.



Overall, most Seattle area healthcare innovators feel the community is collaborative, open and trusting. This is an overwhelming endorsement of the quality of the health innovation community here, and is possibly a differentiator of Seattle from socially colder and more established communities. We did not survey the comparison cities so this article focuses only on Seattle.

Start-up vs Non Start-up

By “health startup” we mean new ventures building products and services in the health sector. Our sample includes all stages of startups, from self-funded/bootstrap through angel, seed, A,and B rounds. About half of the survey sample works in startups, the other half in non-startup organizations including healthcare delivery organizations, payers, consulting firms, and research/academic organizations. While the majority in both segments finds Seattle a trusting culture, we found a difference in responses based on where people worked. In Seattle, those who are working for a health industry start-up are more likely to agree Seattle is an open and trusting place to work, 73% vs 58%.


Yet when it comes to meeting and getting to know people in Seattle, health innovator start-ups are feeling the “freeze”(62%), to a greater extent than those in non-start-ups (55%).


This experience is by no means universal- more than a third of the respondents disagreed that the so-called “freeze” is real. We suspect there are many variables contributing to this experience, but it seems to be felt by enough people to acknowledge as a socially experienced fact. It is helpful to understand this desire for more personal connection so that we can design experiences that facilitate building on what could become one of the region’s most competitive advantages.

Assessing our Impact and our Competitive Advantage

We will share more insights from our Startup Location Attractiveness survey at the November 4th Seattle Health Innovation Forum:Assessing our Impact and our Competitive Advantage. At this event we will also learn about findings from the new release of the WA State HealthCare Sector Economic Development Report, sponsored by the Cambia Grove, the Washington Biotech and Biomedical Association, and the WA Department of Commerce. This will lead to a town-hall discussion of what we can do to improve the competitiveness of the health innovation community in our region, Please join us on Nov 4th at 5:30pm in Seattle to help thaw the “Seattle Freeze” and to connect with others interested in our region’s health innovation community.





Amy Young, President ZenCoud Consulting, moved to Seattle from Anchorage in 2014. She joined the Health Innovators Research team’s Startup Location Attractiveness Study in March 2015.


Ed Butler, a co-founder of Videris Health, moved to Seattle in 2001. In 2013 he organized the Seattle Health Innovation Forum, a grass-roots community of people interested in transforming health and healthcare.


Aug 30

Health Startup Location Attractiveness Study: Institutions

This is the 4th in a series of posts comparing Seattle with other health innovation clusters. We are comparing several cities on a set of criteria of interest to healthcare startups. Katie Smolnycki is a life sciences market consultant who relocated to Seattle in early 2015 and has been a member of the Health Innovator research team. Her post below examines the institutions that can contribute to a vibrant ecosystem for health innovation companies.

Scholarship Weekend February 22, 2014 Artisan Works Photographer: Annette Dragon

By Katie Smolnycki

Continuing on our journey of exploring healthcare innovation hubs, we will examine the various healthcare institutions in  Boston, Chicago, New York City, San Francisco, and Seattle. The comparison criteria in this series include the following:

  • Cost of doing business – Seattle ranks in the middle.
  • Financial capital – Seattle is lowest of the comparison cities in the amount invested in healthcare; 30% of angels are specifically associated with healthcare.
  • Human capital –Highest ranked city in our study with the largest share of college grads[i]; hub for technology and sciences.
  • Health Institutions- this post.
  • Regional culture – to be posted in September.

To explore the institutions in each of these centers of interest, we decided to focus on hospitals, payers, NIH funding, and research institutions.


A competitive healthcare delivery market is favorable for innovators because these systems need to find ways to gain market share. How competitive is Seattle’s healthcare delivery market?  To explore this we looked at the American Hospital Directory, which provides statistics for non-federal, short-term, and acute care hospitals in each state with data collected from each hospital’s most recent Medicare cost report[ii]. Compared with the other health innovation hubs, Seattle has the fewest hospitals and the lowest ratio of staffed beds. San Francisco and Boston have approximately the same number of hospitals and the most staffed beds per their population, with around 300 people per one staffed bed.


Numhospitalsand pop

This suggests that the competitive pressures on Seattle’s hospital systems may be less intense than those cities with higher per capita beds. Concentration of ownership using the Herfindahl-Hirschman Index (HHI) is another method of assessing market competitiveness. The analysis below by David Cutler and Fiona Morton published in the Journal of the American Medical Association in 2013 compares the HHI across the US for hospital referral regions.

Screen Shot 2015-08-28 at 2.19.38 PM

Seattle’s hospital referral region is moderately concentrated. This is similar to the markets in Boston, San Francisco, Chicago, and New York City. This suggests that the healthcare delivery market in Seattle is no more competitive, and is perhaps less competitive than the other hubs in our comparison set.

Payer Organizations

According to a study published by National Association of Insurance Commissioners (NAIC), the top large group insurance companies by market share (ranked largest to smallest) are: United Health Group, Wellpoint Inc. Group, Kaiser Foundation Group, Humana Group, Aetna Group, HCSC Group, Cigna Health Group, Highmark Group, Coventry Corp. Group, and HIP Insurance Group. At least one of top three large group insurers of NY, CA and IL all are represented in the NAIC Top Health Insurance Company report; whereas a main insurer for MA (BCBS of Mass) comes in at 23 and Cambia Health Solutions (the holding company for Regence BlueShield in WA, OR, UT, ID), comes in at 25. Seattle is not the headquarters of a single large national health insurance carrier. Our two Blue carriers, Premera, and Cambia Health Solutions, serve several western states but are not national entities. Group Health Cooperative is Washington-only.

Health Insurers

Of the top 10 health insurance companies  in the US, one is is headquartered in Chicago, two are in the Bay Area, and three are within commuting distance of the New York Metro area. This suggests that Seattle’s payer community may not have had the resources to provide a launchpad for startups, at least until recently.

Cambia Health Solutions is becoming an important player in the health innovation community in Seattle. Cambia Grove opened in the spring of 2015 providing a community space to bring innovators and entrepreneurs together with stakeholders to find innovative solutions from challenges in health care. They offer a variety of programming geared to helping entrepreneurs connect with the other players in the industry. One program hosted by Cambia Grove in July was a Reverse Pitch event which Evergreen Hospital pitched their problems to innovators in the digital health community.[iii].

NIH Research Funding

Funding of research grants by the NIH is an important part to furthering research in higher education centers, hospitals, and non-profits and for-profits research institutions. In FY2015, the NIH invested nearly $30.3 billion in medical research which allows investigators to come up with new ideas that can help change the world. This was $211 million above FY2014 budget, a 0.7% increase in funding, while FY2016 funding is expected to be $31.3 billion. The NIH main themes for driving discovery and innovation in FY 2015 funding were: today’s basic science for tomorrow’s breakthroughs, precision medicine, big opportunities in big data, and nurturing talent and innovation.


Boston received the most NIH research funding in both FY 2014 and 2015. Boston hospitals receive the most funding from the NIH for hospital research having five out of the top six top NIH funded hospitals[iv]. Hospital funding in Boston makes up almost 50% of the NIH funding received in the area. In the other regions, hospital based NIH funding makes up to 5% of the region’s NIH funds. For medical school NIH funding, NYC area schools (12 schools) receive $1.1 billion in research with Boston and Chicago medical schools (5 and 6 schools respectively) receiving over $400 million of medical school funding. Seattle only has one medical school but receives over $300 million in funding putting the University of Washington in the top five for funding in both FY 2014 and FY 2015.

Of the NIH funding that came to Washington in 2014, the University of Washington received $437 million, followed by Fred Hutch at $222 million, representing 75% of the total. This highlights the crucial importance of the UW and the Hutch in Seattle’s health innovation ecosystem. This ratio is similar to each of the other cities, looking at the top 50 organizations receiving NIH funding.

For more information on financial capital in these regions, please see our financial capital blog post

Life Science and Biotech Institutions

Washington State is home to 567 life science companies and research organizations with a majority of those located in the Greater Seattle area. There are 274 medical device companies, 182 biopharma companies and 92 nonprofit research organizations or academic research centers[v]. These companies combined add $11.4 billion to Washington’s GDP and represent the 5th largest employment sector, with a 12% growth in jobs from 2007 – 2013.

Out of the top 15 pharma companies by 2014 revenue[vi], Seattle is only has ties to three: Sanofi (some manufacturing), Gilead (inflammation/respiratory and hematology/oncology therapeutic areas and clinical research), and Bristol Myers Squibb (Zymogenetics ). In June 2015, Bristol Myers Squibb announced the relocation of the 40 Seattle based research and development jobs to San Francisco, leaving their early manufacturing group (approximately 120 employees) in Seattle[vii]. Amgen had a presence is Seattle until this past year when they closed down their facilities to cut costs. Seattle’s biotech sector is predominately small, early stage companies and some large nonprofit research institutions. For example Juno Therapeutics, an immunotherapeutics company, went public in December 2014 with $265 million IPO and a valuation of more than $3 billion. Juno recently announced a partnership with Celgene for $1 billion to work on the development and commercialization for immunotherapies[viii]. Presage Biosciences, an oncology start-up in Seattle that works to use human efficacy data earlier in drug development, announced August 20, 2015 that they received a strategic undisclosed investment from the venture capital arm of Takeda Pharmaceutical[ix]. About half of Washington’s life science companies are medical device companies, with Philips Healthcare being the largest medical device company located in the Greater Seattle area. Despite Seattle’s lack of large biopharma and medical device companies, there is still potential for collaboration with larger companies.

Seattle’s strong technology industry can help foster growth in the digital health space, as well as innovation in medical devices.  In 2014, there was $1.1 billion in transactions across Washington State including IPOs, M&A activity, and venture equity and as of August 2015, there have been $2.5 billion in life science transactions, which is expected to reach $3 billion by the end of 2015. Transactions are approximately 38% medical technology, 31% pharmaceuticals, 23% health IT and 8% other[xi].

Boston, New York City, and San Francisco are home to many of the top biopharma and medical device companies (Johnson and Johnson, Novartis, Roche, Merck, GlaxoSmithKline, AstraZeneca, Bayer, Amgen, and Eli Lilly) and smaller startup companies as well. Chicago is home to fewer top healthcare companies than Boston, NYC, and the Bay Area but is headquarters for few larger companies, such as Abbott Laboratories (AbbVie), Baxter, Takeda (US headquarters), Walgreens, and Allscripts.

In Summary

The presence of institutions with both the resources and the business drivers to innovate are favorable to health startups. Seattle’s position relative to the comparison cities is not as strong as it could be but still offers ample opportunities for health startups:

1. The healthcare delivery system market in Seattle is similarly concentrated as other cities but the per capita staffed bed ratio suggests that hospital systems here may still lack the existential competitiveness of other cities and may not yet be ready to look outside to the startup community for innovative approaches.

2. The health insurance industry in the Northwest has not been a national launchpad for startups.The recent activities of Cambia Health Solutions is a positive development.

3. NIH funding in Seattle lags Boston, New York, and San Francisco but is still respectable. This provides a critical funding stream and keeps Seattle in the running as an attractive location for health startups. This is mostly due to the influence of the UW and Fred Hutch in attracting federal research funds and spinning off new companies.

4. Seattle has a vibrant community of life sciences organizations that are not as  large as those found in Boston and other life sciences hubs. The economic impact of this sector has been strong, with 12% job growth 2007-2013, as the 5th largest employment sector in the state.












Aug 11

Seattle as a Healthcare Hub: Finding Talent

According to a study from the University of Washington, “Humans get smart by being around other smart people.” The study describes this trait as the way in which Seattle is currently transforming itself into a hub of human capital, as educated individuals with talent and creativity have been moving into the city for decades. This influx of knowledgeable and skilled individuals is an absolute plus for those interested in achieving innovation and change.

This is the third in a series of blog posts in which we are contrasting Seattle’s health startup environment with other leading hubs for health and life science innovation. Each of these posts focuses on a different location evaluation criterion, including the cost of doing business, the availability of investment, and  this week it’s about the availability of talent-  the human capital of startups.

The purpose of this series is personal, rather than to create yet one more “top 5” lists. We’re both working on our digital health startups and we are open to locating anywhere in the world that helps us be more successful. While we’re fond of Seattle, our mission is not to promote Seattle. It’s about succeeding in our startups, both of which have co-founders in other major health hubs.

IMG_7319 2(Pictured: Sean Bell of Arrivale discusses scientific wellness at the Seattle Health Innovation Forum on Precision Medicine, July 2015)

Innovation Happens at the Edges

Just as sparks fly between positive and negatively charged bodies, the juxtaposition of disciplines and industries can produce new insights leading to innovative breakthroughs. The Pacific Northwest in the past 20 years has attracted talent to fuel its need for highly skilled, creative people in these sectors:

  • Life sciences
  • Software development
  • eCommerce and Cloud services
  • Aerospace

Seattle is listed  as one of the top 10 life sciences clusters in the United States, according to the 2014 survey by JLL’s Life Sciences group. According to the Washington Biotechnical and Biomedical Association, 567 life science companies and over 34,000 individuals are directly employed in this segment averaging over $83,000 in salaries (compared with an average $53k in WA).

While that is good news for Seattle, it is worth observing that Boston is #1,  San Francisco is #2, and San Diego is #3, Raleigh/Durahm 4th, and the New York/NewJersey megalopolis 5th in that same list of life science clusters. Seattle ranks only 10th on that list. The industrial diversity in Seattle is competitive with these cities, but is not unique. Seattle has unique qualities that we’ll get to in subsequent posts, and is competitive, if not leading, in accessibility of world-class human talent.

Washington state has 90,000 software developers, which are some of the highest paid jobs in the state. Tech employees have a median salary between $100,000 and $140,000 per year, according to the a recent study by the Washington Technology Industry Association.

The Seattle tech knowledge-base has been growing via significant hiring by such new economy leaders as Amazon, Facebook, Google, Tableau, Expedia, Juno Therapeutics, and others. The major players in the rapidly growing cloud computing industry are concentrated in the Pacific Northwest, with Microsoft, Google, and Amazon’s cloud technologists all located in the metro Seattle area, and with low-cost, clean hydro-electric powered data centers in Eastern Washington. Greg Gottesman, of the Madrona Venture Group was quoted in Geekwire as saying “the Pacific Northwest has had an incredible influx of engineers, some to startups and many to bolster the engineering offices of companies that aren’t headquartered here like Google and Facebook,” said Gottesman. “If you believe as I do that top technical talent is the lifeblood of successful startups, I think the trends are very favorable for our region over the next decade.”

The Aerospace industry is a long-time anchor of Pacific Northwest industry. While Boeing has moved its headquarters to Chicago and many of its manufacturing and engineering functions to other parts of the world, others are stepping in, such as Esterline Technologies, Crane Aerospace, Aerojet, Electropact, and others. While the relevance of these industries to health innovation may at first appear remote, the presence of such advanced high-tech companies creates a population of well-insured and educated patients. Healthcare delivery systems in most metro areas must compete to improve quality and reduce costs for self-insured employers.In Seattle this results in fierce competition among delivery systems to maintain an edge. Greg Marchand, Director of Benefits Policy and Strategy for the Boeing Company at a Health Collaborative forum in December 2014. He described their efforts to better manage their $2 billion in annual employee healthcare expenses. The Boeing Accountable Care Organization has created a more competitive model and Boeing has also invested in their own health analytics group to measure improvements.

Health Meetups Compared

We’re seeing this cross-industry innovation interest in the membership growth of the Seattle Health Innovation Meetup, founded two years ago.  The group has experienced net growth of 63% in the last 7 months, currently around 850 members, with event attendance between 80-100.

Screen Shot 2015-08-11 at 11.07.43 AM

The membership growth in the Seattle Health Innovators can be a useful proxy for the engagement of the community supporting health innovation. While larger than the Boston Health 2.0 chapter, we are still smaller than similar groups in other cities in absolute numbers.  The San Francisco-based Health Technology Forum is 2 years older and has 3,439 members, of whom around 150 attend the meetings. The New York City Health 2.0 chapter, founded 7 years ago, has 4,542 members (events draw 73-150).

High in Education Capital

Seattle is also one of the top ten US cities with the largest population of college graduates, making it a destination for educated individuals who are more likely to produce new ideas in every field (CityLab). The city also has a considerable community of individuals going to school in health-related fields The  University of Washington’s Seattle campus had an enrollment of 44,158 in 2014, with 240 new students admitted to its reputable medical program every year, and “the Department of Medicine is comprised of 14 Divisions” for hundreds of students working to receive degrees in the field (University of Washington). We also have Seattle University (7,560 students), Seattle Pacific University (3,891) and a variety of community colleges offering health and technology related training.

City-wide Analysis: Seattle and Health Care

Seattle may not yet be at the level of some the other major cities that have become innovation centers for health and medical care, but it is on its way. Advisors and educated individuals inhabit the city while a large population of young, health-conscious people also flock there. It is beneficial to remember Seattle’s potential and for those who are hoping to create and invent new possibilities in the field to consider making Seattle their creative nucleus. More than anything else, the city’s human capital is especially well suited for this type of work, making it a perfect place for innovators, dreamers, and hard workers to create the next big change in healthcare.


Density matters.  Seattle is compressed between Lake Washington on the east and Puget Sound, making it a walkable downtown, similar in that respect to San Francisco and New York City, only smaller. The high technology companies east-of-Lake-Washington in the communities of Bellevue, Kirkland and Redmond are within a 30-40 minute bus ride from downtown Seattle of the U District.

Considering Making a Move to a Health Innovation Capital?

Seattle’s health startup community has access to world-class human talent in one of the major hubs of technology and health innovation. If you are looking for a way to share new and big ideas with other like-minded individuals, consider the Emerald City. Our next blog posts in this series will compare the health institutions in the area with other cities, and the culture of innovation.


Angela Hong, CEO Healthy Beeps

Angela Hong

Ed Butler, CEO, Videris Health


Jul 24

Seattle Health Innovation Forum on Precision Medicine July 29th

In the July 29th Health Innovation Forum we’ll hear from leaders from two Seattle-based firms on the forefront of this revolutionary approach to health.  Precision Medicine is defined by the NIH as “ an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. “ 

This is the summer networking event of the Seattle Health Innovators, an independent grass-roots community of people interested in transforming health and health care. RSVP here. There is a $10 registration fee to cover the catering of hors d’oeuvres and beverages.

Our speakers will describe their work, followed by an interactive dialog with the audience. We will talk about opportunities at the intersection of life sciences with educated and engaged citizens/patients.

Sean Bell, MBA, is the Chief Business Officer for Arivale, a startup founded by Lee Hood. As reported in Geekwire, Arivale describes itself as “a revolutionary new wellness company combining cutting-edge science, an intimate and unprecedented view of your body, and personalized coaching to help you achieve your unique wellness potential”.

Sean managed the day to day operations of the 100K Project of the Institute of Systems Biology until it became Arivale. It creates an “N-of-1” health data cloud based on an individual’s genomics, metabolomics, microbiome, and “quantified self” metrics. Prior to working with ISB Sean held a senior leadership role in Alere Wellbeing.

Michael Kellen, PhD., leads the technology development team for Sage Bionetworks, a non-profit biomedical research organization founded by Stephen Friend.  Sage Bionetworks is dedicated to developing data-driven methods to improve human health, and has a strong focus on building open systems and networks of individuals that can collaboratively solve complex scientific problems.  They have recently established a program to gather real-time medical information from citizen/patient communities through mobile devices, participating as a launch partner for Research Kit with Apple and other medical centers.

Michael completed a PhD at the UW in 2002 with a focus on computational biology and helped start local bioinformatics company Teranode before joining Sage Bionetworks. His work centers on how technological advances in technology areas such as smartphones and cloud computing can accelerate biomedical research.


5:30-6:00 Networking, food and beverages

6:00-6:15 Community Announcements

6:15-7:00 Precision Medicine Speakers and Discussion

7:00-7:30 Networking, individual Q&A with speakers


The venue is at the Cambia Grove, 1800 9th Avenue, 2nd floor, Seattle, WA 98101.

To RSVP please click here:


Jun 29

Where are the best cities for health startups to get financial capital?



Angela Hong


By Angela Hong, June 29, 2015

This post is part of a series that compares Seattle with other cites using these criteria for what it takes for an area to become a health innovation hub:

  • Cost of doing business / regulatory complexity
  • Talent availability
  • Financial capital
  • Health institutions one might work with
  • Regional culture / quality of life

Our last post compared the relative cost of doing business in Seattle. Seattle falls squarely in the middle compared to the other cities in our sample (Boston, Chicago, NYC, and SF). In this article, we’ll explore how Seattle fares in financial prowess.

In 2012, Seattle was ranked 9th in the top 10 best U.S. cities for business by ThinkAdvisor and also named the “29th most competitive city in the world.” In 2014, it jumped to 4th on Forbes‘ list of “best places to launch a startup.” While many factors make a city favorable to entrepreneurs looking to invest in new health products, financial capital is one of the most important. Its presence in Seattle is helping to make the city an up-and-coming hub for innovation, especially in the field of health.

Who’s Investing?

Compared to other large cities, Seattle is becoming more well-known for its ability to draw ingenuity through financial capital. Exhibit A below shows that the number of angel investors in the city rival those of other major metropolitan areas: such as New York City, San Francisco, Chicago, and Boston. While New York and San Francisco currently outnumber most cities in local angels—at 1221 and 2163, respectively—Boston’s 397 seems reachable for Seattle. The Emerald City, as shown in this Angel List report, has 277 individuals who provide start-up capital for businesses, and this number is even greater than that of Chicago, which currently stands at 271.

This places Seattle in the running with major healthcare innovation hubs. And if the city’s number of investors begins to increase, a rise in healthcare-specific investors at the current rate would put Seattle level with well-established cities in terms of financial capital available for healthcare-related businesses.

Angel compare

Exhibit A: Angel Investor Comparison

Follow the Money

According to this Angel List data, eighty million dollars were invested by Seattle’s angels investing in health startups.This is lower than the other cities in our survey. The highest amount is spent in San Francisco at $1.04 billion and the second lowest is Chicago at $150 million.

Seattle: Financial Capital Overview

While Seattle has many fine qualities which make it an ideal business start-up city, it may not be thought of as a top health innovation hub in the way New York City, San Francisco, Boston, and Chicago are currently perceived. However, with rising numbers of angel investors interested in funding health-related businesses and the amount of financial capital for healthcare innovations already in motion, the city and its resources should be considered by those looking to make a difference in the medical field via creating new products, ideas, and business.


About the author

Angela Hong is a co-founder and CEO of Healthy Beeps She moved to Seattle from Boston in 2014 and is leading the Health Startup Location Attractiveness project.

Jun 17

Where are the best cities for Health Startups?

Deciding where to locate a health startup company often comes down to one question: where are you? Yes, there’s no place like home, but is this the best way to geographically locate your fledgling enterprise? With the odds of founding a successful health startup already stacked against you, why not pick a place where your chances are a little better than they might otherwise be?

As described in our January 2015 and March 2015 posts, the Health Innovators are conducting a quick, unscientific, but structured comparison of 5 cities: Seattle, San Francisco, Chicago, New York City, and Boston along several variables:

  1. Cost of doing business / regulatory complexity
  2. Talent availability
  3. Financial capital
  4. Health institutions one might work with
  5. Regional culture / quality of life

Please participate in this study by taking our Health Innovation Location Attractiveness survey.

Today’s post focuses on the cost of doing business in each of these comparison cities. Future articles will explore the other 4 criteria.

After reviewing state and local government websites for the costs of setting up new companies, we found minor differences in the fee schedules for business licenses and formation of business entities. We found that the complexity of the corporate registration process and business licensing did vary significantly, with Seattle as the easiest, and New York City and San Francisco as the most baffling. California’s $800/year tax on LLC’s is certainly a disincentive, and New York’s antiquated requirement to publish professional LLC formation announcements in 2 newspapers can cost upwards to $2,000.

Office space is another area where we found some differences in our benchmark cities. Using the monthly rate for a private office in a co-working space as a proxy for office space generally we found that an office in Seattle was $100 to $200/month less costly than the comparison cities. A private office at We-Work in Seattle is $500/month, and is $700/month in New York City and San Francisco.

cowork cost

That, of course, raises a more personal question- how much income does one need to live in these cities? As a proxy for cost of living we used the CNN Money Cost of Living Calculator.

cost of living

For the ease of comparison, let’s assume we pay a software engineer $100,000 in Seattle. For an equivalent lifestyle in Chicago, that would only require $92,000. In Boston, $108,000, San Francisco it takes $131,000, and in New York City it would require $175,000 for the same lifestyle that $100,000 affords in Seattle.

Finally, we looked at the KPMG 2014 Competitive Alternatives Study index for comparing the overall cost of doing business. All 5 of our benchmark cities are in the top 10 most expensive cities in which to do business.


According to this analysis, Seattle (101.4) is right in the middle, roughly tied with Boston (101.1), and significantly more than Chicago (99.1). Not surprisingly, New York City (103.6) and San Francisco (104.2) are nearly tied for the most expensive places to do business not only of these 5 comparison cities, but of all 31 US cities over 2 million in population. For comparison, the least expensive city for doing business in this KPMG report was Atlanta (94.7). Perhaps in future comparisons we could include Atlanta, Washington/Baltimore, and San Diego as contenders.

So who wins? It’s not just about the cost of doing business or the hassles of setting up a company. The other factors- human talent, financial resources, startup culture/quality of life, and health institutions with whom startups can collaborate and pilot their innovations will all be reviewed in upcoming posts. Stay tuned! Let us know what you think in the Health Innovation Startup Location Survey!



Ed Butler

CEO, Videris Health LLC

May 06

Population Health Management Innovation Forum

The June 2, 2015 Seattle Health Innovation Meetup will focus on Population Health Management Innovation and will be held at the Cambia Grove in downtown Seattle from 5:30-8:00.

So what is Population Health Management (PHM), and how is innovation driving improvements in its practice?

PHM can be defined as managing the health outcomes of a group of individuals, where medical care is only one of many factors that affect those outcomes. Other factors include public health interventions, aspects of the social environment (income, education, employment, social support, and culture) and of the physical environment (urban design, clean air and water), genetics, and individual behavior.

At the provider level, the Care Continuum Alliance has proposed defining PHM as having three core components:

  1. Central care delivery and leadership roles of the primary care physician
  2. Critical importance of patient activation, involvement and personal responsibility
  3. Patient focus and capacity expansion of care coordination provided through wellness, disease and chronic care management programs.

The Institute for Health Technology Transformation (iHT2) outlines PHM principles and best practices as:

  • Planning for population health
  • Data collection, storage, and management
  • Population monitoring and stratification
  • Patient engagement
  • Team-based interventions
  • Outcomes measurement


5:30 – 6:00                Networking, food, refreshments

6:00 – 6:15                Community announcements

6:15 – 6:30                Key Note: PHM and Innovation

Speaker: Wellesley Chapman, MD, Group Health Medical Director, Innovation & Development

 6:15 – 7:30                Moderated Panel discussion and audience Q&A


  • Wellesley Chapman, MD, Group Health Medical Director, Innovation & Development
  • Angela Marith, Group Health Director, Population Health Management
  • Martin Levine, MD, Iora Primary Care Medical Director
  • Shawn West, MD, Premera Medical Director of Provider Engagement

Topic: How is PHM being performed and what innovations, current or prospective, are needed to improve its practice?

7:30 – 8:00          Networking


Event Registration

We hope you can attend and we encourage you to bring your colleagues. There is a $10 registration fee to cover our costs for food and beverages (refundable up to 1 day before the event). Please RSVP at this link if you can attend, so that we can place the catering order. We look forward to seeing you at the Cambia Grove!

Population Health Management Innovation Forum Planning Team:

  • Kathryn Brown
  • Scott Kennedy
  • Chelsea Steinborn
  • Randy Wise



Apr 08

Regulatory monsters like to eat new biotech companies

The April Seattle Health Innovation Forum features networking at the University of Washington’s CoMotion Incubator with recent UW biotech spin-off companies and members of the Seattle health innovation community.

Regulatory monsters like to eat new biotech companies

Thursday, Apr 16, 2015, 5:30 PM

CoMotion Incubator, Fluke Hall,Suite 300
4000 Mason Road Seattle, WA

59 Health Innovators Attending

Health startups increasingly combine digital health, wearable/implantable biotech devices, and pharmaceutical-relevant data. Having a regulatory strategy is no longer just a “nice-to-have” for people working to transform healthcare. Join University of Washington CoMotion (formerly known as the Center for Commercialization, or C4C) and UW Profession…

Check out this Meetup →

This is a great opportunity for Seattle-based health startups and others interested in health innovation to meet and connect with startups and other resources at the UW. We’re all trying to break down the silos, so please join us.

Panelists will include executives from 3 companies that recently spun out of UW’s CoMotion Incubator: Deurion, Stasys Medical, and M3 Biotechnology. It will also include regulatory experts who will provide insight and context for companies starting down that pathway.

The agenda will feature networking prior to and after the panel discussion.  There is no charge for this event but an RSVP is required at this link so that we know who to expect and can order refreshments.


Mar 12

Where are the hottest health innovation cities?

Angela Hong briefs the Seattle Telehealth Forum on the Location Attractiveness Survey, March 5 2015.


We, Angela Hong and Ed Butler, are co-founders of separate early-stage digital health startups and as a project of the Seattle Health Innovation meetup group, we are conducting a “location attractiveness” study to help determine where our new companies will be based. Yes, we love Seattle, but we want to be objective about it.

This is an exciting time to be in this field. The decision as to where to locate our early stage operations is not easy. We would like to take a systematic look at the most attractive metropolitan areas in the US for establishing and growing a new digital health startup. We have just begun this process and will provide updates via this blog on our progress. Where do you think the hottest health innovation cities are?  We intend to find out.

With digital health investments reaching $4.1 billion in 2014, there is no question that the healthcare sector is ripe with opportunity. Unlike the glacial pace of change in health reimbursement and big-iron electronic health record systems, the 2014 spike in digital health investment is new and it is rapid. The top six categories, representing 44% of 2014 digital health investment are analytics/big data, healthcare consumer engagement, digital medical devices, telemedicine, personalized medicine, and population health management.

This study is being conducted from the standpoint of early stage digital health startup entrepreneurs. While we have worked within large healthcare organizations, consulting firms, and health IT vendors, we’ve learned to appreciate the difference between what is relevant for a big company and a startup. One of the first tasks we set for ourselves was to identify the criteria to use for assessing whether a city would be a good place to start a digital health venture.


      Angela Hong, Chelsea Steinborn, Ed Butler at the Seattle Health Innovation Forum on Telehealth

The criteria we have decided to use to objectively assess different metro areas for suitability are as follows: regulatory environment, talent, financial capital, institutions and the regional culture.

Regulatory Environment: In order for entrepreneurs to want to incorporate or even set up shop in a particular location, the ease of forming the business is important. How hard and expensive is it to form a company? Are there any state or local laws that make it easier or harder to build a digital health product? Is this a location where we have to spend more of our precious startup funds on lawyers?

Talent: Startups cannot compete head to head with large companies on salaries, benefits, and, arguably, job security. It takes a certain mindset to offset the risks and low salaries of startups with the opportunities to work on something truly meaningful, and to have a chance of a windfall when the successful exit event occurs. It takes a certain population density to create a critical mass of  skilled designers, engineers, health professionals, behavioral and life science researchers, marketing, sales professionals who are ready for this kind of a ride. Diversity is also crucially important in building cohesive and productive teams.

Financial Capital: Like most other types of startups, having access to financial capital whether it’s via venture capital or the angel community is extremely important. Unlike other industries, healthcare administration is inherently a harder industry to understand due to complex regulation and legacy institutions. The accessibility of investors whose investment strategies include the health industry is a rare resource and could make a difference in startup location attractiveness. It’s not just the money- we need savvy investors with whom we can gain market insights and key connections. Being 30 minutes away from a face to face meeting reduces friction and accelerates progress and accountability.

Institutions: Most healthcare startups need to form development partnerships and early adopter agreements with   large health organizations for testing or piloting their product. Such institutions may include hospitals, payer organizations, pharmaceuticals, and life science research institutions. This is a big opportunity but also can be a pain point for many startups because of the predilections of too many institutional decision-makers to work only with “safe” name-brand corporate suppliers.

Regional Culture: Perhaps one of the more important criteria is a startup-friendly culture. Being in a location where startups thrive and can support each other can be a powerful advantage. How open and friendly is the startup culture in the metro area?  Is it cut-throat competitive? How likely is it that other companies will poach your team? Typically startup entrepreneurs need help or advice when building their company and what better way to get help or advice if your neighbor sitting next to you at the coffee shop can provide that guidance. Quality of life for our teams is critical to being able to recruit the best people. Despite the hype around startups, it is not all about late night sprints and cold pizza. Living in a beautiful area with diverse cultural resources (museums, concerts, parks) and the ability to maintain a healthy lifestyle and to build relationships all contribute to building a sustainable team and an amazing company.

We are interested in what you think.  What do you consider important when determining what city you want to live in?  What do you think are the top health innovation cities in the US?






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