Advancing Women’s Health through an Equity Lens

00;53;36;28 - 00;54;03;12
Tom Haederle
Women's History Month here in March of 2023 includes an exciting new historical line, one that is still being written. And that is the very recent history of female led venture capital firms that are out to change women's lives for the better. One such firm is SteelSky. It invests in innovative companies working to improve health outcomes for women by focusing on improving health care, access, quality and affordability.

00;54;03;29 - 00;54;52;03
Tom Haederle
Raising capital for investment funds isn't easy, especially for historically marginalized groups. But SteelSky and a number of similar funds got a big boost last year when the American Hospital Association announced it was providing early financing. Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. Financial support of investment funds that focus on addressing disparities in health outcomes and creating meaningful economic opportunity aligns with ASHA's strong commitment to these issues.

00;54;52;21 - 00;55;18;20
Tom Haederle
In this podcast, recorded in May of 2022, SteelSky Ventures founding partner Maria Velissaris talks about her goal of advancing women's health through an equity lens. Joining the discussion is Lara Khouri, executive vice president, chief strategy and transformation officer at Children's Hospital, Los Angeles. She's also a member and past chair of AHA’s Maternal and Child Health Council. Let's give a listen.

00;55;19;16 - 00;55;52;29
Lara Khouri
I'm so excited about this conversation today and thank the American Hospital Association for the opportunity to lead this important discussion on the connection between women's health and innovation with an equity lens. The AHA announced it's providing early financing for investment funds run by leaders focused on improving health care access, quality and affordability. The funds were selected because they financed historically marginalized entrepreneurs who have limited access to the capital needed to develop innovative solutions in health care.

00;55;53;23 - 00;56;21;22
Lara Khouri
I’m so excited because SteelSky Ventures is one of the funds receiving early AHA investment. It's a female led venture capital firm focused on companies working to improve health outcomes for women. SteelSky Ventures has invested in 14 women led and women oriented health care startups since 2017. And that's just so far. My conversation partner this afternoon is Maria Velissaris.

00;56;21;28 - 00;56;45;16
Lara Khouri
Maria is a venture capitalist and she's founding partner of SteelSky Ventures. She is passionate about developing a pipeline of female entrepreneurs, something we're going to talk about more in a moment. In March 2021, Maria was named by Forbes as one of eight female venture capitalists to watch. So, Maria, welcome again and thank you. Let's jump right in.

00;56;46;03 - 00;56;48;25
Maria Velissaris
Wonderful. Thanks for having me. I'm excited to chat today.

00;56;49;14 - 00;57;07;03
Lara Khouri
So I've got so many great questions I want to ask you. And I had to pick just a few. So I'm really excited to hear what you have to say. So first, I understand that SteelSky Ventures is among the largest, if not the largest, women led venture fund in health care today. Can you tell me a little bit about yourself?

00;57;07;04 - 00;57;09;12
Lara Khouri
SteelSky Ventures and how you got here?

00;57;09;25 - 00;57;31;08
Maria Velissaris
Yes, I'd be happy to. And it's been quite a journey to SteelSky, but have been really excited all the way. I started my journey as an entrepreneur. I'm a serial entrepreneur turned venture capitalist. So really always had a passion for building businesses, even from when I was a young girl starting lemonade stands, babysitting clubs, garage cleaning businesses.

00;57;31;08 - 00;57;53;23
Maria Velissaris
It's just always been in my DNA to be a builder. And since then, you know, 17 years of my career learning how to build companies and operate and then I jump to the other side of the table and learning how to invest. And I started investing in female led companies, typically. And then I just saw really a lack of dollars going into women's health companies because it's hard to navigate health care.

00;57;53;23 - 00;58;30;21
Maria Velissaris
And a lot of angel investors don't have that expertise. And so that's where I saw that I could really make a difference and carve out a market for myself in my fund. And so I started SteelSky Ventures Fund in 2020, and since launching, we've now invested in 17 companies and raised a platform of over $72 million. And so we're really excited about what the state of women's health care and being able to be a big part of pushing that forward and so happy that also having the partnership with the AHA and other women's health enthusiasts like yourself so that we can create better outcomes for women around the world.

00;58;31;13 - 00;58;55;05
Lara Khouri
Well, that's wonderful. It's so nice to hear your journey. And I'm sure that bringing that entrepreneurial and operating experience into the venture capital side has made you particularly well equipped to be able to identify opportunities that are going to be able to be successful and make the type of impact that you're looking for. And I'm curious about that impact and the big picture.

00;58;55;05 - 00;59;12;04
Lara Khouri
So you've made health equity a focus of your investment of your investing. Can you talk a little bit about why you see health equity as such an important feature of what you do and from your perspective, how do you see health equity connecting with health outcomes?

00;59;12;22 - 00;59;37;17
Maria Velissaris
Very good questions. I think post-COVID, it really illuminated for us the disparities in our health care system. And health equity has to be top of mind when we're making investments. We have to understand when we're investing in a company how it not only impacts women who have access to wiFi and cars and transportation and healthy food, but how does that affect the other half and how does the other half live and how can we better serve them?

00;59;37;23 - 00;59;55;21
Maria Velissaris
Because that is where the majority of health care spending is and that's where the majority of the progress needs to be made. And so we make sure that our investments all have a lens toward health equity so that we can make sure we are serving the most vulnerable populations, which also happen to be the most expensive populations for payers.

00;59;55;29 - 01;00;16;04
Maria Velissaris
And by investing in companies that can create better outcomes for them health wise, it also can create better outcomes for, you know, health care systems, for payers because they're saving money, they're having better outcomes, are getting better ratings, and in it's just a win-win for everyone. But I think it's definitely should be top of mind more than it is.

01;00;16;21 - 01;00;33;04
Maria Velissaris
It's a shame that I actually have to have a women's health fund because women's health has been overlooked. I should just be able to have a health care fund. But not all funds are focusing on women and the needs of other underserved communities. And so that was really important to us, and it's been a driving factor for our fund.

01;00;33;25 - 01;01;06;05
Lara Khouri
It's so wonderful to hear that intention that you're bringing to it. And it is always striking to think about how women are half the population, but we're disproportionately underinvesting in women's health. And so to imagine how you can accelerate that and make an impact through that intentionality is really wonderful. I'm curious for you, as you bring this lens and start to engage in companies and explore ideas for making a difference, what qualities are you looking for from the companies that you fund?

01;01;06;05 - 01;01;14;17
Lara Khouri
And especially curious about how you think about identifying companies that are run by founders that are going to be able to make a difference?

01;01;15;03 - 01;01;36;17
Maria Velissaris
Well, it's really hard decision making process. We get hundreds and actually thousands of portfolio companies coming to us every day. So it's a lot. It's a groundswell and it's been really tough to try to figure out which companies to invest in. But we are able to focus our efforts on a few key verticals that we think have the most need.

01;01;36;22 - 01;01;59;05
Maria Velissaris
And so when we're looking at entrepreneurs, we're looking at companies that are really solving big pain points, right? So there's a lot of reports around vitamin versus a painkiller. And we're trying to invest in companies that are pain killers that are solving the most challenging problems in healthcare. So that is one of our criteria for investment. Another one is inclusivity, like I mentioned before.

01;01;59;10 - 01;02;26;19
Maria Velissaris
Are you thinking about gender equality? Are you thinking about racial equality? Are you thinking about socioeconomic equality? Are you thinking about geographic diversity? Those are all components that we look at when we're evaluating companies and we want to make sure people are serving all of these markets. And for us, we really also want to make sure that things are covered by insurance and that people are taking Medicaid because we just do not want to continue to leave out whole bottom of the pyramid.

01;02;27;07 - 01;02;38;24
Maria Velissaris
And also, we're looking for passionate teams that want to make change in the world. We have an opportunity to invest in any companies that we want. We want to invest with like-minded individuals who have aligned missions.

01;02;39;12 - 01;03;05;27
Lara Khouri
That's wonderful. It's I liked your painkiller versus vitamin analogy. We probably need both of those. But as you think about big impact, that's a wonderful way to think about it. And it's also really neat to hear how much interest there is. Right? It's exciting. And I imagine that you all existing and coming to the table really clear about your goals motivates people to be interested in the work.

01;03;05;27 - 01;03;26;10
Lara Khouri
And so just by your existing, you're kind of building that and it's a wonderful way to imagine the impact that you're making going even beyond those companies that you're able to to fund and finance. So that's really wonderful to hear. So I've got one last question for you, although I could ask you many, many questions actually, I'll ask I'm going to ask you two more questions.

01;03;26;22 - 01;03;43;04
Lara Khouri
When you think about success and impact, how do you know whether you're achieving what you want to achieve? So what are some of the metrics or what do you look for to indicate that you're making the progress that you want to make, not just from a business perspective, but also from an impact perspective?

01;03;43;20 - 01;04;02;07
Maria Velissaris
We look at number of lives impacted. Our goal is to change and increase the health of women around the world. So how are we doing that? How many lives are we touching? How many people are living more pain free because of the companies that we've invested in? How are we creating better ways to access and engage the health care with the health care system?

01;04;02;07 - 01;04;25;19
Maria Velissaris
How are we helping marginalized communities feel safe when they go to the doctor? These are all different components that we look at to measure our outcomes and to measure if we are making the impact that we want to see and that we are intentional about trying to see in the world. And so we look for number of lives impact, we look for if people are healthier and safer and all of these things are measurable.

01;04;25;28 - 01;04;43;00
Maria Velissaris
So it's really important to us to keep track of those metrics so that we can make sure that we are actually doing what we say that we're doing. We're putting our money behind these companies to create better outcomes, and these can be measured, and we want to make sure that we continue to measure them and make sure that, you know, we're actually having outcomes.

01;04;43;00 - 01;04;51;15
Maria Velissaris
Right? There's a lot of people throwing money in a lot of places. But to truly make sure that you're being impactful, you have to be able to measure these outcomes.

01;04;52;13 - 01;05;14;14
Lara Khouri
You almost sound like you're talking about how hospitals think about what we do as well. It's really nice to hear somebody, you know, that the opportunity to have that perspective that you have driving where funding is going is going to make a big difference. And what you talk about is scale. And what you talk about is is impact.

01;05;14;14 - 01;05;34;04
Lara Khouri
And to talk about impact in scale in the populations that you're targeting is really exciting. And I think it really resonates for me as somebody who's been involved in the delivery side of health care for most of my career. It really is is nice alignment and I'll use that actually to segway to what I promise you will be my last question, although like I said, I could ask many, many more.

01;05;34;28 - 01;05;54;13
Lara Khouri
Part of what brings us together today is that engagement that the American Hospital Association has with SteelSky. And so I'm curious because I know that in addition to the AHA, you've got some other non kind of nontraditional investors in health care who've been engaged with you. And I'm not surprised because you're offering something really, really special here.

01;05;54;29 - 01;06;01;28
Lara Khouri
And you talk a little bit about how these partnerships come about, how you've been engaged with the AHA and where you see it going.

01;06;02;13 - 01;06;23;02
Maria Velissaris
Well, it feels good. We see ourselves as solution providers, right? We're solution providers for hospital systems, payers and women across the world. And so those are key stakeholders. So we talk and engage with health systems so that we can understand what are your biggest pain points, what are your gaps in care? And then we can go to the market and focus on finding solutions to those gaps.

01;06;23;07 - 01;06;45;24
Maria Velissaris
And so that we feel that partnering with the end customer really helps us drive great investment because we are focusing on the areas that are the greatest need for all of our key stakeholders. And that's why the partnership with the AHA is so important and so impactful for our fund is because we are hearing straight from the user community what they need and we can bring exactly what they need.  

01;06;45;24 - 01;07;05;00
Maria Velissaris
And sometimes we also have the ability to co-create together. A lot of the companies that we're looking at a very early stage and they're still in their foundational development until we're getting really unique insight from the hospital systems or the payers or the pharmaceutical companies about what they need to do to make their product offering more appealing to this community.

01;07;05;00 - 01;07;15;25
Maria Velissaris
We can do that early on, and so that's why it's such an interesting and important partnership so that we're building companies and solutions that actually can serve the needs of the end users.

01;07;16;14 - 01;07;39;08
Lara Khouri
It's such an effective approach, I expect, because you're thinking about your market in both your end user, the population you want to impact, as well as that entity and the stakeholders who are going to be involved in actually actualizing those opportunities. So it's a really, really smart and exciting way to think about how you advance some of these innovations.

01;07;39;08 - 01;07;57;05
Lara Khouri
So congratulations and thank you so much for your thoughtful answers. I know that this discussion is going to be a great resource for our AHA members and members of the public. I understand you have a few questions for me as well, and I'm very happy and honored to talk to you and answer any questions you might have for me, Maria.

01;07;57;28 - 01;08;19;02
Maria Velissaris
Yes. Laura Now it's time to turn the tables in your end. So I do have a lot of questions for you that I'm sure the audience will be really excited to hear. I know that innovation is really important at Children's Hospital Los Angeles and at SteelSky, one of our focus areas is maternal and child health, and we're constantly looking at new innovations in the space.

01;08;19;10 - 01;08;27;04
Maria Velissaris
Can you tell me about some recent innovations that you've been looking at from the hospital perspective? And what are some of your key focus areas of the year?

01;08;27;18 - 01;08;56;14
Lara Khouri
Sure. Thanks for that question. It's really timely. You know, mental and behavioral health conditions in children and youth is a growing crisis in our our country. And you've talked about disparity. And this is certainly something that's come up, especially on the heels of COVID, but certainly existed beforehand. And there is a dearth of resources and infrastructure for screening, for diagnosis, for treatment for a large number of patients, especially those who are in underserved communities.

01;08;56;28 - 01;09;33;04
Lara Khouri
When I was learning a little bit about you and SteelSky saw that you've invested in Bend Health, which is also focused on helping increase access to mental and behavioral health for women and families. We have an accelerator called Kids X, and we're supporting a few innovative startups that are working on products ranging from things like voice biomarkers that screen for depression while providers are talking to patients and families, to things like digital therapeutic that can use to can be used to treat depression through app based cognitive behavioral therapy.

01;09;33;22 - 01;10;07;06
Lara Khouri
Through our Office of Virtual Care, we've launched a virtual autism assessment program. And this is a really neat innovation that allows families to asynchronously submit videos for their children so they're able to, at their time in convenience, submit videos. And one of our autism specialists will provide an assessment. So it's a unique form of access. It's a really patient and family centered approach, and it offers something that's really underserved right now, especially in our populations, that we focus on serving.

01;10;07;23 - 01;10;38;19
Lara Khouri
So we're also working on supporting technologies that can help improve screening, diagnosis and treatment of a wide range of mental and behavioral health conditions. So there's definitely a lot going on and you've noticed it in your work. We've noticed it in our work. And it's something that, just like you were saying before, we have to decide that we're going to pay attention to it and through that intention and bringing innovation and expertise and that entrepreneurial spirit that you've described, we think there's a lot of impact that can be made. 

01;10;38;19 - 01;10;55;01
Maria Velissaris
Definitely. And it sounds like your hospital system is really on the forefront of innovation, technology and change. Sometimes we know that hospitals can get a bad rap for being slow to adopt. What are some of the components that make this so successful at Children's?

01;10;55;18 - 01;11;22;05
Lara Khouri
So one of the things that we've built here at Children's Hospital Los Angeles, which I alluded to, is an accelerator. So in 2019 we launched Kids X and it's actually a national consortium of 30 children's hospitals that are working together to accelerate pediatric digital innovation. You talked about the kind of lack of attention that's brought to women's health, and often women's health and children's health are kind of alongside each other.

01;11;22;17 - 01;11;45;26
Lara Khouri
And we see the same thing in pediatric challenges as well. So we brought together these 30 hospitals to understand the process by which they test and implement innovative new solutions. Through that understanding, we developed a toolkit that our kids across hospitals can use to accelerate the speed by which they can launch pilots and studies of digital innovation tools.

01;11;45;26 - 01;12;25;25
Lara Khouri
During the past two years, KidsX hospitals have launched more than 25 projects using this process. So it really takes innovation and moves it into an operationalization. That's often the challenge that we face in our provider settings. As you alluded to at Children's Hospital Los Angeles, we've used this process to test and evaluate an augmented reality-enabled gamified physical therapy app, and we've also used it to test a robot that can deliver medications to patients in the hospital and a clinical decision support tool that helps our emergency department physicians conveniently leverage clinical best practice to inform their decision making.

01;12;25;25 - 01;12;45;11
Lara Khouri
So one of the things that we've tried to do is demystify how you test innovation, create process and clarity around how you can do it successfully. And we've done it not only here at Children's Hospital Los Angeles, but in collaboration with many of our peer children's hospitals, because we, many of us face the same types of challenges.

01;12;45;11 - 01;12;50;15
Lara Khouri
And being able to accelerate that testing of innovation has been really, really effective.

01;12;50;24 - 01;13;14;20
Maria Velissaris
Amazing. It sounds like so many amazing things are going on over there, things that I should be probably getting involved with. As we wrap up, I could talk to you all day. I would love to just understand a little bit more and selfishly for input to my portfolio companies. What are some key characteristics that you see of companies that are creating successful digital applications for health systems?

01;13;14;20 - 01;13;38;03
Lara Khouri
So, you know, it's a lot of what you've talked about, Maria. For us in the provider environment, we are such a regulated environment. We're so focused on quality and safety that we do a lot of work to standardize practice, to put into place protocols to make sure that we're addressing risk of errors and hospital acquired conditions in so many different things.

01;13;38;16 - 01;14;14;21
Lara Khouri
So we can often identify problems and opportunities for improvement. But how we integrate change and how we change our processes is the place where the rubber hits the road. And so I actually will reflect back to you something you were saying, which is really understanding the market of the user, right? So for us having innovation and tools, digital solutions and otherwise that understand and anticipate our operating environments and are able to accommodate and flex for that is the best way for us to execute on innovation.

01;14;15;01 - 01;14;48;16
Lara Khouri
And so understanding not only your end user, so you've talked about wanting to make an impact for women. If you're thinking about women, if you're thinking about children, whoever your targeted population is, as providers having tools that can easily integrate into our electronic medical records, into our processes that anticipate some of the barriers and the regulatory and quality and safety realities that we're managing, I think is one of the most important things, because the worst thing is to have a great idea that can't be implemented and executed, right?