“Physicians are at the epicenter of changing the way we live our lives” – AGA launches GI Opportunity Fund
“Physicians are at the epicenter of changing the way we live our lives”
AGA launches GI Opportunity Fund
Scope Forward has always been about finding the way forward for gastroenterology. Naturally I was excited that a leading GI society such as the American Gastroenterological Association (AGA) was scoping forward by launching a venture capital fund called the GI Opportunity Fund (in partnership with Varia Ventures).
What was even more exciting is that AGA chose to invest in Virgo to launch the fund. I interviewed Virgo’s cofounder Matt Schwartz earlier this year – we talked about the value of data in GI.
In this interview, you’ll learn from Tom Serena (CEO of AGA) on why (and how) AGA chose to go down the route of venture investing. How the market opportunity for GI is enormous. How to invest and participate in this fund? If you are an entrepreneur, how to land an investment.
More importantly, you’ll understand the central premise of this interview. As Andrea Vossler, Cofounder and Managing Director of Varia Ventures said, physicians are the epicenter of medical care. You are the ones who are innovating. It’s time to step forward and make your ideas into a reality. If you listen closely, Matt has this one piece of advice for GI entrepreneurs.
◘ “Our goal is to get Virgo integrated into as many health systems around the globe as quickly as possible”
The Transcribed Interview:
Praveen Suthrum: Hi everyone. Welcome to The Scope Forward Show. I’ve been really looking forward to doing this interview for a while now, so it’s exciting. You have some great news, Tom, so congratulations to AGA and the whole team. I first want you to make the announcement that you have that will help us get started. Then I want to introduce everyone.
Tom Serena: I am Tom Serena, the CEO of the American Gastroenterological Association, and we have recently, in partnership with Varia Ventures, launched a venture capital fund called the GI Opportunity Fund.
Praveen Suthrum: Excellent. So, Tom Serena, you’re the CEO of the American Gastroenterological Association. Matt Schwartz is co-founder and CEO of Virgo. And Andrea Vossler is co founder and managing director of Varia Ventures.
So all of you have come together to make an investment in Matt’s company, Virgo. And it’s great. You’ve created this investment fund and you’ve made your first investment. So it’s exciting and congratulations to all of you.
I want to start first by asking you, Tom, what is the back story here? How did you go about it? How did AGA as a GI Society decide to go down the route of venture investment, which is something new I would think for medical specialty society.
Tom Serena: I would say it’s pretty unique. But we did learn something from our GI Society—SAGES: The Society of American Gastrointestinal endoscopic Surgeons. AGA, we referred to as the centre for Innovation and Technology a dozen years ago. It’s basically a group of experts who can give guidance to start-ups founders and a physician entrepreneurs. And we did that for a number of years.
We have an annual tech summit with a shark tank event embedded in that. And as I said, it went on for a little over a decade. But the problem that we saw was we didn’t cover the last mile where companies want funding. And the opportunity came to us because one of our board members, Mike Coachman, was connected to SAGES, who had already been working with various so this was kind of serendipitous, but it really worked well because we found the last mile because now we can help companies get funded as well.
Just as part of the back story, we’ve been trying to do something for a decade, but associations move slowly and they’re pretty conservative. So we had some fits and starts and it took a while to get comfortable with this. We made our first actual direct investment in a start up, RX Health, in 2018. So it sort of got everybody used to, okay, this is a new era and a new frontier. And now the board is really excited. They see the synergy of having the ability to do this funding.
The key to getting everybody comfortable, I will say, is how comfortable we are working with Varia ventures because having a partner who knows what they’re doing is really what we need if we can do the clinical side. But we really didn’t have any experience in venture capital, so that shows how we got here.
Praveen Suthrum: Andrea, your fund or firm, you help entities like AGA invest or do you also invest? What is the nature of your business?
Andrea Vossler: Yeah, so Varia Ventures is a venture capital firm started by my partner and I. We partner with medical societies and other professional organizations to help them launch and manage their venture programs.
As Tom mentioned, we have been staying sharply focused on GI. Our initial partnership was with SAGES, which is how we got connected to the AGA. And what’s great about that is there’s opportunities for synergies, obviously, across both organizations that are focused on GI, including beyond resources and key opinion leader support, the ability to co-invest from time to time in interesting opportunities.
Praveen Suthrum: What kind of investments have you already made in GI?
Andrea Vossler: I’m glad we’re having this conversation. Virgo is our first investment through the fund. We are actively fundraising through both funds, although we have held an initial close at the AGA fund and we’ll have another close before year end.
I know Praveen, one of your questions a bit later on is how can people participate, which I’ll cover then, but we are generally looking I will say our investment thesis is to invest in early stage high growth opportunities. We’re primarily looking for companies that originate through the AGA or are in the GI space. Our interest, I would say, is from a market opportunity standpoint.
The market opportunity for GI is enormous, I think digestive health issues and the impact of nutrition on health such as everyone. So we’re really excited about it from an investment standpoint. So in addition to investing in GI and investing in early stage companies, we’re looking at interesting opportunities where there might be limited competition, there’s a significant market opportunity. There are other smart investors around the table who invest in this particular industry. We look for a great team like Matt’s in place, who are disciplined and dedicated. We often look for positive indices of traction. It can be trials, it can be initial partnerships, it can even be revenue, although that does have to be later stage. So those are all the sort of things that we look for when we’re thinking about making an investment through the AGA fund. And our hope is that we will have, at least in this initial fund as we get going because it’s a new initiative for the organization that will have a nice portfolio of somewhere between five to eight, maybe even ten investments, depending on how much capital we close on in this initial fund.
Praveen Suthrum: Excellent. And coming to GI itself and this portfolio that you’re considering building, does it have to be digital GI companies or it doesn’t matter what kind of start up companies?
Andrea Vossler: No, that’s a great question. They don’t have to be digital GI companies. We primarily look for either medical device or health tech companies. We tend to stay away from pharma, mostly because the pathway to exit is very, very long. It can be ten to 15 years and it’s often too long to provide a return to our investors. However, that being said, if there were really compelling opportunity and it was closer to market, we might consider it.
But generally speaking, we do focus on medical device and healthtech you don’t need to be in Healthnet, you could be a medical device. And about 20% of the portfolio will be allocated to making investments outside of GI. So that could be in other healthcare companies and it could even potentially be outside of healthcare. But because this is partnership with the AGA and we sort of the missing piece, I would say, as Tom mentioned, with the work that they’ve done over many, many decades, we are staying pretty sharply focused on GI. But if you are in health care and you have a compelling opportunity, we will consider a company here and there to ensure that our portfolio is diversified for our investor base.
Praveen Suthrum: And does it have to be US based or is this global?
Andrea Vossler: We do look at foreign companies. We have foreign companies apply, we will consider them. There is some complexity with investing outside of the US. So I would say if you’re interested, please apply. And if it’s not the right fit from a structural mechanic standpoint, we’ll let you know upfront so that we don’t spend a lot of time looking at your company and are doing diligence if it’s not going to be workable for us from an investment standpoint.
Praveen Suthrum: The reason I asked that question is because I see a lot of innovation in GI happening outside of the US. And they’re selling in the US, all of them, but the innovation seems to originate in different parts of the world. It’s quite an interesting thing that I’ve been noticing, but sure, thanks for answering that.
So Matt, it’s a full circle for you. Just a few minutes ago. I was asking Tom, didn’t Matt pitch at the AGA Tech summit? And he said you did. And I asked, did you win? So he said, no, he did not win. So it really doesn’t matter whether you win or not, you can get the investment. That’s a good one. So congratulations to you and your team. Since the last time that we did this interview on The Scope Forward Show till now. You made the Olympus investment announcement and now the AGA. So it’s incredible. So it’s a full circle for you. I love to get your reflections. How do you feel having arrived at this point?
Matt Schwartz: Yeah, thanks for being it’s incredibly rewarding for us to now officially have the AGA as a partner in our company. Looking back over the years, not only did we pitch in the shark tank back in 2018 and as you said, we didn’t win, but it was a great experience. We actually really started the company the year before after attending the AGA Tech Summit, me and my co founder Ian, we went to the Tech Summit on the recommendation of Dr. Dravid Cave. Thought it’d be a great place for us to go and explore the concepts we were kicking around for Virgo. And we received such positive feedback from the attendees at the Tech Summit who were incredibly encouraging and supportive of what we were doing.
And it really gave us the confidence and understanding that we needed to go out and start the company with a focus on the GI space. So it’s just so rewarding to now be able to have the AGA as an official partner in what we do. And it’s hard to believe that was almost six years ago now. But the company has come a tremendously long way since then.
Praveen Suthrum: So it offers tremendous credibility to have a partner like AGA. And I’m sure this is not about the money, it’s beyond that. Can you talk a little bit about that? How does this investment help you? I’m sure you could have taken this money from anyone else who have in the pipeline.
Matt Schwartz: First of all, we really trust the AGA and its membership in their thought expertise. And beyond just the credibility and the money, that’s what’s most important to us is that the AGA has a broad and diverse membership that can give us really valuable feedback. And ever since the beginning of our company, we’ve valued physician input in helping to guide our product development and focus on the things that are going to be most important and impactful for them. I think having that exposure to the AGA’s membership just helps to accelerate the amount of feedback that we can receive in and think gaining more exposure to the AGA’s membership so they understand what it is that we’re building toward can be incredibly impactful. So I think that’s probably the number one thing we look for.
Number two is as we grow as a company, I think historically we have not really played in spaces that are directly reimbursable, but I think that could become more of a longer term strategy. And knowing that the AGA and its membership plays such a significant role in helping guide policy in the GI space, I think that’s going to become a strategic advantage for us just to understand where the winds are headed when it comes to reimbursement and policy long term by having a more direct relationship with the AGA.
Praveen Suthrum: That’s a very interesting point. Just for context, Matt, can you please recap what Virgo does as a company and what kind of benefits do you offer through your solutions to the GI community?
Matt Schwartz: So at Virgo, we provide the leading cloud video capture management and AI analysis platform for endoscopy. Since launching in 2018, we’ve helped physicians around the country and now starting to be around the globe, capture over half a million endoscopic procedure videos.
And then starting in 2021, we launched a new suite of tools called Virgo Trials that’s designed to help biopharma companies accelerate clinical trials in IBD and other diseases that involve endoscopy. So our core platform, we’ve got a small device that helps doctors automatically record their Endoscopy videos. We help doctors use those videos just in standard of care treatment. We also enable doctors to use their own video data for research programs, training programs, quality improvement initiatives, and then the clinical trial benefits are pretty clear. We can help doctors get more of their patients enrolled into clinical trial opportunities.
So there’s a number of different value propositions, kind of depending on who the target audience is, whether it’s academic medicine, private practices, biopharma companies. There’s something in the Virgo platform for everyone. And we’re really committed to building innovative tools for whoever the audience is. It’s not just one thing for one group. We want to make sure it’s really targeted platform for all audiences.
Praveen Suthrum: I’d like to know what kind of an exit horizon do these investments have? Are we talking five, seven years or shorter? What is typical here?
Andrea Vossler: I can answer that, Matt, and then maybe you can speak more specifically to Virgo. Generally speaking, we see these investments exit and I would see a three to seven year time frame investments where we invest and they’re a bit farther along.
We’re investing in sort of a seed to Series A. And what that means is seed, there’s some positive indices of traction. A, you’re getting into an inflection point where they’re really focused on growth. And so just by operation of vesting at one of those stages and the check size that one might be investing in, that sort of dictates the length of time that may elapse until there’s an exit.
Now, that being said, we do look in terms of what we invest in from an investment criteria standpoint, we do look for companies that are going to exit quickly. But as Matt mentioned, he’s been in business for, I think Matt, you said six or eight years. It takes time for these companies to mature. Our past investment experience, we see these companies exiting in three to seven years. You may occasionally have a company that exits quicker than that, and you always have stragglers that exit beyond the seven year. It’s one of the reasons that a standard fund terms ten years and I’ll let Matt speak more specifically to Virgo and what they’re anticipating in the future.
Matt Schwartz: We started the company back in 2017 and I think one of the things that is unique to healthcare and start-ups is that healthcare is a complex industry, very complex incentive structures, and it can be time consuming and challenging to find the right business model that really cracks that code and works for everyone in your ecosystem. And so we spent the first couple of years with Virgo focused primarily on building product and understanding the market and trying to build a foothold with leading academic medical centres in the country to buildout the base of our business.
And then from that we always knew we would overtime, uncover the right venture scale type of business model. And we think we really struck on that with the launch of our Virgo Trials product and being able to work so closely with leading pharmaceutical companies. And we’re seeing tremendous results there. But now with this investment, this was part of our Series A raise. You mentioned Olympus also participated in the Series and our focus now is on growth. Our goal is to get Virgo integrated into as many health systems around the globe as quickly as possible. That’s what our primary focus is on at the moment.
I think there’s a ton of runway for us in company building just directly. We’re not so concentrated on exit strategy at the moment, though I do think there will be an attractive exit opportunity sometime in the next call. It three to five years. But at the moment we are really just laser focused on building up the company and spreading Virgo across the globe as quickly as we can.
Praveen Suthrum: Tom, I want to get back to you on the whole decision making process, or the Pivoting process if you will. For a large organization such as the AGA, I’m sure you must have faced resistance with your board with your own staff and so on. And the reason I want to bring up this topic is because there could be other large entities, other large organizations out there that must be reflecting on similar questions, ideas and so on. They must be thinking, hey, how do I convince my partners, how do I convince the board? How did you navigate all this with the AGA and what kind of resistance did you face, how did you circumvent that?
Tom Serena: So as I said that our partnership with Varia was key. You need to have people that you trust. But I will say the keystone of this is Mike Coachman. It’s a person that the board trusts. Mike was on the board. He’s an advanced endoscopist at Penn. He is well aware of how venture works. He’s worked with many small compensates and they trusted him. So my role is to sort of navigate it through the board, get the approval process done. And honestly, I wish there was a formula, but it’s all about people you trust and especially getting outside the lines of our traditional business lines. Concerns about conflicts and those things had to be overcome.
But eventually I think our board realized it’s sort of the traditional business lines of a society. Education publication induced. They’re static or declining and the competition is unreal, especially when you think about publications and open access issues. So we need to expand our business lines. Sorry if I’m repeating myself, but it is about having somebody who the board trusts sort of bring the idea to fruition.
Praveen Suthrum: Got it. So I want to touch upon that aspect of business lines for a GI society. So it’s not the education and that means through conferences like DDW and through publications and other means of education. But this is completely out there. Right? So this is venture investing and where the risk is high, the chance of failure is high, and so on. So putting all this into context, what do you see as the future of AGA? Where is all this going? If you have to throw a stone and we land five years from now, how do you see all this play out and evolve?
Tom Serena: I see the GI Opportunity Fund as an inflection point. The fact if I have every confidence this is going to go great, it’s important that it’s successful because the board can then take the next risk. The show and I pass around your weekly digest, we’re all trying to figure out what the next thing is. Of course, we’re all looking at private equity and how that’s going to affect not just GI but us. Private equity can provide a lot of resources that we historically have done.
AI from a standpoint of how do we address physician burnout? Because we see volume coming through multiples increasing in GI, because the lowering of the screening age and just the multiple therapeutic. So I really wish I had an answer. I’m kind of exhausted just from getting us to the Opportunity Fund. But we’ll keep looking.
Andrea Vossler: I might just jump in and say tattoo and Mike coachman Alison Kim and others within the AGA have been tremendous partners and they have done tremendous work, I think, to get their internal organization wrapped around this idea. On our end, my partner and I think one of the reasons that we partnered with AGA and the AGA was attracted to us is because one of our missions is to monitor access to venture capital. And my partner and I have a long history of working with physician founders and physician investors.
And the challenges in working in healthcare are significant and they’re getting more challenging as the regulatory regime changes and as there’s increased pressure on many of the physicians in our network. And they’re innovating the next big thing. I mean, they’re right in the epicentre of changing the way that we live our lives and the value of that. It’s been challenging for them to capture because unless you’ve had access to traditional venture capital which typically require checks in the $250,000 million range to participate in the fund we’ve really tried to make the fund accessible to the membership and accessible generally so that the individuals who are innovating are able to participate in the upside of that.
And I will know as well, our economic arrangement with the AGA is to share in successful deal exits. So the focus is to create a sustainable initiative for the AGA, not just because we’d like to set up the next fund, but the next fund after that and after that because we believe it could be a long term, very sustainable and successful model.
Praveen Suthrum: If there are people out there in the industry, could they become investors in the fund and what does that process look like?
Andrea Vossler: We are working hard to close the fund. By the end of this year we have had an initial closing, we will probably have one more closing and then close out the fund and deploy the capital. So I would encourage anyone who’s interested in investing to reach out. They can reach out to myself, to Tom, or they can go to our website, which https://againvest.varia.com/, and you can log onto the site register, you can access the fund materials, you can set up a call to speak with myself or my investment partner.
There’s different mechanisms to participate. If you’re interested but you’re uncertain, I would say check out the website and give us a call and we can talk through some of your questions. There’s also a webinar that we hosted about a month ago which includes a general overview of the fund as well as specific questions that investors had that I think a lot of investors had and that’s posted on the portal as well. So that’s easily accessible for anyone who’s interested.
Praveen Suthrum: And does it have to be clinicians only or open to anybody in the GI space?
Andrea Vossler: It’s open to anyone in the GI space with the one caveat that they do need to be an AGA member. But I think you’re not a member. Enrolled as a member is pretty straightforward and I think it’s a very small membership fee.
Praveen Suthrum: So there’d be a lot more people wanting money than putting in money out there. So I want to ask on their behalf, what does that entail? So if there’s an entrepreneur out there and is looking to be in Matt’s shoes, what do they have to do? What does that process look like?
Andrea Vossler: So we connected with Matt because he had contacts within the AGA. So I would say, at least initially, if you have a lead within the AGA or you know someone within the AGA that could make an introduction, we always welcome the soft or the warm introductions because I think that’s helpful. You have someone who can say that they’ve either watched the company or worked with the company. So we’ll take a closer look at it.
But even if you haven’t had any connection to the AGA, that’s not a problem. They go to the website as well. There’s a separate registration form for founders so they can submit their information or submit their interest. We are being a little careful with accepting too many applications right now until we finalize closure of the fund. But as long as you go on and sign up and submit your pitch deck, we’ll be reaching out to you probably after this month, once we complete our final closing.
Praveen Suthrum: And what kind of check sizes do you write or planning to write?
Andrea Vossler: Yeah, so our this initial fund, because it’s our first initiative with the AGA, it is a small fund, so our check sizes are probably going to be, I would say, in the $50,000 to $250,000 range in terms of an initial check size. And if we have additional capital for follow and financings, we’re retaining a little bit of a reserve for that.
And this is what we did with Matt’s company as well. We do have partner funds. So, as Tom mentioned, we’re working with SAGES and setting up a fund that one has a bit of a different focus on SAGES innovations. But to the extent it might be an interest tone of our partner funds, we can co invest together to bring up the size of the check. So in Matt’s company, we wrote a $250,000 check out of the AGA fund, and then one of our partner funds matched that for a $500,000 investment in total.
Praveen Suthrum: Excellent. So, Matt, I want to get back to you, and I’m sure there are a lot of entrepreneurs out there who might be looking up to you right now and wanting to know how can they be in your shoes or how can they take the path that you’ve taken? What advice do you have for them? Again, not just broadly healthcare, but specifically GI. And how is this different from the wider industry, wider sector of healthcare?
Matt Schwartz: Yeah. So the number one piece of advice I give to any entrepreneur I meet in the GI space is that they have to attend the AGA Tech Summit. And I know this probably sounds like just a plug for the AGA, but it really meant a ton to our business. And I’ve worked in a number of different clinical areas within healthcare and have been to all sorts of scientific meetings across different clinical specialties. And I can honestly say what the AGA has cultivated in the Tech Summit is unique across anything I’ve seen in healthcare. The Tech Summit really fosters open communication between physicians, entrepreneurs, larger industry players, and the FDA.
In my experience, it’s a great opportunity. Whether you’re a physician, entrepreneur, someone coming from industry, if you just have an idea and you’re very early stage, the Tech summit is really the place to connect with the right people within the GI community to help grow your concept, whether that means finding medical advisory board members or finding early customers. I think the AGA Tech Summit is the best place to do that.
And I think back to the first Tech Summit we went to in 2017. I think all of our initial customers came out of meetings that we got at the Tech Summit. And when you go to a lot of scientific meetings, it can be difficult to approach physicians that you don’t know. They’re oftentimes there just to present their own research and network with their colleagues and leave. And at the Tech Summit, pretty much everyone that shows up there is looking to learn about something that they’ve never heard of before, which is the perfect environment for an entrepreneur. So I’d say, as Andrea said, it’s always helpful to have a warm lead to someone at the AGA. If you’re an entrepreneur out there right now that doesn’t have one of those warm connections, the best way to build that network is by going to the Tech Summit, which I think is always in April. It used to bounce back and forth between San Francisco and Boston. I think it’s in San Francisco now. You’re going find me there. I’m happy to try to provide more advice and do more networking, but that’s the best advice I can give.
Praveen Suthrum: Excellent. Now I want to close by asking a broader question to the whole group, and all of you can pitch in, which is based on whatever you’re seeing happening in GI right now. And I’m sure you’ve been looking at the space for a while from different lens. I’m interested to know what is the future of GI from the lens that you’re seeing?
Matt Schwartz: I can take it first if you guys want. So I’m a little bit biased here with the nature of our business, but I think data is playing an increasing role in the GI space that goes from everything from AI, which is built on the foundation of having large data sets, to just more precision medicine and predictive analytics. I know there’s a ton of interest in the start up community around using AI to build new treatment protocols. In the biopharma space, there’s a huge undertaking to discover new data based biomarkers, whether that’s genomic biomarkers, microbiome biomarkers, endoscopic biomarkers. And so I think increasingly the GI community is looking for new ways to capture and build robust and well annotated data sets. I think that’s going to have an increasing impact down the road, basically, on all aspects of care, from pharma treatment to endoscopic therapies.
Andrea Vossler: I might just add, and Tom has a bit more insight into this, but the AGA has a number of research centres at the AGA, including, I think, a new one just spun up around AI to your point. I don’t know, Tom, if you want to maybe give a little background on some of the research centres and that is where some of the deal flow coming from.
Tom Serena: Matt. That was great insight. We had a consensus conference around AI we just didn’t want to repeat. I mean, there are organizations focused on this. We’re not going to be at the bleeding edge, but we’re trying to figure out what AGA’s niche is with regard to AI.
I would also say one of the things we’re heavily investing in from a time standpoint, or clinical trials and Matt, this ties to Virgo as well, because just diversity of trials and just helping to capitalize enrolment just to be more creative and figuring out the keys to recruiting patients, frankly, that’s kind of boots on the ground. It’s not as sexy as tech, but it’s so important.
Praveen Suthrum: Anything else that all of you wanted to talk about or share before we wrap up today.
Tom Serena: The one thing I was really surprised at when we started fundraising for the fund, I kind of had in mind your typical investor. But I probably personally know only about 20% of the investors that the people that were interested in this fund and are earlier in their career than I thought they would have been and incredibly enthusiastic. And I found these, like, gold veins of investment clubs. They’re already working together to make other investments. So I just sort of discovered a whole new world. And it’s really gratifying because I think VC is probably complicated if you haven’t been or maybe intimidating if you haven’t been involved in it. Like, it’s high risk where I think these early on investors understand how it contributes to a diversified portfolio. So something I’ve learned.
Praveen Suthrum: Thank you for sharing that.
Matt Schwartz: That’s a great point. Just a second. That I think it’s only been, what, maybe a week, week and a half since we announced this investment with the AGA. And it’s been fun. I’ve been on the road the past couple of weeks and have run into physicians now who told me that they’re participants in the AGA’s GI Opportunity Fund, which is amazing to hear.
Historically, we would oftentimes run into physicians who were curious about investing in Virgo, didn’t exactly know how to do it or what the right pathway was, and we didn’t always have a good vehicle for them to make smaller investments. And so I’m grateful that the AGA has given the physician community that sort of an opportunity to be participants in helping shape new innovation in the field. It’s great.
Praveen Suthrum: So congratulations once again to all of you and to your teams. This is amazing. And this is exactly the kind of things that I look for through the Scope Forward lens. I want to see what’s new and who is innovating in what way. So this is an amazing announcement. So I wish you all the best and thanks so much for coming on the platform and making this announcement.
Tom Serena: Thanks for the opportunity. I really enjoyed it.
Matt Schwartz: Yeah, thanks. Praveen, as always.