Houston health tech leader to expand accelerator to continue connecting female founders

HOUSTON INNOVATORS PODCAST EPISODE 203

Ayse McCracken, founder of Ignite Healthcare Network, joins the Houston Innovators Podcast to discuss how she's growing her impact on female health tech founders. Photo via LinkedIn

With a decades-long career in health care, Ayse McCracken's most recent professional chapter has been laser focused on finding, supporting, and accelerating female-founded startups in health tech with her nonprofit, Ignite Healthcare Network.

Originally founded in 2017 as a pitch competition, Ignite has evolved to become an active and integral program for female health tech entrepreneurs. Ninety-one founders have graduated from Ignite and gone on to raise over $550 million in funding for their ventures. Currently, Ignite has 19 women in its 2023 cohort, which concludes November 9 with the annual Fire Pitch competition.

"Having an impact in the health care industry and finding solutions is important to me," McCracken says of her passion for Ignite on this week's episode of the Houston Innovators Podcast. "The second aspect of that is there are so many women in health care, and yet you don't see them in leadership roles."

With Ignite, McCracken is actively seeking out these potential female leaders, and giving them the support — through mentorship, programming, and networking opportunities — they need to grow their business.

Each year, McCracken explains, she's pushing the envelope with what she can accomplish with Ignite. This year, she hosted a new event in Dallas to reach female founders there, and coming soon, Ignite will launch a platform that will extend its relationship with its founders and keep them looped in with potential customers, mentors, investors, and more.

"We're in the process of building our own platform that continues to connect our ecosystem so that we're not just an episode in the journey of an entrepreneur, but that we have the ability to help them along their path," McCracken says. "That path is a rollercoaster for a variety of reasons — whether it's gender or market related — and if we help to provide a community that can provide support for companies that have promise, our goal is to, over time, triple the money that female entrepreneurs are getting."

But McCracken says she wants Ignite to do more than just find investors for her network of founders.

"Success to me isn't just getting people an early stage investment," she explains. "Success to me is getting companies that actually commercialize, get their products in the market, and that they are actually making an impact on health wellbeing, patients, and so forth."

McCracken shares more about the future of Ignite on the podcast. Listen to the interview here — or wherever you stream your podcasts — and subscribe for weekly episodes.

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As the health care industry continues to evolve, experience management technology will play an increasingly important role in addressing health equity gaps and improving the health and well-being of patients across the globe. Photo via Getty Images

Houston expert: How technology can be used to bridge the health equity gap

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Progressively over the last decade, the health care industry has become increasingly aware of the role that social determinants of health play in the health outcomes of patients.

Social determinants of health, or SDOH, are the conditions in which people are born, grow, live, work, and age, and they have a significant impact on a person's health and well-being. Examples of SDOH include income, education level, housing, and access to healthy food.

One of the key challenges facing health care organizations and providers is how to address health equity gaps, which are the differences in health outcomes between different populations. Health equity gaps are often caused by social determinants of health, and they can be particularly pronounced among vulnerable populations such as low-income communities, racial and ethnic minorities, and those living in rural areas.

Experience management technology has emerged as a powerful tool for addressing these equity gaps. This technology uses feedback, behaviors, and other relevant SDOH data in order to understand the unique needs of different populations and develop targeted interventions to improve their health outcomes.

One of the key ways that experience management technology can help decrease health equity gaps is by segmenting populations by social determinants of health. By collecting data on patients' demographics, such as their age, race, income, and education level, health care organizations can gain a better understanding of the SDOH that are most relevant to each population. This information can be used to develop personalized actions that address the specific needs of each population, rather than relying on a one-size-fits-all approach.

For example, health care organizations could use experience management technology to gather feedback from patients on their access to healthy food. By segmenting the patient population by zip code, health care organizations could identify patients in rural areas who do not have easy access to quality care facilities and providers. These patients could then be targeted with interventions such as transportation assistance programs or care coordination programs, which could help address their specific needs.

In addition to segmenting populations by social determinants of health, experience management technology can also help health care organizations gather insights into patient behaviors. By integrating data on patients' health behaviors, such as adherence to treatment or missed appointments, health care organizations can develop targeted interventions that encourage healthy behaviors.

For example, health care providers could use experience management technology to collect data on patients' treatment habits. Patients who report low adherence to treatment could be targeted with interventions such as treatment education programs or care coaching, which could help them develop healthier habits over time.

Finally, experience management technology can help health care organizations gain insight into their patient’s end to end journey. By integrating data from multiple sources, such as electronic health records, patient feedback, and social determinants of health data, health care organizations can develop a more comprehensive understanding of patients' health needs and brand expectations. This unified illustration allows health care organizations to improve business outcomes such as lower readmission rates, and create loyal patients that will refer their friends and family in the most important and sensitive moments in their lives.

In conclusion, experience management technology has emerged as a powerful tool for addressing health equity gaps by segmenting populations by social determinants of health, understanding and acting on their unique needs through feedback, behaviors, and dynamic integrations. By leveraging this technology, health care organizations can develop unique solutions that improve the health outcomes of vulnerable populations, such as low-income communities, racial and ethnic minorities, and those living in rural areas.

As the health care industry continues to evolve, experience management technology will play an increasingly important role in addressing health equity gaps and improving the health and well-being of patients across the globe.

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Ariel Jones is the head of health care provider solution strategy for Qualtrics XM, an American Experience Management company providing software solutions for customer and employee experience.

A Rice research team is tapping into materials science to better understand Alzheimer’s disease, a UH professor is developing a treatment for hereditary vision loss, and a BCM researcher is looking at stress and brain cancer. Photo by Gustavo Raskosky/Rice University

These 3 Houston research projects are coming up with life-saving innovations

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Research, perhaps now more than ever, is crucial to expanding and growing innovation in Houston — and it's happening across the city right under our noses.

In InnovationMap's latest roundup of research news, three Houston institutions are working on life-saving health care research thanks to new technologies.

Rice University scientists' groundbreaking alzheimer's study

Angel Martí (right) and his co-authors (from left) Utana Umezaki and Zhi Mei Sonia He have published their latest findings on Alzheimer’s disease. Photo by Gustavo Raskosky/Rice University

According to the Centers for Disease Control and Prevention, Alzheimer’s disease will affect nearly 14 million people in the U.S. by 2060. A group of scientists from Rice University are looking into a peptide associated with the disease, and their study was published in Chemical Science.

Angel Martí — a professor of chemistry, bioengineering, and materials science and nanoengineering and faculty director of the Rice Emerging Scholars Program — and his team have developed a new approach using time-resolved spectroscopy and computational chemistry, according to a news release from Rice. The scientists "found experimental evidence of an alternative binding site on amyloid-beta aggregates, opening the door to the development of new therapies for Alzheimer’s and other diseases associated with amyloid deposits."

Amyloid plaque deposits in the brain are a main feature of Alzheimer’s, per Rice.

“Amyloid-beta is a peptide that aggregates in the brains of people that suffer from Alzheimer’s disease, forming these supramolecular nanoscale fibers, or fibrils” says Martí in the release. “Once they grow sufficiently, these fibrils precipitate and form what we call amyloid plaques.

“Understanding how molecules in general bind to amyloid-beta is particularly important not only for developing drugs that will bind with better affinity to its aggregates, but also for figuring out who the other players are that contribute to cerebral tissue toxicity,” he adds.

The National Science Foundation and the family of the late Professor Donald DuPré, a Houston-born Rice alumnus and former professor of chemistry at the University of Louisville, supported the research, which is explained more thoroughly on Rice's website.

University of Houston professor granted $1.6M for gene therapy treatment for rare eye disease

Muna Naash, a professor at UH, is hoping her research can result in treatment for a rare genetic disease that causes vision loss. Photo via UH.edu

A University of Houston researcher is working on a way to restore sight to those suffering from a rare genetic eye disease.

Muna Naash, the John S. Dunn Endowed Professor of biomedical engineering at UH, is expanding a method of gene therapy to potentially treat vision loss in patients with Usher Syndrome Type 2A, or USH2A, a rare genetic disease.

Naash has received a $1.6 million grant from the National Eye Institute to support her work. Mutations of the USH2A gene can include hearing loss from birth and progressive loss of vision, according to a news release from UH. Naash's work is looking at applying gene therapy — the introduction of a normal gene into cells to correct genetic disorders — to treat this genetic disease. There is not currently another treatment for USH2A.

“Our goal is to advance our current intravitreal gene therapy platform consisting of DNA nanoparticles/hyaluronic acid nanospheres to deliver large genes in order to develop safe and effective therapies for visual loss in Usher Syndrome Type 2A,” says Naash. “Developing an effective treatment for USH2A has been challenging due to its large coding sequence (15.8 kb) that has precluded its delivery using standard approaches and the presence of multiple isoforms with functions that are not fully understood."

BCM researcher on the impact of stress

This Baylor researcher is looking at the relationship between stress and brain cancer thanks to a new grant. Photo via Andriy Onufriyenko/Getty Images

Stress can impact the human body in a number of ways — from high blood pressure to hair loss — but one Houston scientist is looking into what happens to bodies in the long term, from age-related neurodegeneration to cancer.

Dr. Steven Boeynaems is assistant professor of molecular and human genetics at Baylor College of Medicine. His lab is located at the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, and he also is a part of the Therapeutic Innovation Center, the Center for Alzheimer’s and Neurodegenerative Diseases, and the Dan L Duncan Comprehensive Cancer Center at Baylor.

Recently, the Cancer Prevention and Research Institute of Texas, or CPRIT, awarded Boeynaems a grant to continue his work studying how cells and organisms respond to stress.

“Any cell, in nature or in our bodies, during its existence, will have to deal with some conditions that deviate from its ideal environment,” Boeynaems says in a BCM press release. “The key issue that all cells face in such conditions is that they can no longer properly fold their proteins, and that leads to the abnormal clumping of proteins into aggregates. We have seen such aggregates occur in many species and under a variety of stress-related conditions, whether it is in a plant dealing with drought or in a human patient with aging-related Alzheimer’s disease."

Now, thanks to the CPRIT funding, he says his lab will now also venture into studying the role of cellular stress in brain cancer.

“A tumor is a very stressful environment for cells, and cancer cells need to continuously adapt to this stress to survive and/or metastasize,” he says in the release.

“Moreover, the same principles of toxic protein aggregation and protection through protein droplets seem to be at play here as well,” he continues. “We have studied protein droplets not only in humans but also in stress-tolerant organisms such as plants and bacteria for years now. We propose to build and leverage on that knowledge to come up with innovative new treatments for cancer patients.”

Arianne Dowdell spoke with InnovationMap about Houston Methodist's DEI initiatives — and how they will help develop the hospital of the future. Photo courtesy of Houston Methodist

Q&A: Houston innovator on DEI initiatives, importance in health care

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Prioritizing diversity, equity, and inclusion within health care innovation goes hand in hand, according to Arianne Dowdell, vice president and chief diversity, equity and inclusion officer at Houston Methodist.

"I think we're in a very interesting time when we think about how health care looks. It's changing drastically and so people have a lot more options for where they choose to get their health care and who their providers are," she tells InnovationMap. "So I think that the thought of the patient comes first is really going to be the key of understanding how do we tackle health equity."

Houston Methodist, under Dowdell's leadership, is putting the patients at the forefront of the hospital system's priorities through its DEI initiatives — whether that's employee programs or training the future leaders of the health care industry through its DEI Summer Scholarship Program.

In an interview with InnovationMap, Dowdell shares more about these ongoing initiatives and her role, as well as the importance of DEI in innovative health care.

InnovationMap: Tell me a bit about your role leading DEI at Houston Methodist. What are you tasked with and why is it important to the organization?

Arianne Dowdell: In my role, I'm responsible for really leading the vision for unparalleled safety, quality and service, and innovation through the lens of DEI. And what that really means is thinking about how we execute our diversity, equity, and inclusion strategies. When we think about our employees, our patients as well as our community. So, my role is rather broad in scope. I oversee DEI for all of the Houston Methodist hospitals in the area and we year by year target and have certain goals of what we want to accomplish under each of those layers. When we think about our patients and our employees in the community.

IM: In what ways do DEI and innovation intersect?

AD: You know, the wonderful thing about innovation is that there is such a huge overlap with DEI. When we think about our patient care, we just start there and think about what we're doing with our new hospital that's opening.

For example, we talk about making it the hospital in the future. Part of that innovation piece means that we're meeting our patients where they are with the needs that they have. So, a lot of times we talk about equity versus equality and what people need and what we have to remember when we think about equity, especially with our patients and the fact that we serve such a diverse community, is making sure that those innovations that we're coming up with as we're thinking about the patients varies right in different aspects to make sure that every patient that comes in the door is receiving the very best care that they have. It's a great opportunity being at a hospital that's so innovative to make sure that we're considering our innovative technologies to meet the different patients that we have that are coming through our doors every day.

It doesn't matter if you're down here in the medical center or out in Baytown. The innovation and what we're thinking about and the technologies and the way that we communicate with our patients, all that is part of innovation, which helps our DEI initiatives become more successful in everything that we're doing.

IM: What are some of the initiatives you’ve gotten to spearhead so far in your tenure?

AD: Our department's been around for about two and a half years. And so there's a couple of things that we're really excited about that are ongoing, but we've seen a lot of traction and measurable results. One is the employee resource groups we currently have — I think we're at nine, maybe 10 at this point for our groups — and we have close to 2,000 employees that are part of the groups working to make sure that they are empowered in the workplace and have support, but we also provide professional development opportunities for them.

Another thing that we've started are solidified DEI training programs and actually going and working with departments, both those that are clinical and non clinical within the hospital on DEI related issues. That's been a big success for us as well. And we're really evolving those trainings to become more of educational opportunities as we really start to have a heavy focus on health equity moving into 2023.

We also have a comprehensive training communications program, so we communicate out all of our efforts at all of our hospitals. And so engaging our CEOs at each of those hospitals and making sure that we allow all of our employees to have a way of learning about the work that we're doing in various mediums has been something we've worked really hard to achieve. And we also have different DEI groups and committees at each of our hospitals. That's been a way for us to connect and have leaders at all of our hospitals that are supporting our overall system wide initiatives.

It's been really fun the past two years to have different layers of the work that we're doing, including our 25 million DEI Grant to different nonprofit organizations in the community to make sure that we're looking at all these different layers. As I had mentioned before, that touch on everything that we do. And we're also going to be hyper focused moving into next year of making sure that we diversify our cancer center as well. And so now that we've kind of laid that first layer foundation, it's really nice to see how the team is evolving and the work that we're doing and also using data to show the results of the work that we're doing. So, with two years under our belt, it's nice to have some of that information now.

IM: How is Houston Methodist supporting future leaders in health care?

AD: One of the things I really wanted to make sure that we started once COVID slowed down a little bit, was to give underrepresented students an opportunity to pursue careers in health care that are non clinical. A lot of people in college, they don't know about all the different aspects of what runs a hospital, right? And so I thought it was a great opportunity for us to launch this program that we started last summer.

We started with six students that received scholarship funding and they all fall below the federal poverty line is how we established what the criteria was along with grades, etc. but a really great opportunity for students to come here for ten weeks on a paid scholarship in various departments throughout the hospital to learn what those inner workings are, to then pursue careers, possibly in things like DTI, human resources, spiritual care, managed care. So it was really fun to watch the first cohort of students go through last year.

These are our future leaders and teaching them all about the aspects of what, like I said, runs a hospital. But when we think about care of our patients, how everyone is such an integral part to it. And so for going into this summer coming up, we've actually more than doubled the number of opportunities that will be available. So, we now have 17 spaces that are available for students and we're branching out to all of our community hospitals and we've reached out to more schools around the nation. And so I'm excited to bring in this next cohort of leaders to really begin to think differently about how we look at care overall and manage hospitals from a diverse aspect. It's been a great program and our leadership here at the hospital is also very engaged, which I love.

IM: What’s on your radar for 2023?

AD: So, 2023 is really going to be a focus on health equity. Establishing we've got various dashboards that we're establishing to track and monitor what we're doing, but also working with all 29,000 plus of our employees to help them understand what role they play in achieving health equity so we can focus on the role that our clinicians play. But it's equally as important for the people that work at registration to understand the importance of the questions that we ask to make sure we're meeting the needs of our patients when they call and set up appointments.

We will be really hyper focused on that. We'll also be leveraging even more of the work that our employee resource groups do. And so I'm very excited about that as well as they become more involved in the community. When you talked about prevention and education, a lot of the members of our ERGs are now out in the community and doing a lot of really great work. And so those are just two of the programs that I'm really excited about for 2023 that will be hyper focused on.

IM: Why is equity in health care so important and what does the industry need to do to accomplish it?

AD: I think we're in a very interesting time when we think about how health care looks. It's changing drastically and so people have a lot more options for where they choose to get their health care and who their providers are. And so I think that the thought of the patient comes first is really going to be the key of understanding how do we tackle health equity. Because when we look at all the different requirements from systems throughout the country, and then we look at results from what patients say, we have to spend the time to marry those two together.

At the end of the day, that still is our patient comes first — so how are we educating our future clinicians? Are we working with our med schools to make sure we're tackling that because we really have to look to the future generations? How are we reporting out our efforts and our outcomes is going to be important to. Keeping that patient centered focus is going to be key to achieving health equity. And also a lot of times we don't want to acknowledge what our shortcomings are. Know people always want to say this is where we excel, but really taking the time to acknowledge what can we do better, and doing those deep dives, It doesn't matter if you're a large health system or if you're one of the newer branches that's coming out. You have to take the time to really look at what those results are, to make sure you're measuring them to achieve those new goals. So I think that that's actually going to be the key to moving forward and making sure you keep politics out of it to the extent possible and really just stay patient. Focus is what's going to be necessary because people have choices for where they want to go for their health care. And I think we all have to be mindful of that.

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This conversation has been edited for brevity and clarity.

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A Rice University student decided to use his data science skills for good. Photo courtesy of Biokind Analytics

Houston student launches data science nonprofit to support the health care industry

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For Alex Han, it all started with peanut butter.

Han was a high school student in Korea when he learned that the spread is a pure odorant that could be used to test smell in each hemisphere of the brain—issues on the left side was thought to be a predictor for Alzheimer’s disease. He later learned that the method wasn’t as airtight as previously thought, but Han was hooked. Alzheimer’s research became the teenager’s passion. While still in high school, Han began volunteering for Alzheimer’s Los Angeles, translating their brochures into Korean.

When it came time to choose a college, Han says Rice University appealed to him for many reasons.

“I loved the atmosphere. I loved the campus—it’s so beautiful. The diverse food, the people, I even liked the highway,” he says of Houston. “In Korea, everything is so close and compact. I loved the whole scenario of the city.”

A scholarship was also part of the appeal, as well as the pull of the world’s largest medical center. Han’s instincts were correct. Now, a junior at Rice, he has been working at renowned geneticist Huda Zoghbi’s Baylor College of Medicine lab for almost two years.

But dividing his obligations between full-time studies and his wet lab position wasn’t enough to keep Han’s active mind occupied. Last May, the statistics and biochemistry student began another endeavor that uses both his specialties. It was then that he founded Biokind Analytics. The nonprofit was designed to explore how data science can support health care nonprofits.

Han reached out to Alzheimer’s Los Angeles to offer his data analysis services on a volunteer basis and was shocked that the association had never considered it before.

“I was really surprised—even small stores and restaurants use statistics to boost their profits. [Alzheimer’s Los Angeles] receive a couple million dollars every year in donations. They have data stores but hadn’t really capitalized yet in the area of analytics.”

Han, along with a small team of Rice students, including vice president Zac Andrews and development director Masha Zaitsev, made Alzheimer’s Los Angeles a pet project, analyzing geospatial trends in its donorship and interpreting the past year’s donation trends. “We wanted to see if the demand was the same in Houston. We found that this pattern was consistent. A lot of nonprofits are willing to have us analyze the data sets they’ve already been tracking and provide data analysis for healthcare nonprofits.”

Less than a year after Han established Biokind Analytics, the 501(c)(3) already has seven chapters on college campuses around the country. From UC Davis and San Diego in the West to Brown University and the University of Virginia on the East Coast, the data science students have helped a diverse range of medical nonprofits, mostly based in the Houston area. They run the gamut from ALS Association of Texas to Nora’s Home, which serves organ failure and transplant patients.

Biokind Analytics has now completed seven projects and analyzed $100 million in funds. Each student group includes four to six members, mostly majors in the worlds of statistics, data science, and biochemistry, all working with the help of faculty advisors. At a total of about 35 students nationwide, Han says that he’s dedicated to growing at a steady pace to avoid potentially expanding too fast, too soon.

Another question for the future is what will happen to Biokind Analytics when Han completes his undergraduate studies in 2024. He plans to continue his medical studies with the goal of one day becoming a physician specializing in Alzheimer’s who uses data analytics to aid in patient care. But no matter how active Han continues to be in the nonprofit he started, his stated attachment to the cause and a growing group of both student leaders and healthcare associations eager for their services are sure to keep Biokind Analytics active long after graduation.

A Houston expert shares how to improve on communication in the health care setting. Image via Getty Images

Houston expert: 3 emotional intelligence tips for improving patient-practitioner experience

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After spending hours with healthcare professionals as both a consultant and patient, I know that it takes a special kind of person to take care of others in their most distressing and vulnerable times. That responsibility has been in overdrive because of COVID, causing emotional burnout, which in turn affects patient care. By equipping yourself with emotional intelligence, you can be more resilient for yourself and patients.

Emotional intelligence is keeping your intelligence high, when emotions are high.

Health care sets up an environment for a tornado of emotions, and the rules and regulations centered around patient-provider interactions are often complex to navigate. This leaves many on the brink of emotional exhaustion, and for survival’s sake, depersonalization with patients becomes the status quo. Feeling a disconnect with their patients is another added weight, as few get into this industry for just the paycheck – it’s the impact of helping people get healthy and stay healthy that motivates them. I’ve seen it time and time again with people in my life, as well as on my own patient journey as I battled stage 3 cancer.

Before the pandemic, reducing job burnout among healthcare workers became a standard policy. Now, it’s more than a policy, it’s top priority with staff shortages growing in healthcare. A February 2022 survey conducted by USA Today and Ipsos of more than 1,100 health care workers found nearly a quarter of respondents said they were likely to leave the field in the near future.

It’s time to maximize your health by embracing emotional intelligence with these three tips, which will also enhance your communications with peers and patients.

​Recognize your emotions.

Pushing away emotions takes more energy than acknowledging them because rarely do you have to push them back just one time, it is a constant tug-of-war. When you don’t process your emotions, they can show up as physical pain. Recognize your emotions beyond the narrow definitions of sad, angry or happy — use as many adjectives as you can think of, get descriptive, look up synonyms. Write them down. Share with your therapist. Acknowledge it when you work out. Talk it out into a notes page on your phone. Once you recognize, you can acknowledge, process, and address.

Acknowledge your strengths and weaknesses.

Your colleagues can be a catalyst. When you’re overworked, your endurance changes, and it’s important to share that with your team, because they are feeling the same — and in these situations you can lean on each other. Verbalizing that you need help and asking others how they can be supported cultivates trust. This dynamic between colleagues allows your team to be more adaptable, which leads to improved culture. Your patients will feel this shift, as they will be more at ease and more likely to listen to your instructions and advice

Don’t assume, ask. 

Assumptions lead to destruction. You can’t read minds – especially when you exist in a diverse city with an array of cultures that approach life and work responsibilities in various ways. If you need to take a day off, ask. If your patient is looking confused, slow down and ask what’s going on. If you’re starting to overcompensate because you notice a colleague struggling, ask them how you can help. If you need more resources at work, but think you shouldn’t ask because of budget cuts, ask anyway. Assumptions are rarely correct, and it leaves just one person carrying all the weight —YOU. Do yourself a favor, open up the dialogue.


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Sahar Paz is the CEO of Own Your Voice Strategy Firm and a Harvard-certified emotional intelligence expert with a mission to transform the patient-provider experience.

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Houston medical robotics startup announces $42M series C

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A Houston medical device company that's tapping into robotics technology for the operating room has just announced a major chunk of fresh funding.

EndoQuest Robotics Inc. announced that it has closed a $42 million series C to advance its robot technology that's targeting endoluminal and gastrointestinal minimally invasive procedures. Returning investors, CE Ventures Limited and McNair Interests, and new investor, Puma Venture Capital, led the round of funding.

"Our investors share our vision of leveraging robotics to redefine the possibilities in minimally invasive procedures," Kurt Azarbarzin, CEO of EndoQuest Robotics, says in a press release. "This financing enables us to continue innovating and refining our technology, ultimately improving patient care and transforming the future of endoluminal interventions."

The funding will go toward continued research and development, regulatory initiatives, commercialization, and other key initiatives. Dr. Vipul Patel, the co-founder and senior venture partner of Puma Venture Capital, is a robotic urologic surgeon and sees potential in EndoQuest's technology.

"I've had the privilege of seeing just about every robotic surgical system either in development or on the market today and can honestly say that EndoQuest's system is a true game changer for both physicians and patients," Patel says in the release.

Founded in 2017, EndoQuest's robotics technology has not yet been cleared by the FDA and is not for commercial sale in the United States.

"The EndoQuest team is trailblazing novel solutions in minimally invasive surgery," Neeraj Agrawal, executive director of Crescent Enterprises, the parent organization to CE Ventures Limited. "We welcome our new partners, and remain fully supportive of the Company and the prospects to transform healthcare with our innovative endoluminal surgical platform."

EndoQuest Robotics is targeting endoluminal and gastrointestinal minimally invasive procedures. Image via endoquestrobotics.com

Houston expert: How to build startup runway in a choppy venture funding market

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The venture funding market in 2023 has been very tough.

The number of rounds closing is significantly down from the 2022, and a record number of companies are raising. Overall VC fundraising is down, but great deals are getting funded well and at good valuations, while many are struggling. Fewer new investors are writing lead checks and being more cautious when they do, later stage investors are shifting earlier stage to manage risk, bad cap tables, operating plans, and reluctant insiders are killing otherwise good deals, and everyone is working on ensuring their portfolio is in good shape.

This is just another venture cycle. The sky is not falling, the playbook for this cycle was written long ago. But if you are a founder, you may need to take action. If you are less than 15 months of runway, it’s time to go to your investors with a plan. You need to either be well on your way to closing a round, starting your fundraise if the company is ready, know your investor group’s plan to bridge or do an inside round if necessary and what you need to achieve to unlock that, or bring them a realistic plan yourself to get to 18 to 30 months of runway. But whatever you need to do, you need to do it now.

The runway plan

The core of a good runway plan is building a cash wedge by taking a little from everywhere, and drop margin and cash. A little revenues, a little in pricing, a little headcount reduction, a little insider capital, a little new capital, and a little balance sheet help. How much a little is, depends on your own dynamic. The secret to a good cash wedge runway plan is starting early, and doing it now. Every day of delay increases the depth of the changes needed for the same runway – until you reach a point where the brutal burn math just doesn’t work, and the changes become costly or even untenable.

Focus on your customers. Nothing cures runway or fundraising ills like revenue. You’ve built these relationships for a reason. They are taking your calls because they care. If you and your team aren’t spending most of your time with customers right now, you are doing it wrong. Good customers get it. Focus their attention on how your product makes them money, and how much. Support their internal efforts to grow the account. Open book it, raise prices if it makes sense, and ask for more volume or contract extensions at good prices if you can’t. With new customers, focus on getting more phase ones that fit in the budget your champions have available quickly. Bet you and your customer can find more budget later when you’ve demonstrated value to them. Bid every grant and non-dilutive source that makes sense, which builds leverage for yourself and your investors.

Burnmatters. In a tight market, no one likes to buy burn, and demonstrating efficiency of revenue and backlog relative to capitalization and burn level matters. If you’re going to cut (and you probably should), cut much deeper than you think, and do it now. You ran this company when it was four people and no money, you can do it again if you really had to. Start making quick decisions about what you can defer and cut in the near term, there is always an easy 5 to 10 percent of costs you can cut and push to next year, and often a few points that can be pulled from supply chain deals. Overplan for growth, but don’t release to spend until your capital markets plan is clear.

Rebalance your spend. Shift your cost structure and organization chart forward towards the customer. Aggressively expand customer facing lead generation, guerilla marketing, applications engineering and direct sales efforts, at the expense of internally facing ones like R&D, manufacturing, and overhead. Repurpose people, change comp structures, job descriptions, or adjust costs and headcount. Get your team on board with the focus and where your runway is. A 12-person startup has about 2,000 labor hours a month to throw at its problems, 3,000 hours on overdrive, when your runway shortens, it’s time to hurl those at customers. Keep in mind, none of this is permanent, good startup organizations are elastic and in six months you can shift back or add again. You’re only really making 180-day changes here. That’s what the nimble startup means. It’s about runway and quick product and operational shifts.

Hit the balance sheet for cash. Depending on company stage and type, sell any underutilized assets and inventory, defer some capex, put someone on collecting AR and adjust your contract terms and pricing to pull forward cash flow, term out and negotiate payment terms on AP, leases and debt. One huge caveat. Do not take venture debt. Until you are profitable, venture debt does not actually create the runway in the real world that you see on paper, and has killed more good startups on the cusp of greatness. Venture debt is Lucy, runway is the football, and you are Charlie Brown.

Adjust your capital markets strategy. The classic rule is raise all you can when you can, because capital is available most when you need it least. But that’s not the whole story. And founders need to realize it is really dangerous to take a deal to market that is not ready, and doesn’t have the right level of insider support, is priced or structured wrong. While the market sets the price and terms, once you’ve a cap table full of investors, both new and existing investor appetite, and valuation, becomes a partial function of existing and new investor appetite and support. Take out a deal that’s not ready, or with too much burn, too little insider support, too high a last valuation, too large a convert or safe overhang or prior capitalization, too little team ownership, or too much valuation or cash need relative to its team, technology, TAM and traction (and cap table), and a founder and board can turn a good opportunity into a death spiral headed straight off a cliff, fast.

The "Magical 25" percent ratio. This is an art not a science, but the Magical 25 percent ratio on a prototypical startup will give you an idea of how powerful a Runaway Plan can be to get a deal done and reset a founder’s opportunity.

Imagine a middle of the road seed funded SaaS startup, burning $350,000 gross, with $100,000 in MRR, which has raised $3 million in cash from three investors and spent half of it. On its current trajectory it has six months of cash left, and is bankrupt by March. Market turned down, and the initial investor calls don’t result in a lead VC leaning in. The logic of burn rate math is brutal. In 90 days the company is on fumes, and it has no term sheet in hand, with the odds of getting one generally falling. And in today’s market the $1 million in ARR has become the new minimum not sufficient condition for fundraising, and the company will need to get farther on it’s A to be attractive to a B round investor. If the founder does nothing and waits 90 days they’ll be begging their investors for a bridge, and begging new investors for a flat round, and will likely end up with downround or an ugly insider bridge. At $250,000-a-month burn and no term sheet, within 150 days the founder will then need an inside round of between $4.5 and $6 million to get to the prototypical 24 month runway, or a $1.5 to $2 million bridge to buy enough more months to fundraise and build value. That’s 1.5x to 2x the capital raised, or over half the existing capital in a bridge, and puts intense pressure on strength of your cap table, growth rate, broad insider support, and quality of revenues in a tight venture funding market.

If the founder instead cuts costs 25 percent immediately, and then throws all hands on deck to find 25 percent more revenue — at this level of burn the startup probably has a team of at least 12 to 15 people, meaning the founder can throw at least 2,000-3,000 man hours in an all hands customer push in just the next 30 days if they had to. At the same time, the founder goes to his largest investors, walks through the cash and cost plan, and asks them to give him a term sheet for a seed extension with existing investors all kicking in 25 percent of their contribution to date, with the extension equal to 25 percent of the total capital at close. It can be papered fast and cheap. That adds $750,000, leaving the founder to find one new investor to join the insiders at the last price for 25 percent of the extension – a much easier ask of a new investor in a tough market, and probably one the founder has a couple of interested parties that have been watching, or certainly one of the founder’s investors can make a quick call to a friend to close. Brutal burn rate math has now become magical burn rate math and the company has 18 months of runway, has halved its net burn, and can additionally get away with half the A round equal to 1x the capital it has raised to date at the end of it if need be.

The "magical" part is the founder has now changed the odds for everyone – his team only has to find 25 percent revenues and costs. His insiders are only asked for 25 cents on the dollar support at a price they should love, leaving the typical fund with plenty of follow-on reserves after that, a new investor does not have to carry the lion share of the burn, set price, do as much dd, or worry about investor fatigue, and the insiders don’t have to go it alone and have external validation, and the founder has minimized their dilution, and their fundraising time. If the founder then is able to keep costs flat for just 6 months in a sprint and pick up another 25 percent in revenues, the runway at the current cashout date is still 16 months, and the company is set up well for its next round, with on $4 million in capitalization on nearly $2 million in ARR, a new investor with dry powder in the deal, and plenty of reserves left on the cap table to support the A, with a lot more traction – leaving the size of A round the company has to have at less than half the level of before, the effective revenue multiple insiders and new investors are facing halved, the burn the new investor had to buy halved and lots of time and options for the founder to drive value, dilution, and scale.

Founders, it’s your company. Your decision. Just be aware, how and how fast you play the tough decisions when the market shifts, changes the calculus for your investors, and their level of confidence and ammunition to back your future decisions. When you feel the market starting to tighten up, consider giving yourself, and your investors, some breathing space, then use that breathing space to drive value.

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Neal Dikeman is a venture capitalist and seven-time startup co-founder investing out of Energy Transition Ventures.

Houston entrepreneur launches platform for on-demand ordering with biz support for restaurateurs

it's chewtyme

While Ashley Loveless Cunningham has advised clients how to fix bad credit and build a healthy financial life for years, a look at her family’s own spending on food delivery came as a wake-up call.

Like a lot of busy households, they loved to order food through delivery apps, so much so that Cunningham realized it was time for a change. With the delivery charge and other fees that apps like DoorDash and GrubHub tack on, a food order can easily double in price. A $15 bowl from Chipotle that her son liked to order cost almost $40 by the time it got to the house — and that doesn’t even include a tip for the delivery driver.

“I thought, wait a minute. This is ridiculous,” she says.

She says she brainstormed, and began to look into ways to offer an alternative, not only for consumers, but for minority-owned restaurants that were struggling to keep their doors open.

So, Cunningham, whose business ventures include her financial literacy business New Credit Inc. and a perfume line, created her own app, ChewTyme.

The app launched in Houston and Atlanta last Friday, and has drawn over 3,000 consumer downloads, which Cunningham says is a “pretty good” start.

Cunningham, 40, a native of Mobile, Alabama, says she moved to Houston with her family ten months ago, drawn by the opportunity to grow their various businesses. And, the city’s vibrant food scene offered another avenue.

“Everybody moves here to open a restaurant,” she says of Houston.

Extra support on the side

Through restaurant owner clients of her credit counseling business, she learned that many were struggling to remain open. A lot of the business owners aren’t aware of the many options available to them, in business lines of credit, assuming their own personal financial credit is in good shape.

That’s where the business education side of the app comes in, where restaurateurs will gain access to “Business University,” financial guidance for their journey in the industry.

“I tell people, it’s not only about cash funding. There are other resources out there, things we need to thrive in the business space,” she says, adding that this includes mentorship and publicity services.

Many restaurant owners told her they partner with at least two or three food delivery apps already. But she thinks ChewTyme will stand out.

“A lot of people I’ve talked to, they just don’t know where to start,” she says. Her partnership with the restaurants would solve that issue, helping restaurateurs create a “full, state-of-the-art profile” that guides them every step of the way.

While she's yet to onboard her inaugural Houston restaurants, the app has begun to draw interest, Ashley says, especially from entrepreneurs who need a cheaper way to scale their business growth.

Cunningham says ChewTyme offers a competitive alternative to many third-party apps, which she says charge anywhere from a 20-22 percent commission on a restaurant’s delivery orders. The app will charge a 17 percent commission, with no monthly fee, and a flat $4.95 delivery rate to consumers, whom she plans to attract with discounts and promotions.

She hopes to initially sign up 25 restaurants in Houston and the same number in Atlanta, during the beta run of the app. As they work out the kinks, she feels confident in expansion.

Her biggest challenge moving forward is hiring quality drivers, she says.

“That really scares me. People who want to work, who have integrity. I’ve heard horror stories because people literally pick up their food and don’t deliver it,” she says.

ChewTyme is working with contracting partners who are conducting screening and background checks for potential drivers, and onboarding restaurant owners with follow-up. Interested restaurateurs or drivers can request more information on ChewTyme's website.

Tapping into a high-growth market

Third-party food delivery exploded in popularity during the pandemic, and a 2021 McKinsey report found that food delivery more than tripled since 2017. Post-pandemic, the on-demand services industry growth hasn't waned.

The Texas Restaurant Association fought for a law passed in 2021 to prevent third-party apps from adding restaurants to a delivery platform without a financial agreement or partnership, according to Christine Robbins, executive director of the association. But now that relationship seems to have settled into a profitable venture on both sides.

Taj Walker, of H-Town Restaurant Group, which owns Hugo’s, Xochi, and six other local restaurants, says the apps don’t typically charge a fee unless the restaurant takes part in an app’s ad promotion of their restaurant.

An app’s commission can range from 10 to 25 percent, he says, which their restaurants compensate for by charging 10 percent more on app orders than in-house food. The apps have become an important revenue stream for some H-Town’s more casual eateries, especially Urbe and Prego, which are popular among younger clientele, Walker says.

While Cunningham’s main goal is to uplift minority entrepreneurs and communities, the app will be available to any restaurateur who wants it.

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