Category Archives: Insights

Running Through Walls: Thinking Long Term is the Greatest Gift

Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to a value-based care incentive structure, and why building a valuable solution requires a long time horizon.

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Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

Welcome Evan Neu

Venrock is pleased to announce that Evan Neu has joined us as a Partner and General Counsel in our Palo Alto office. Evan will manage our legal and regulatory strategy, as well as oversee the operations and administration of Venrock.

Prior to Venrock, Evan was a Managing Director and Deputy General Counsel at TPG, a leading global alternative asset manager. Earlier in his career, he was an Associate with Debevoise & Plimpton LLP in New York.  He earned his B.S. from Cornell University and his J.D. from the University of Pennsylvania Law School.

We’re excited Evan is joining us and look forward to having his legal expertise to lean on moving forward.

Welcome to the team Evan!

Running Through Walls: Diversifying the Cap Table

Venrock partners Bryan Roberts and Bob Kocher, speak with Heather Fernandez, co-founder and CEO of Solv, about Solv’s mission, building more cap table diversity in tech, and the healthcare field today. Fernandez delves into Solv’s Series C funding round where she created a special purpose vehicle (SPV) focused on women of color, bringing in first-time investors who wouldn’t otherwise have access. Fernandez also shares how Solv is unlocking capacity with software, its pricing strategy, and its goals for the next 2-3 years.

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Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

Welcome Ganesh Srinivasan

Venrock is thrilled to announce that Ganesh Srinivasan has joined us as a partner in our Palo Alto office. He will help us expand our efforts to find passionate entrepreneurs, focused on building the future in data infrastructure and developer tools. 

The amount of data being generated and stored has exploded in volume. This, coupled with increased needs of data driven applications like AI, has led to the emergence of a new architecture and a paradigm shift in how we solve for new performance requirements. Ganesh’s technical expertise and knowledge will be a welcome addition to the team and our portfolio companies. Ganesh is particularly excited about Venrock’s deep focus on this space as shown by the investments in companies like Astronomer and Decodable, which are pushing the boundaries of innovation.

Ganesh brings a wealth of tech operating experience to Venrock. In the past decade, he has helped scale engineering teams at Confluent, Uber as VP Engineering, and LinkedIn during their hyper-growth phase. Most recently, he served as Chief Product Officer at Confluent, which is the leading provider of data streaming infrastructure based on Apache Kafka. During his time at Confluent, his team grew 20x as he led the company’s transition from an open source on-premise model to a cloud based SaaS offering. Confluent went public during his tenure in 2021.

Venrock’s rich history of investing in early stage companies, starting with Apple and Intel, includes Cloudflare, Dataminr, Devoted Health, Lucid Motors, Lyra, Personal Capital and Nest. We’re excited Ganesh is joining us and look forward to building companies together.

Running Through Walls: The Balancing Act of Drug Discovery

Larry Hamann, co-founder, president, and CEO of Interdict Bio, speaks with Venrock Vice President Mariana Mihalusova about lessons learned from his career in drug discovery. Hamann delves into where his love for organic chemistry stems from and why inclusive environments are essential to building successful teams. He also speaks about the do’s and don’ts when structuring collaborations with big pharma, when a drug is “good enough” to move forward in development and new approaches he’s excited for.

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Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

Running Through Walls: Bust The Liars Without Elevating The Liars

Venrock partner Bob Kocher speaks with Dr. Drew Altman, CEO of the Henry J. Kaiser Family Foundation (KFF) and founding publisher of Kaiser Health News (KNH), about dealing with misinformation and skepticism with expertise and facts. Altman reveals how misinformation, fragmented media, and a broken political system exacerbate the public’s low trust in experts. Altman discusses KHN’s origin story, the importance of busting liars without elevating them, and his thoughts on the Inflation Reduction Act. 

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Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

Running Through Walls: Healthy Skepticism in Product Management

Jim Del Favero, Head of Product at Figure, a fintech company using blockchain to help homeowners better tap their home equity, joins Venrock partner Brian Ascher to discuss what makes a great product manager. Del Favero reveals why great PMs focus on outcomes, not outputs, and critically think about the problem that needs to be solved. Del Favero and Ascher also talk through common mistakes PMs make, the engineering and PM relationship, and data-driven vs. years of experience decisions.

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Want more? Here’s the latest on Running Through Walls.

Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

Welcome to the New Database Era

The new category of cloud database services emerging

One of the most profound and maybe non-obvious shifts driving this is the emergence of the cloud database. Services such as Amazon S3, Google BigQuery, Snowflake, Databricks, and others, have solved computing on large volumes of data, and have made it easy to store data from every available source. Enterprise wants to store everything they can in the hopes of being able to deliver improved customer experiences and new market capabilities.

It has been a good time to be a database company.

Database companies have raised over $8.7B over the last 10 years, with almost half of that, $4.1B, just in the last 24 months, up from $849M in 2019 (according to CB Insights).

It’s not surprising with the sky-high valuations of Snowflake and Databricks and $16B in new revenue up for grabs in 2021, simply from market growth. A market that doubled in the last four years to almost $90B, is expected to double again over the next four. Safe to say there is a huge opportunity to go after.

See here for a solid list of database financings in 2021.

20 years ago, you had one option, a relational database.

Today, thanks to the cloud, microservices, distributed applications, global scale, real-time data, deep learning, etc., new database architectures emerged to hyper-solve new performance requirements. Different systems for fast reads, and fast writes. Systems specifically to power ad-hoc analytics, or for data that is unstructured, semi-structured, transactional, relational, graph, or time-series. Also for data used for cache, search, based on indexes, events, and more.

Each came with different performance needs, including high availability, horizontal scale, distributed consistency, failover protection, partition tolerance, serverless, and fully managed.

As a result, enterprises on average store data across seven or more different databases (i.e., Snowflake as your data warehouse, Clickhouse for ad-hoc analytics, Timescale for time series data, Elastic for their search data, S3 for logs, Postgres for transactions, Redis for caching or application data, Cassandra for complex workloads, and Dgraph for relationship data or dynamic schemas). That’s all assuming you are collocated to a single cloud, and that you’ve built a modern data stack from scratch.

The level of performance and guarantees from these services and platforms are unparalleled, compared to 5–10 years ago. At the same time, the proliferation and fragmentation of the database layer are increasingly creating new challenges. For example, syncing across the different schemas and systems, writing new ETL jobs to bridge workloads across multiple databases, constant cross-talk and connectivity issues, the overhead of managing active-active clustering across so many different systems, or data transfers when new clusters or systems come online. Each with different scaling, branching, propagation, sharding, and resource requirements.

What’s more, new databases emerge monthly to solve the next challenge of enterprise scale.

The New Age Database

So the question is, will the future of the database continue to be defined as what a database is today?

I’d make the case that they shouldn’t.

Instead, I hope the next generation of databases will look very different from the last. They should have the following capabilities:

  • Primarily compute, query, and/or be infrastructure engines that can sit on top of commodity storage layers.
  • No migration or restructuring of the underlying data is required.
  • No re-writing or parsing of queries is needed.
  • Work on top of multiple storage engines, whether columnar, non-relational, or graph.
  • Moves the complexity of configuration, availability, and scale into code.
  • Allows applications to call into a single interface, regardless of the underlying data infrastructure.
  • Works out of the box as a serverless or managed service.
  • Be built for developer-first experiences, in both single-player and multiplayer modes.
  • Deliver day 0 value for both existing (brownfield) and new (greenfield) projects

There are many secular trends driving this future:

1. No one wants to migrate to a new database. The cost of every new database introduced into an organization is an N² problem to the number of databases you already have. Migrating to a new architecture, schema, configuration, and needing to re-optimize for rebalancing, query planning, scaling, resource requirements, and more is often a [value/(time+cost)] of close to zero. It may come as a surprise, but there are still billions of dollars in Oracle instances still powering critical apps today, and they likely aren’t going anywhere.

2. Majority of the killer features won’t be in the storage layer. Separating compute and storage has increasingly enabled new levels of performance, allowing for super cheap raw storage costs, and finely-tuned, elastically scaled compute/query/infra layers. The storage layer can be at the center of data infrastructure and leveraged in various different ways, by multiple tools, to solve routing, parsing, availability, scale, translation, and more.

3. The database is slowly unbundling into highly specialized services, moving away from the overly-complex, locked-in approaches of the past. No single database can solve transactional and analytical use cases fully; with fast reads and writes, with high availability and consistency;all while solving caching at the edge, and horizontally scaling as needed. But unbundling into a set of layers sitting on top of the storage engine can introduce a set of new services to deliver new levels of performance and guarantees. For example, a dynamic caching service that can optimize caches based on user, query, and data awareness; managing sharding based on data distribution query demand and data change rates; a proxy layer to enable high availability and horizontal scale, with connection pooling and resource management; a data management framework to solve async and sync propagation between schemas; or translation layers between GraphQL and relational databases. These multi-dimensional problems can be built as programmatic solutions, in code, decoupled from the database itself, and perform significantly better.

4. Scale and simplicity have been trade-offs up until now. Postgres, MySQL, and Cassandra are very powerful, but difficult to get right. Firebase and Heroku are super easy to use but don’t scale. These database technologies have massive install bases, and robust engines, and withstood the test of time at Facebook and Netflix-level scales. But tuning them for your needs often requires a Ph.D. and a team of database experts, as teams at Facebook, Netflix, Uber, Airbnb all have. For the rest of us, we struggle with consistency and isolation, sharding, locking, clock skews, query planning, security, networking, etc. What companies like Supabase and Hydras are doing in leveraging standard Postgres installs but building powerful compute and management layers on top, allow for the power of Postgres, but with the simplicity of Firebase or Heroku.

5. The database index model hasn’t changed in 30+ years. Today we rely on general-purpose, one size fits all indexes such as B-trees and Hash-maps, taking a black-box view of our data. Being more data-aware, such as leveraging a cumulative distribution function (CDF) as we’ve seen with Learned Indexes, can lead to smaller indexes, faster lookups, increased parallelism, and reduced CPU usage. We’ve barely even begun to demonstrate next-generation indexes that have adapted both to the shape and changes of our data.

6. There is little-to-no machine learning used to improve database performance. Instead, today we define static rule sets and configurations to optimize query performance, cost modeling, and workload forecasting. These combinatorial, multi-dimensional problem sets are too complex for humans to configure, and are perfect machine learning problems. Resources such as disk, RAM, and CPU are well characterized, query history is well understood, and data distribution can be defined. We could see 10x step-ups in query performance, cost, and resource utilization, and never see another nested loop join again.

7. Data platform and engineering teams don’t want to be DBAs, DevOps, or SREs. They want their systems and services to just work, out of the box, and not have to think about resources, connection pooling, cache logic, vacuuming, query planning, updating indexes, and more. Teams today want a robust set of endpoints that are easy to deploy, and just work.

8. The need for operational real-time data is driving a need for hybrid systems. Transactional systems can write new records into a table rapidly, with a high level of accuracy, speed, and reliability. An analytics system can search across a set of tables and data rapidly to find an answer. With streaming data and need for faster responsiveness in analytical systems, the idea of HTAP (hybrid transaction/analytical processing) systems are emerging — particularly for use cases that are highly operational in nature — meaning a very high level of new writes/records and more responsive telemetry or analytics on business metrics. This introduces a new architectural paradigm, where transactional and analytical data and systems start to reside much closer to each other, but not together.

A New Category of Databases

A new category of cloud database companies is emerging, effectively deconstructing the traditional database monolith stack into core layered services; storage, compute, optimization, query planning, indexing, functions, and more. Companies like ReadySet, Hasura, Xata, Ottertune, Apollo, Polyscale, and others are examples of this movement and quickly becoming the new developer standard.

These new unbundled databases are focused on solving the hard problems of caching, indexes, scale, and availability, and beginning to remove the trade-off between performance and guarantees. Fast databases, always-on, handling mass scale, and data-aware, blurring the lines between the traditional divisions between operational and analytical systems. The future looks bright.


Welcome to the New Database Era was originally published on TechCrunch.

Source: https://techcrunch.com/2022/06/01/this-is-the-beginning-of-the-unbundled-database-era/

Running Through Walls: Culture and Connection

Venrock partner Brian Ascher speaks with Nicole Alvino, co-founder and CEO of Firstup, about effective workforce communication both digitally and in person. Alvino highlights fostering employee connection through authentic and transparent communication, using the power of video to drive engagement, and discusses expectations for corporate social responsibility. Plus, Alvino reveals a non-obvious lesson learned – employees want to hear from their peers (not just their leaders).

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Farzad Mostashari, founder and CEO of Aledade, speaks with Venrock’s Bryan Roberts and Bob Kocher about improving the quality and efficiency of patient care with a focus on preventative care. With the recent launch of Aledade Care Solutions and new focus on Medicare Advantage, Mostashari delves into Aledade’s efforts to scale and deliver where average primary care practices can’t. Mostashari also reveals his approach to value based care incentive structure, and why building a valuable solution requires a long time horizon.
  1. Thinking Long Term is the Greatest Gift
  2. Diversifying the Cap Table
  3. The Balancing Act of Drug Discovery
  4. Bust the Liars Without Elevating the Liars
  5. Healthy Skepticism in Product Management

2022 Healthcare Prognosis

When we published our 2021 survey results, vaccines had yet to be broadly released, Tiger Global was still a growth investor and SPACs were en vogue (at least the raising part…). 2021 respondents overwhelmingly correctly predicted a booster would be available before vaccine protection waned, SPACs would return to being a niche product, and that a return to office would include a hybrid approach. However, the Delta and Omicron variants threw a curveball at us and subsequently forced mask mandates back into effect. Covid continues to be unsettling with BA.2 now taking hold and resulting in Philadelphia reinstating an indoor mask mandate on April 11, 2022.

Three months into 2022, the world seems even more unpredictable. While Covid cases have fallen in most of the world from Omicron peaks, there are worrisome signs in China and a giant reservoir of unvaccinated people which could give rise to more variants. Russian aggression and hostilities understandably are top of mind given the worldwide human, economic and political ramifications. Once again, we asked our network of experts for their opinions on the latest trends in health tech, world issues, and the outlook for Covid-19.

Our commentary on the most interesting findings from this year’s survey, followed by the full results, can be found here. Thank you to the hundreds of healthcare experts who took the time to share their views and opinions with us.