Piction Health

Founders: Susan Conover & Pranav Kuber
Founding: 2019
Mission: Forging a world where everybody has access to high-quality medical care with a hair, skin and nail specialist
Employees: 9 & 66% Local
Workplace: Flexible
Stage & Capital Raised: Seed & $4M raised
Investors: Argon Ventures, Flare Capital Partners, TBD Angels, Techstars & assorted Angels
Key Customers: CT, NH & MA Patients
Glassdoor Rating: N/A
Valuation (estimated): <$25M
^ this is a useless number. There is no tangible valuation until the business is sold or goes public. Don’t forget it!

Piction Health is “fast, convenient, AI powered digital dermatological care”. Founded by Susan Conover & Pranav Kuber in 2019, this seed stage Boston based healthtech startup & their team are aiming to build the largest dermatology practice in the world. Their goal is to bring better, more scalable skin care solutions to patients across the country in the $29B U.S. specialty dermatology market.

Piction Health is currently serving patients in Connecticut, New Hampshire, and as of March 14th…Massachusetts. The home of an extremely freckled population. That’s thoughtful market prioritization right there!  So if you have anything on your skin that might need attention, go sign up here for an appointment today. Got to get the product plugged early. Ok, so how did this startup come to be?

Susan was originally trained as a Mechanical Engineer and began her career in management consulting before a health scare changed her career trajectory. She tried to book an appointment to see a dermatologist but the wait time was 3 months (!). When she finally got in to see a doctor she was diagnosed with Stage 2 Melanoma. If she had waited much longer, it could have spread and become lethal. Scary stuff. And quite preventable, really.

The experience was life changing for Susan and she moved to Boston to attend MIT as a Graduate Fellow where she wrote a thesis titled “Prime Areas for Improvement in Skin Cancer Detection and How Technology Can Help”. Sound familiar? Susan later met Pranav, Piction Health’s Co-Founder, doing improv and they teamed up to start the company together. Pranav was in the U.S. on an H1-B visa as a Senior Software Engineer working at another company full time for the first three years of Piction Health’s life. Because it’s almost impossible to start a startup as an immigrant. And there’s nothing funny about the care, attention & technology Susan, Pranav & team are bringing to digital dermatology.

Together they’ve worked through the problem maze and discovered some critical insights. There are gaps in dermatology care and the delivery method. PCPs aren’t sufficiently trained so they’ll refer many skin care cases out to a specialist. Then, if you google anything about dermatologists, you’ll find things like “why is it so hard to get a dermatology appointment?” and uncover there is a shortage of trained doctors each year. Also, a lot of dermatologists are focused on cosmetic procedures. It is the social media era, remember? Next, virtual care is becoming more normalized these past few years. There’s a huge opportunity for a digital company focused on triaging patient cases and providing high quality, affordable & accessible dermatology care in a more scalable way. 

When COVID sent us all home, Susan, Pranav & team were building the largest proprietary database of skin images in the world from dermatologists across 20+ countries covering pretty much every skin tone from South Africa to India to Tunisia all the way back to Boston. Today they have >1M images and 300K+ patient case files to help power their AI platform. 

Piction Health leverages AI to triage skin and nail care images. With the power of current smartphone camera technology, more than 60% of dermatology cases can be effectively treated through high quality images without an in person visit. They’re also working to incorporate and automate treatment plans for psoriasis, so if a patient’s case is getting better or worse they can help change medication without needing another physical trip to the doctor. Or see a nurse practitioner instead.

When I chatted with Susan, I asked her to explain Piction’s AI technology to me like I was a third grader. Because when it comes to AI technology and neural networks, that’s about my grade level. So, what is a neural network? A neural network is a type of artificial intelligence model that is designed to recognize complex patterns and relationships in data. It is inspired by the structure and function of the human brain, which consists of interconnected neurons that process and transmit information (h/t GPT-3, “what is a neural network”). Basically, multiple algorithms working together to process, organize, and verify data. When it comes to images, the neural networks are called Convolutional Neural Networks (CNN) but I’m going to leave that level of detail out for this one. Feel free to google that one yourself.

Now the Piction Health use case, directly from Susan: “You know how a doctor goes to medical school and studies their textbooks, then goes and does a residency to get real life repetitions and tested on their progress? Well, Piction’s AI does the same thing. It trains on 1M photos and 300K patient case files to teach a computer to recognize skin diseases and the distinguishing features of conditions like psoriasis, shingles, and then test the accuracy of those judgments. Imagine if a resident could review 300K cases over the course of their training.” This is a category where well trained AI can truly perform in a much more scalable and consistent way than the best dermatologist in the world possibly could.

Today, you can get a personalized care plan with Piction Health within 2 days for $80, less than 1/2 of the typical cost of a dermatologist visit, or use an HSA or FHA card as a qualified medical expense. They’re scaling to hundreds of digital patient visits per month this spring and gearing up to support major healthcare insurance providers in the months ahead. If you need an in person visit for something that is flagged as higher risk, Piction will work to get you an appointment with an expert dermatologist quickly in your area too. 

Operators to Know (Locally):

• Bridget Toomey, Lead Machine Learning Engineer
• Dr. Neal Kumar, Medical Director of Dermatology
• Andy Chen, Product Manager

My investigative powers continue to need work so apologies to the Piction Health team I’m sure I missed many operators internally

Key Roles To Be Hired:

• Chief Operating Officer
• More roles coming in the months ahead!

If I were interviewing here are some questions I’d ask (Answers by Susan Conover, Founder & CEO):

• Could you share some details about the critical milestones Piction Health needs to hit next to continue its growth trajectory?
  • Our next major milestones include caring for 500 patients, becoming in-network with all of the major payers in the states we’re open in, and developing the operational efficiencies and automation to make care delivery easy for our patients, providers, and team. 
• What are the biggest challenges as the company continues to enter new markets?
  • We see our New England states as a prime opportunity to test various parts of our care delivery with different state environments. New Hampshire, Connecticut, and Massachusetts all have different regulatory requirements, coverage laws, structures under which patients are covered, etc. We believe figuring out these things in these 3 states will allow us to scale easily across all 50 states because of the variety in this market. 
• What are the most important roles you’ll be looking to add in 2023?
  • Our most important roles include expanding our provider team with NPs and dermatologists and bringing on operational leadership with expertise in care delivery and virtual care so we can scale quickly. 
• Does the product eventually become a marketplace between doctors and patients or a B2B SaaS revenue model for healthcare networks? Or something else entirely?
  • We’re an all-in-one dermatologist provider solving the vast majority of skin issues with a virtual-first process. Our aim is to become the largest dermatology practice in the world. What this means is we employ providers, bill for care to insurers and patients, deliver care, take on liability for care delivery, and other aspects of being a provider. We’ve seen other companies in healthtech provide tech-enabled services, and exit with this model, like Iora Health and One Medical. 

We’re optimizing for readability here so to learn more about Piction Health you’ll have to D.Y.O.R. I’m excited to watch this team bring more dermatology appointments into the digital age. All New Englanders and eventually patients across the U.S. with skin & nail ailments applaud your efforts. See you around town and in the digital waiting room!