Sramana Mitra: If you look at your entire body of competitors, what is the degree of penetration of your kind of technology? Brett Williams: I don’t have the number on it. Anecdotally, the...

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Funding of Latin American startups has doubled each year over the past two years.

And while most of this capital has been directed toward Brazil and Mexico, this surge is starting to have an effect on startups in the region’s smaller markets. The increased availability of capital for later rounds is creating more opportunities for startups to scale both regionally and globally. And while it may not be one of the largest countries in Latin America, Peru continues to have one of the best-performing economies and fastest-growing startup scenes.

In 2019, a new record was set for the amount of capital invested into Peruvian startups, at least $11 million, a 24% increase compared to 2018. Most of the money went to fintech (47%) and edtech (37%) startups. Over the past four years, more than $22.7 million in public funds went toward startup-related projects as well.

The government-backed program Innóvate Perú awarded approximately $13.8 million of its total investments almost exclusively to startups. Total venture capital investment will likely exceed US$25 million in 2020, doubling what was achieved in 2019, and will continue to grow from there.

In 2019, Peru’s development bank, COFIDE, announced a new fund of funds to invest in venture capital firms, mirroring similar entities such as Chile’s CORFO, Colombia’s Bancoldex and Mexico’s NAFIN. While there are plenty of opportunities to secure seed-stage capital in Peru, many startups still have to look abroad for growth capital. Keynua, Xertica, Turismoi and Runa are just a few of the Peruvian startups that sought international investors to lead their rounds over $1 million. Following in the path of similar funds, the fund of funds will invest $20 million in half a dozen venture capital firms, which would in turn invest in approximately 120 startups.

As government support for entrepreneurs continues to pour in, the Peruvian startup ecosystem is entering a new phase. More and more startups are launching, graduating from accelerator programs and seeking ways to reach their next milestone. Local early-stage investors are stepping in to fill the financing gap and have teamed up to form the Peruvian Seed and Venture Capital Association, PECAP, to share investment opportunities and lay a strong foundation for venture capital in Peru. Here’s a look at just a few of the opportunities for more venture capital to step in.

Fueling Peru’s growing fintech sector

A massive fintech boom is playing out across Latin America, with the size of the industry expected to exceed $150 billion by 2021. Peru is home to an estimated 120 fintech startups actively tackling the issues of financial inclusion and better servicing the region’s small and medium-sized businesses. Peru’s economy is still largely informal, with approximately 14 million people underbanked. In 2017, María Laura Cuya started Peru’s Fintech Association to work alongside regulators, academics and other organizations to improve financial literacy and access to financial products, with a focus on Peruvian SMEs.

A few of Peru’s fintech sectors stand out, including factoring and foreign exchange, where a number of startups are quickly gaining traction and already branching out to neighboring markets. Innova Funding, Innova Factoring, Facturedo, Kambista and Rextie are just a few examples. Peru’s membership in the Pacific Alliance also makes it an attractive initial market prior to launching in other Pacific Alliance countries.

In 2019, Peruvian fintechs Keynua and Apurata were selected for the Y Combinator accelerator program, putting them on the international radar. Traditional banks in Peru are also shifting their mindsets and warming up to fintech partnerships. The publicly traded Peruvian bank, Credicorp, for example, recently set up a corporate venture fund called Krealo. The bank made its first investments in Culqi, a local payments gateway, and Independencia, a lending platform.

Impact investing opportunities

Latin America is a top destination for impact investment capital, outpacing many other regions in the world, with a 15% compound annual growth rate over the last five years, according to the Global Impact Investing Network. Edtech represents a rising entry point across the region for impact investors thanks to its potential for both financial and non-financial returns.

According to an OECD report, approximately 30 million young people in Latin America are not participating in any form of education, training or employment, and 76% of this total are women. Laboratoria, co-founded by edtech thought leader Mariana Costa Checa, helps women develop technical skills and has expanded across the region from its headquarters in Lima to train more than 1,000 women so far. The startup has received praise from global companies, including Walmart and Facebook. In 2019, the skills development platform Crehana raised the largest-ever round for a Peruvian startup ($4.5 million) from both regional and global funds.

Peru attracted more impact investment capital than Mexico, a longtime leader in the region, for the first time in 2018. Much of this investment is focused on improving Peru’s education system. Local startups are addressing everything from early childhood education to workforce training, and as more success stories emerge, more resources will be needed to fully tap into Latin America’s large markets for these solutions.

Supporting long-term startup growth

The government-backed program Innóvate Perú has financed more than 3,400 entrepreneurial projects to date, and more than 25 private institutions are now accelerating, incubating and investing in Peruvian startups. New startup creation is at its highest rate ever; however, these companies are outgrowing their angel and seed-stage supporters and are now seeking ways to take their ventures to the next level.

Over the past few years, Latin America has proven that it is a place where startups can scale and succeed. Now, with more startups coming out of the region’s smaller, underserved markets, like Peru, there is an opportunity to deploy capital effectively and bring impactful solutions to millions of people across the region.

*Angel Ventures was an investor in Culqi before it was sold to BCP. Neither Angel Ventures nor Greg Mitchell currently hold any shares.

Matteo Franceschetti, CEO of Eight Sleep, would prefer that you don’t call his startup a mattress company.

Eight Sleep does sell mattresses, albeit smart ones packed with sensors and temperature regulation controls. The company has raised north of $70 million from backers including Founders Fund and Khosla Ventures. A great deal of this funding surrounds the idea that there is more untapped potential in the sleep economy than existing players in the space have been able to imagine.

While Franceschetti says he intends for his company to remain private for the “foreseeable future,” Eight Sleep is in a less-than-comfortable spot following Casper’s botched IPO last week. Though Casper’s stock popped on its first day of trading, the process of pricing its shares ended up leaving its private investors a bit less than ecstatic. Casper debuted trading at a value of $575 million, a far cry from the $1.1 billion private market valuation it had previously achieved.

Franceschetti has been aiming to transform Eight Sleep into a company more focused on a robust tech platform than your average bed-in-a-box company. The startup’s initial effort, a smart sleep cover for your existing mattress, evolved into a mattress with a layer of sensors that then transformed into a sensor-laden mattress with a heating and cooling unit, called “The Pod.” The company’s product development has aimed to build out a more end-to-end platform for sleep, something Franceschetti says has made him reticent to compare his company to other direct-to-consumer mattress companies.

Last February we launched Extra Crunch, and today we’re celebrating its one-year anniversary. As a token of appreciation to our readers, we’re offering a limited-time deal for annual Extra Crunch membership. From now until the end of February, new users signing up for Extra Crunch in the U.S. can get a full year of membership for only $99 plus tax (normally priced at $150/year). 

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Since launching Extra Crunch, we’ve published more than 1,000 articles on fundraising, early-stage investing, startup PR and other topics targeted to entrepreneurs and investors. In addition to TechCrunch writers, we’ve run contributions from Julian Shapiro at Demand Curve, Jake Saper at Emergence Capital, Rory O’Driscoll at Scale and many others.

Some of our top stories from the past year:

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Cryptocurrency exchange Coinbase is launching margin trading today. Margin trading lets you trade on leverage. But it works both ways — margin trading lets you multiply your gains and your losses.

Margin trading is going to be available on Coinbase Pro, the company’s exchange interface for educated investors. Both retail and institutional investors will be able to submit margin trading orders with up to 3x leverage. It’ll work with any pair of assets with USD as the base currency.

For now, the feature is limited to 23 U.S. states if you’re a retail investor. Institutional investors in 45 states and nine international countries can access margin trading, though.

There are many potential use cases for margin trading. For instance, you can allocate a tiny portion of your portfolio to a margin trading order to hedge across multiple positions. Coinbase believes it has enough liquidity to help investors set up sophisticated margin trading orders.

If you’re a retail customer living in one of the 23 states where margin trading is available, you might not be able to use it. The company wants to restrict margin trading to the most advanced traders.

Coinbase is going to track your past activity on Coinbase Pro and look at trades, balances, deposits and withdrawals. If you’re an active trader, you’ll be able to access margin trading.

Here’s the list of 23 U.S. states with margin trading for retail investors: Florida, Texas, Illinois, New Jersey, Virginia, Georgia, Arkansas, Alaska, Oregon, Connecticut, New Hampshire, Massachusetts, Nebraska, North Carolina, Oklahoma, Colorado, Kansas, Maine, South Carolina, Utah, Wisconsin, Wyoming and West Virginia.

Disclosure: I own small amounts of various cryptocurrencies.

Marketing startup Habu is emerging from stealth today and announcing that it has already raised $15 million in Series A funding.

The company comes out of super{set}, the startup studio created by Krux founders Tom Chavez and Vivek Vaidya. In fact, Chavez is Habu’s chairman, Vaidya serves as CTO and their former Krux colleague Matt Kilmartin (who eventually became chief customer officer for Salesforce’s consumer engagement platform after Salesforce acquired Krux) is the startup’s CEO.

Kilmartin told me that Habu was created to solve a “still elusive” marketing challenge — delivering “omni-channel orchestration for the entire customer journey.” In other words, he’s saying that chief marketing officers are still struggling to deliver personalized messages to potential customers across every channel and at every stage.

Kilmartin argued that’s because they’re challenged by new privacy regulations, plus the fact that many marketing tools struggle to integrate data from the major digital ad platforms. And then there are the limitations of the big marketing clouds (including Kilmartin’s old employer Salesforce), which he said are “stitching together all the stuff they bought — their goal is to have everyone go all-in on one of their stacks.”

So Habu isn’t trying to build yet another marketing platform. Instead, the company describes its core product as a “marketing data operating system” that can be used alongside the aforementioned clouds, bringing a company’s customer data together across platforms, then providing automated insights and recommendations on how to use that data to deliver personalized marketing. And it does this in a way that complies with privacy regulations like GDPR and CCPA.

“We’re trying not to be a platform,” Kilmartin said. “It’s a modular, interoperable suite of services.”

Habu’s software can pull in a marketer’s first-party customer data, as well as data from platforms like Google and Facebook. Kilmartin said that while these platforms remain a “blind spot” for many marketers, “They have APIs and frameworks to be able to do this, it just requires a level of sophistication. And there just aren’t that many extra data scientists that these brands have sitting around.”

In addition to super{set}, Habu’s funding comes from Ridge Ventures. And although Habu is only launching publicly today, it already has customers in the CPG and media industries.

Update: An earlier version of this story incorrectly identified some of Habu’s customers.

Hello and welcome back to our regular morning look at private companies, public markets and the gray space in between.

This morning we’re exploring Airbnb’s march to the public markets. The popular DIY hospitality startup promised last year that it would go public in 2020. That timeline means that its 2019 performance will be included in an eventual S-1 filing, putting the results on public display.

Recent news, however, doesn’t paint a perfect picture for the famous unicorn. Indeed, Airbnb’s history of rapid growth and profitability appears to have been replaced by slowing growth and profit struggles. The Wall Street Journal reported results from the company’s third quarter that are at once encouraging — a return to profitability — and troublesome; Airbnb’s first three quarters of 2019 are in the red as a group, a change from historical profitability.

If Airbnb goes public soon, as it has promised, its recent, trailing results will matter. To get ready for its IPO, let’s rewind through what we’ve learned about Airbnb’s revenue, revenue growth and profitability over the years. Doing this will help us understand how the startup went from rising profitability to posting, through the first three quarters of 2019, a nine-figure net loss.

The Airbnb public offering (likely a direct listing) is going to be the financial event of the year. Get excited.

Rewind

The following data points were culled from a host of reports over the past half decade. Each is accompanied by its original source, and I encourage you to read the pieces to get a feel for how Airbnb has been discussed through time. The tone of Airbnb coverage largely tracks its performance; when Airbnb was at the steepest part of its growth curve, the media was enthused. Lately, however, the writing is a bit different.

You’ll see why:

“Whatever your symptom, WebMD says you have cancer.” It’s a long-running joke that underscores the distrust of perhaps the top source of medical advice, stemming from a confusing site clogged with ads that’s been criticized for questionable information and pushing pills from its sponsors.

Health Guide is the new medical handbook for the internet, where 30% of content is written by doctors and 100% is reviewed by them. On a single clean, coherent page for each condition, it lays out a tl;dr summary, what the ailment really is, how to spot the symptoms and what you need for treatment. Rather than pushing you to nervously keep clicking, it just wants to answer the question.

Health Guide officially launches today. It was built by digital pharmacy Ro, which has raised $176 million for medicine brands Roman for men’s health, Rory for women’s health and Zero for smoking cessation. With Ro, patients can get a $15 telemedicine consultation with a doctor, receive an instant prescription and have it filled and sent to you from the startup’s in-house pharmacy operating in all 50 states. A competitor to Hims & Hers, Ro scored a $500 million valuation last year.

Rather than aggressively hawking its own products at the end of articles, Health Guide just lists the medications you could take, insists you ask a doctor what’s right and leaves it up to you to choose where to buy.  Ro founder Zachariah Reitano calls Health Guide “a significant investment in trust. There’s not a clear ROI (return on investment) to it but it’s one of those long-term bets . . . Providing education to patients will serve Ro really well in the long-run.” He acknowledges the suspicions of self-dealing, and says “if we don’t do this correctly, it can hurt more than it can help.”

On Health Guide you can search for specific conditions, browse categories like diabetes or hair loss and browse featured articles like “Proven ways to increase the density of your bones” or “How do you test for gonorrhea.” There are no banner ads, so your search about the flu or testosterone won’t immediately lead to you being bombarded with promotions for Mucinex or dicey supplements. “On these other sites . . you have [advertisers] with unregulated supplements and services that are the highest bidder beside medical information, which creates a lot of distrust.”

The simplicity and accuracy of Health Guide has already attracted a sizable audience. It’s on pace to reach 30 million readers this year, with 25% being women despite Roman’s initial focus on aiding men with erectile dysfunction. It already ranks in the top 10 Google results for 300 medical questions. The no-filler entries come signed by the specific doctors that wrote or approved them, and Ro pledges to have them reviewed and updated at least once per year. At the bottom are links to all the original source material, including peer-reviewed medical journals.

Reitano tells me that the idea from Health Guide came after Ro’s physicians and customer service were bombarded with the same patient questions over and over. The easiest move was to put all the answers on an open site they could send patients to. A major goal was to debunk hoaxes other sites often don’t address directly. “For something like vaccines where there is a potential for misinformation, you’ll see us take a strong stance. We won’t let the potential for misinformation spread through Health Guide.”

One thing Health Guide is missing that could keep people coming back to WebMD is a symptom checker. Right now it’s better at research on major conditions or lifestyle choices than figuring out why your throat’s sore. But given it’s day one and Ro has tons of funding, it has plenty of time to improve. There’s sure to be concerns about how it collects data and what treatments Health Guide lists. So as a precaution, it never forcefully makes recommendations besides asking a doctor for personalized advice, and there’s just one button atop the site for visiting its medication marketplace.

Ro is trying to move fast as the ePharmacy space heats up. It plans to launch 10 more products in the next two quarters, with a focus on Rory for women. It just struck an exclusive deal with Pfizer to provide Roman customers with generic Viagra, offering clear supply chain transparency around a drug that’s often counterfeited. And thanks to its licenses across all states, it’s helping new weight loss treatment Plenity launch nationwide atop its diagnosis, prescription and fulfillment technology.

Yet Reitano sees space for multiple startups to succeed in replacing embarrassing and inconvenient in-person trips to the doctor or drug store. “It might be a somewhat cheesy answer but . . . the best thing about competition is it makes everyone build a better experience for patients,” he says, citing NURX and PillClub enhancing birth control access. “I think all this innovation in digital health — it’s an absolutely massive market. No one’s taking market share from someone else. We’re raising the bar for care.”

Headspace, the Los Angeles-based mindfulness and meditation company locked in a bitter competitive struggle with Calm for leadership in the mental wellness world, has raised new capital to try to take the pole position.

The company has just closed on $93 million in new equity and debt financing from a slew of investors as it pursues a number of clinical studies that could provide scientific validation for the somewhat nebulous claims around the benefits associated with mindfulness and meditation.

That clinical validation can also unlock new dollars in the form of government payments for mindfulness therapies that could be used to treat a variety of conditions. It also makes more valid the company’s pitch to companies as a useful component of an employee benefit program.

The company touted a pipeline of 70 clinical studies working in conjunction with academic partners, including Carnegie Mellon, University of California San Francisco and Stanford University.

Headspace’s new cash comes from investment firm blisce, with participation from Waverly Capital, Times Bridge (the investment arm of The Times Group of India), The Chernin Group, Spectrum Equity and Advancit Capital. A $40 million debt financing from Pacific Western Bank supplemented the $53 million in equity.

“Headspace has shown millions of people the power of using mindfulness to mitigate stress, anxiety, and other everyday issues while continuing to advance the field through clinically-validated research,” said Richard Pierson, the chief executive and co-founder of Headspace, in a statement. “As we think about the next ten years and beyond, we are focused on harnessing this power and applying it to other areas of our members’ lives to help them create healthy routines that last a lifetime — whether that is through our Headspace consumer app, the work we currently do with hundreds of employers, or with healthcare providers as we look to deliver better access.” 

So far the company’s app has been loaded more than 62 million times in 190 countries. It already has over 2 million paid subscribers and more than 600 businesses are using Headspace’s on-the-job mental wellness tool.

The new money will be used to double down on its pitch to businesses and healthcare practitioners, according to a statement from the company, as well as to look at international markets. The company already has German and French versions of the app and has appointed the Apple executive Renate Nyborg to lead its European expansion.

As the new cash comes in, Headspace also has more money to compete for the attention of consumers with Calm, which raised an $88 million round (one that valued the company at over $1 billion) a little over a year ago.

Backed by TPG Capital and the entertainment agency CAA, Calm has recently inked deals with big time celebrities like LeBron James, who also has an equity stake in the company.

Calm’s approach seems to center more on a direct-to-consumer strategy that has seen the company enlist celebrities like James, John McEnroe, Matthew McConaughey’s and the English comedian, actor and writer Stephen Fry.

Brett Williams: Attackers have increasingly become sophisticated. In Cyber Command, I saw that capabilities that were earlier exclusively only nation state capabilities are now readily available on...

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Entrepreneurs are invited to the 472nd FREE online 1Mby1M mentoring roundtable on Thursday, February 13, 2020, at 8 a.m. PST/11 a.m. EST/5 p.m. CET/9:30 p.m. India IST. If you are a serious...

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I have spent a decade already on One Million by One Million with the mission of helping a million entrepreneurs reach their first million in revenues. The journey has led me down many corridors of...

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According to an Allied Market Research report, the global complaint management software market is expected to grow at 11% CAGR to reach $8.3 billion by 2026 from $1.93 billion in 2018. Zendesk (NYSE:...

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Sramana Mitra: Can you talk more broadly about the space of invoice financing? What’s happening from a FinTech point of view? Steven Uster: I’ll take a step back even before FinTech. When my...

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MoEngage, a San Francisco and Bangalore-based startup that helps firms better understand their customers and improve their engagement, has raised $25 million in a new financing round as it looks to grow its network in North America and Europe.

The new financing round, Series C, was led by Eight Roads Ventures . F-Prime Capital, Matrix Partners India, and Ventureast also participated in the round. The six-year-old startup, which is an Alchemist alum, has raised about $40 million to date.

MoEngage offers a product that allows clients to get deeper insight about the way their customers — or users — are engaging with their apps and websites. “We can, for instance, tell at what time a customer is using the app,” said Raviteja Dodda, founder and chief executive of MoEngage, in an interview with TechCrunch.

These insights, all displayed on one dashboard, could be very useful for firms to retain their existing customers or find optimized ways to attempt to sell more to them.

“Based on your understanding about the customer, you can send them personalized notifications. Say you’re using a ride-hailing app. The firm would now know how often you use their app and at what time you tend to avail their service. Based on these learnings, they can offer you deals or reminders that could help them improve their conversion rate,” he said.

MoEngage today works with a number of major firms in North America, Europe, and Asia. Some of its clients include Deutsche Telekom, CIMB Bank, Travelodge, Samsung, McAfee, Vodafone, retail chain Future Retail, ride-hailing service Ola, budget-hotel operator OYO, grocery delivery startup Bigbasket, and music streaming service Gaana.

In total, Dodda said his startup has amassed “hundreds of clients” in over 35 countries and is serving more than 400 million active users for them each month.

“MoEngage, with its differentiated offering, scalable platform and a customer-first approach, will play an important role in enabling us to deliver contextual and relevant communications to our customers and drive higher customer lifetime value,” said Arun Srinivas, chief operating officer at Indian ride-hailing startup Ola, in a statement.

MoEngage, which competes with a handful of startups including India-based Clevertap, will infuse the fresh capital to find more customers in North America and Europe, and scale its product operations, said Dodda.

“What differentiates MoEngage from other engagement platforms is the combination of their ever-evolving AI-enabled customer journey capabilities, industry-best channel reachability and top-notch customer support. We are thrilled to partner with Raviteja and his team as they look to expand globally,” said Shweta Bhatia, Partner at Eight Roads Ventures.

Revolut, the European banking and money transfer app that now claims over 10 million customers, has partnered with open banking API provider TrueLayer to add bank account aggregation features to its app.

The new functionality means that Revolut’s U.K. customers — both consumer and business — can now connect their external U.K. bank accounts to Revolut, enabling them to see all of their bank balances and transactions, regardless of which of their U.K. bank accounts the data resides in. Known as account aggregation, the feature is designed provide a more complete view of your spending and other transactions, and was one of the early promises of open banking.

However, despite being adopted by legacy banking apps, such as Barclays, along with a plethora of money management apps, the aggregation use case hasn’t exactly seeped into the consciousness of most consumers. Revolut’s move to roll out aggregation features has the potential to help change that. Or so says TrueLayer co-founder and CEO Francesco Simoneschi.

“I think this is the moment Open Banking will go mainstream,” he tells me, perhaps a little over optimistically. “Revolut is putting this feature at the very core of their customer journey and will set the standard for the next phase – not just in the U.K. but everywhere”.

“With the launch of our new Open Banking feature, U.K, customers can now view and manage multiple external bank accounts, enabling them to interpret their day to day spending across all of their accounts,” adds Joshua Fernandes, Product Owner for Open Banking at Revolut. “We’re delighted to see that new legislation such as Open Banking is changing our financial landscape for the better, and I’m proud that Revolut and TrueLayer are at the forefront of this experience”.

From a regulatory point of view, Revolut is authorised as an “Account Information Service Provider” (AISP) by the U.K. regulator, the Financial Conduct Authority. This permits it to access official U.K. Open Banking APIs for information purposes on behalf of customers.

What it doesn’t allow is Revolut to transfer funds and make payments via third party bank accounts, which would require a different Open Banking license. Were this to happen it would make it even more convenient to add and withdraw funds from Revolut and use the app’s budgeting and money transfer features, so I wouldn’t be surprised to see that come next.

Impala has raised another round of funding just a few months after raising an $11 million Series A round. This time, the startup is raising a $20 million Series B round led by Lakestar. Latitude Ventures is also participating in the round.

The company is building a service that works pretty much like Plaid, but for hotel rooms. The hotel industry relies on old-school “property management systems” to manage rooms, room types, pricing, extras, taxes, etc.

Instead of asking hotels to switch to an entirely different property management system, the company is upgrading those systems with a modern API. This way, you can build applications that query hotel data directly with a few lines of code. You get a standardized JSON response from the API.

Impala is currently compatible with a handful of property management systems. The company is still adding more systems in order to cover a wider range of hotels.

Three hundred hotels are currently working with Impala, such as Accor hotels (Mercure) and Hyatt-branded hotels. The company currently has a backlog of 3,500 hotels. It really shows that the industry has been waiting for a product like this.

While Impala is still focused on surfacing data in an easy-to-code manner, the company is already thinking beyond read-only data. The startup wants to let developers book rooms directly using the Impala API.

It could open up hotel bookings to many other services. For instance, you could imagine being able to book rooms on Lonely Planet’s website. Services selling train tickets and flights could upsell you with hotel rooms.

In order to offer rooms on the usual hotel booking services from Booking Holdings websites (Booking.com, Priceline, Agoda, Kayak…) and Expedia Group websites (Expedia, Hotels.com, HomeAway, Trivago…), many hotels currently work with channel managers to send out information to multiple services at once. In the future, Impala could replace those channel managers with its API.

You’ve been busy. I’ve been busy. But people are talking about Slack all over Twitter, so let me catch us both up.

All the ruckus concerning Slack and its publicly traded stock appeared to kick off with a Business Insider story, which had the following headline:

Slack just scored its biggest customer deal ever, as IBM moves all 350,000 of its employees to the chat app

Given the context of the simmering Slack versus Teams battle, having Slack win what appeared to be a huge, new contract was big news. Slack’s shares shot higher, and the news engendered all sorts of headlines that now look a bit silly.

Like this one:

Slack may survive after all, after IBM choose [sic] them as exclusive supplier for 350,000 employees 

Slack shares traded up sharply all day. They were worth 15.4% more than yesterday, and then, all of a sudden this fine afternoon, trading of Slack’s equity was halted, pending news.

This led to general chaos, with everyone trying to figure out what had happened. Had Google bought Slack? Had Slack bought a small poodle? Was IBM not a Slack customer? It wasn’t clear.

Halting a stock, to be clear, is a big deal, and instantly brings attention to the company in question. Public firms don’t hold for news much, as it’s no good and no fun. It’s also why earnings come after hours.

Later, Slack released an SEC filing, which included the fact that IBM was already one of its customers. This meant that IBM was not a new customer, and that the headline 350,000 employee figure would not manifest itself in that many novel seats of Slack sold.

The company itself put a final bit of ironmongery in the human plasticware, saying the following in the filing to tamp down the market’s enthusiasm:

IBM has been Slack’s largest customer for several years and has expanded its usage of Slack over that time. Slack is not updating its financial guidance for the fourth quarter of the fiscal year ended January 31, 2020 or for the fiscal year ended January 31, 2020.

Womp womp, I believe is the phrase.

Also this happened, but the day’s events appear to be mostly a lot of whatnot that wound up being not what we thought.

When Slack finally did begin to float in after-hours trading, it quickly gave back about half of its gains. Slack shares are currently worth $24.56 in after-hours trading. They started the day worth around $23, and traded as high as the mid $27s.

Now you know.

U.S. femtech startup CurieMD is offering menopause diagnosis and treatment prescription via a telehealth platform — beginning in California, where it launched late last year.

Founder Dr. Leslie Meserve  says the goal is to widen access to treatment and support services for mid-life women, spying a business opportunity in offering an auxiliary digital service targeting an area of women’s health which she says is often overlooked within standard health service provision and suffers from a lack of trained physicians.

She also suggests there is a “unique fear” in the U.S. around the use of hormone therapy for treating the menopause that’s left an access gap in support services — blaming concerns sparked by misleading publicity attached to the 2003 Women’s Health Initiative study which implied a link with breast cancer.

“The authors of the study released a press release prematurely that then became an overnight sensationalized story about hormone therapy causing breast cancer,” she explains. “What they didn’t say was that in the estrogen-only arm of the trial there was actually a lower incidence of breast cancer. So that was never stated anywhere. The other thing they failed to state was that the slight increased risk was not statistically significant… They did women a huge disservice by releasing this press release prematurely.”

More than 15 years on, Meserve believes the time is right for telehealth services to help plug the information and support gap that still orbits menopause, in part as a consequence of “deeply rooted” but misplaced fear of hormone therapy.

Investment in products targeted women’s health and wellness has also been jumping up in recent years as VCs cotton on to an underinvested opportunity which more founders are also focusing on — led by female entrepreneurs driving attention toward women’s issues.

There are now a number of femtech startups specifically focused on menopause. Asked about competitors, Meserve points to several other U.S. startups — including Gennev and Elektra Health.

“There is a lot more interest in telehealth and I believe the time is absolutely right for more information to be given to the world… to make sure that women know that going through menopause is not the end of anything — it’s the beginning of a wonderful second half of life,” she suggests, arguing that the regular healthcare services women are accessing often don’t have the time to dedicate to discussing menopausal symptoms and potential treatments with their patients.

“Telehealth is not going to be appropriate for every single medical issue, that’s for sure, but the diagnosis and treatment of menopausal symptoms is really based on a discussion,” she says. “We do let patients know that we are an adjunct to the regular care that they need to be receiving from their gynecologist and primary care physicians. But menopausal treatment requires a lot of discussion, a lot of talk therapy — it’s a very cognitive diagnosis and treatment. And many OB-GYNs and primary care doctors really don’t have the time needed to explain the pros and cons of hormone therapy to their patients.

“They do the physical. They address immediate, urgent needs, but they may not have the time to address something that doesn’t feel as urgent. Menopausal symptoms — from insomnia to hot flushes — they don’t feel as urgent to practitioners so I don’t think that they’re always given the time needed. And we know that physicians and other practitioners are very rushed. The way our insurance models go they have to see patients every nine to 15 minutes and sometimes a 15-minute office visit just isn’t enough to perform both a pap smear, a physical and answer all of these questions. So we’re an adjunct. We’re not in place of their regular physical exams — we’re an addition to those.”

Meserve practiced in primary care for close to two decades before moving into specializing in menopause services herself — a shift that led to the idea of setting up a company to address mid-life women’s health issues via a web-based telehealth platform.

“I’ve kind of grown up with my patients and a few years ago I was noticing that my patients were having lots of menopausal symptoms so I self-trained in the treatment of menopause and then became a certified menopause practitioner,” she tells TechCrunch, explaining her own transition from practicing in primary care to focusing on menopause care. 

“I realized obviously I was only going to be able to see a very small number of patients and patients in my community. And I know that women across the country are suffering with these symptoms and they’re not able to find physicians that are comfortable talking about menopause and treating menopause. And so, through friends of friends, I was connected to another physician in our community, along with his friend who has expertise in startups and we had the idea [for the company].”

“We know that there’s a lack of trained physicians in this area, we know that women want this relief — they want symptom relief, they want to live wonderful lives,” she adds, saying the key idea is to use telehealth consultations and algorithmic triage to reach “as many women as are wanting the treatment.”

CurieMD patients fill in an online quiz about themselves and their symptoms to get treatment suggestions — which can include a prescription for an oral contraceptive or, in cases where there may be a risk associated with taking estrogen, an antidepressant for perimenopausal symptom relief; and a plant-based hormone therapy for menopausal women — with the startup using an algorithm to help the telehealth practitioners offer the right treatment suggestions.

“Based on the way that patients answer questions in our questionnaire they’re driven down a certain path to help our practitioners choose the right therapy,” she explains, noting that they’re not using AI to drive recommendations. Rather, patients’ responses are used to determine which additional questions they get asked to pull out other relevant information — in a classic decision tree algorithm.

“The first thing we have to determine is whether they’re in perimenopause or menopause,” she says, discussing the decision flow. “So in perimenopause their cycles are fluctuating, their ovaries are coming in and out of retirement. That happens in their 40s. And women start to have perimenopausal and menopausal symptoms at that time — many of them do. So they”ll be having hot flushes, night sweats, irritability, mood symptoms. But the treatment for perimenopause is different from menopause. Perimenopausal patients can be treated very effectively with low-dose oral contraceptive pills — so one of the algorithm’s branches is, first of all, are you in menopause or perimenopause?

“And then for menopausal patients they have the option of choosing bioidentical hormone therapy. And if they have had a hysterectomy they only need estrogen — and so they would go down the pathway asking about their estrogen needs. And then if they still have a uterus they will need both estrogen and progesterone. So then they have the choice of what type of estrogen they want to choose — whether they want oral estrogen or estrogen delivered through the skin, which is a patch.”

In cases where a woman is having vasomotor symptoms such as insomnia and hot flushes but has had breast cancer or where there’s another contra-indication to estrogen (such as having previously had a blood clot), CurieMD’s platform may prescribe an antidepressant to treat her symptoms.

“They are candidates for an antidepressant called Venlafaxine [that’s] very effective for treating vasomotor symptoms in all patients — but we use it mostly for women who are unable to take estrogen,” says Meserve.

For now the platform has just three doctors performing remote consultations for the “dozens” of early sign-ups it’s seen so far — with a third-party company supplying the trained physicians that are conducting the remote consultations.

“We’re working with a large, national company that hires physicians who have chosen to provide telehealth,” she says. “They’re board certified and we provide additional training in women’s health for them — especially in the medications… that we offer.”

Per Meserve CurieMD applies “narrower” prescribing guidelines than an in-person physician might use — exactly “because it is a telehealth company.”

She gives the example of a patient who has had a blood clot in the past — where an in-person physician might be able to discuss with a patient’s haematologist and come up with a plan for them to be on a very low-dose estrogen patch. In this case, CurieMD’s remote service would not be able to offer such a joined-up approach to prescribing a treatment.

“In telehealth we don’t know all the physicians in each patient’s community so we’re not going to be able to do co-ordinated care as well with specialist, outside of the box patients,” she says. “So if they have any risk factors, such as a history of clotting, or of course if they have a history of breast cancer we’re not going to be able to treat those patients with hormone therapy. So if they really want hormone therapy that’s going to be an in-person visit with a physician.”

Another exception would be patients who have migraines and who may want to be on an oral birth control pill. “It depends on the type of migraines they have,” she says. “So that’s beyond the scope of what we’re going to prescribe.”

As part of the questionnaire process patients are also asked to rate the severity of their symptoms. Meserve says she’s confident this will enable it to not only demonstrate to individual patients the efficacy of the prescribed treatment but also enable it to present findings to the wider medical community — with the aim of demonstrating “the safety and efficacy of telehealth” for this particular use-case.

“One of the things that I’d like to make sure that we’re doing is really convincing the medical community at large about the safety of telehealth in certain medical conditions,” she says. “It’s not appropriate for every medical condition… There are certain things that need to have an in-person visit. But the medical community is starting to understand and adapt and trust telehealth — but I think the more data that we have the more we’re going to be able to convince them that this is a nice adjunct to in-person visits.”

“Patients are more accepting of [telehealth] than physicians are. Physicians are very conservative and very slow to change and so I feel that one of our missions is to present the data to physicians and help them understand that this is not a substitute for good in-person care, it’s just an addition,” she adds.

The business model for the service is direct to patient — which means CurieMD is not plugging into the U.S. insurance healthcare market. Rather, there’s a sign-up fee (currently waived), a per consultation fee and recurring subscription (taken via credit card) for any ongoing prescriptions which are shipped to patients by a mail-order pharmacy contracted for that piece of the service. (In an FAQ on its website, the startup claims its consultation fees “are lower than that of most co-pays and our medication pricing is competitive with that of most pharmacies.”)

The team has raised around $1 million in angel and VC investment to fund development of the business so far.

Meserve says the plan is to scale nationwide, taking a state by state approach to building out coverage in order to get the necessary contracts and physician licences in place.

“I would like to be in another 20 states by the end of this year,” she adds.

In terms of differentiation versus the growing number of femtech startups that have also supported an opportunity to offer menopause-related treatment support, she says: “We believe we’re the only one that contracts with a pharmacy and has the prescription delivered through a mail order service.”

She also flags that the hormone therapy CurieMD’s service prescribes — and delivers “right to the door in discreet packaging” — is a bioidentical plant-based “FDA-approved” treatment, suggesting that’s another point of differentiation for its approach.