With 2 acquisitions under its belt and $80M from investors, Fabric is building tech to fix healthcare's capacity problem

Fabric, formerly known as Florence, officially launched out of stealth about a year ago and has rapidly built out its tech that automates clinical and administrative work in healthcare.

The startup has already notched two acquisitions in the past 10 months to broaden its capabilities. In April, it picked up Zipnosis from Bright Health in an all-cash deal to expand its asynchronous virtual care capabilities, and, in January, the company bought conversational AI assistant Gyant, another all-cash deal, to expand its "digital front door" for patients.

The company provides a telemedicine platform for health systems and has built a suite of products, from patient intake to self-scheduling to provider documentation tools, to help streamline workflows for in-person and virtual patient visits using conversational AI. The technology improves both the provider and patient experience, according to executives, while also improving operational efficiency.

The company says it's now working with 70 health systems and payers, and its customers include Luminis Health, OSF HealthCare, MUSC Health and Intermountain. 

"We've had tremendous growth. We went from really zero to 70 health systems over the last year, and we scaled from zero to past eight figures in annual recurring revenue," Fabric CEO and founder Aniq Rahman said in an interview. "We've now had about 5 million patients being treated through our telemedicine platform."

The company is aiming for triple-digit revenue growth year over year, he noted.

Fabric's care enablement system was designed to improve patient access while driving clinical and operational efficiency from symptom onset through virtual and in-person treatment and post-visit engagement. Rahman said the company's technology addresses clinical capacity problems with its patient care and management software that focuses on three main areas—engagement, in-person care and virtual care.  

The acquisition of Gyant enables Fabric to serve as a patient entry point for other services. "We are now engaging with patients in everything from finding care and finding a provider to scheduling a provider, searching symptoms and asking billing questions. We've had about 13 million digital interactions, which is also helping reduce contact center volume," Rahman said. "We're trying to tackle a lot of seemingly disparate things, but they all connect because they are all part of the patient journey."

Fabric also is attracting big-name investors who see the potential for AI-powered care enablement tech.

The company recently pocketed $60 million in a series A round backed by General Catalyst. Thrive Capital, GV (Google Ventures), Salesforce Ventures, Vast Ventures, Box Group and Atento Capital also backed the round. A year ago, the company picked up $20 million in seed funding backed by many of those same investors.

Fabric plans to use its series A funds to expand its team, advance product development, build out its AI capabilities and invest in more acquisitions, with a particular focus on AI firms.

"We're going to continue being opportunistic when it comes to finding strategic M&A opportunities. In this market, it's great to have a war chest to just give us more optionality to control our own destiny, a lot more than many other companies in this current environment," Rahman said. "We're going to continue looking for things that can help 'unclog' some of the bottlenecks in hospitals."

Investors are sinking cash into care enablement companies as another startup, Memora Health, also backed by General Catalyst, raised $30 million back in April. Memora developed an AI-enabled platform that helps providers manage complex care needs and digitizes clinical and administrative workflows.

“Our team has what we think is a unique view of the challenges in healthcare across our health system partnerships, and in order to solve the largest problems, we believe you have to address one of the biggest constraints: clinical capacity,” said Holly Maloney, managing director at General Catalyst, in a statement. “Aniq and Aiden [Feng] are repeat entrepreneurs that we admire, and believe they have the right end-to-end care system, network and relationships in place to uniquely address these challenges, and we are excited to join them as they grow."

Healthcare has a lot of friction, especially within clinical workflow and patient intake. Rahman, previously president of analytics company Moat, which was sold to Oracle in 2017 for $850 million, says he recognized an opportunity to use technology to tackle these challenges.

The company aims to create a modern system for managing patient capacity that eliminates hassle for both clinicians and patients. It started with emergency departments. Its ER mobile app experience enables patients to start their nursing intake while they're sitting in the waiting room to improve triage and get patients through their ER visit faster, Rahman said.

Like many healthcare startup founders, Rahman said he was inspired to launch Florence based on a personal experience with the healthcare system.

A few years ago, Rahman's father had a heart attack and spent time in the hospital.

"He's fine now, but I just spent a lot of time in the hospital seeing the heroes that saved his life and the work that the front-line workers, nursing staff did day in and day out. And at the same time, I observed the inherent sort of chaos and dysfunction of a system where technology has not really been brought to the forefront," Rahman said in an interview last year. "I think there is an opportunity on the enterprise side and there are also consumer opportunities as well, which kind of dovetails with my prior builder experience from my private businesses." 

With its two acquisitions and through internal product development, the company has built out its products to automate workflows from patients' symptom onset to post-visit follow-up, according to Rahman.

The company's team includes physicians and engineers from leading health systems and technology companies, and Fabric has built clinical protocols that map to 400 unique diagnoses. "That intelligence is baked into all of our products now," he noted.

"We've taken a very collaborative approach to AI. It's not a large language model black box. We have a clinical quality advisory council comprised of about 15 chief medical officers across our health system partners," he said. "Our view on AI is it should help improve workflows and create efficiency, but it shouldn't be replacing the physician or provider in the loop because, at the end of the day, human judgment is very important as well."

Fabric's engagement suite uses conversational AI to identify patient symptoms and navigate and schedule them for the most appropriate type of care, whether it's primary care visits or urgent and virtual care.

Its virtual care product can gather patient symptoms and condition-specific information with intelligent adaptive interviews, reducing wait times to seven minutes and provider work time to as little as 89 seconds, according to the company.

Fabric's in-person care software can help prepare patients for appointments, keeping them informed while also automating the intake process. Saad Chaudhry, chief digital and information officer at Luminis Health, said Fabric's in-person care software helps nurses save time and led to a 33% reduction in left-without-being-seen rates.

The company claims that its technology can decrease call center wait times by 35% and reduce rooming to discharge times by 20%.

"One of our observations, especially as an outsider coming into healthcare, is that a lot of these health systems have solutions to do bits and pieces of this. They have a vendor for intake, a vendor for scheduling and another vendor for virtual care and there's nothing that ties it all together. There's just a ton of point solutions. We're trying to be this end-to-end platform for health systems to help enable better care and integrate deeply with their EMR (electronic medical record system) and CRM (customer relationship management system)," Rahman said.

He added, "One of the things that buyers have been telling us is that, 'Hey, this is amazing because we're able to actually rip and replace three or four different point solutions and work with something that can help us really across multiple sites of care in the hospital.' We're just getting started, and the series A with General Catalyst is going to help accelerate that."