Former Athenahealth CEO Jonathan Bush returns to entrepreneurship with new startup

Jonathan Bush, the CEO and co-founder of Athenahealth, is a controversial figure in the controversial field of healthcare.

More than two decades after he started the now-public healthcare company, Bush lost Athenahealth to Elliott Management, an activist investor that bought the company alongside Veritas Capital. During this tense period of time, domestic violence allegations surfaced from his ex-wife, Sarah Seldon. Bush took responsibility for what he described as “regrettable incidents” that happened 14 years ago during a “particularly difficult personal time” in his life. Seldon, who TechCrunch attempted to reach for this story, made a statement then too, explaining that she and Bush have a “co-parenting relationship” with “respect, collaboration and love.”

After these public incidents, Bush went quiet and only later re-emerged as the executive chairman of Firefly Health, a primary care startup.

Now, Bush is back once again, this time as the co-founder of a new startup that aims to re-invent the digital health data stack. The company, Zus, wants to create a shared data platform that doctors, regardless of specialty or location, can access to better understand their patients. Think of it as massive, fancy Google Doc built for healthcare, that health tech startups can use to kickstart their solutions, faster.

Along with its launch, Zus announced today that it has raised a $34 million Series A led by Andreessen Horowitz, with participation from F-Prime Capital, Maverick Ventures, Rock Health, Martin Ventures and Oxeon Investments.

Bush’s venture-backed return to entrepreneurship may come as a surprise to some, including himself.

“I loved running Athena very much, all 22 years,” he said. “But I also loved fourth grade, and I don’t want to go back. I didn’t feel like I wanted to run a company again.” He changed his mind for two reasons: First, he expects that building a platform company will be different, and potentially less controversial, than building a traditional services business. Second, he sees “strong calling” to bring his tool to life amid a broader digital health boom.

“These digital health companies will largely not work if they aren’t dramatically accelerated,” he said. “All of them now are facing this quandary: that it’s very hard to hire engineers, enormous regulation and complexity, one too many types of complexity associated with building technologies in medicine.”

With Zus, he’s trying to create capacity. The company has a lot of plans, which includes a growing library of software tools around patient relationship management, a data aggregation service that helps standardize medical records for sharing purposes, a platform that sits atop this information so that multiple doctors can access the same information and a patient portal that lets users understand how their data is shared and accessed.

So far, the platform is being used by four partners: Cityblock Health, Dorsata, Firefly Health, which is Bush’s previous employer, and Oak Street Health.

Part of the company’s existence can be tied to recent regulation progress. The 21st Century Cures Act gave patients the right to access their medical records, and by next year, third parties can access that same data as well. Many think this newfound data portability could seed a massive new generation of healthcare apps, although there are some concerns about if patients know what they are signing up for.

Mimi Liu, chief technology officer of Firefly Health, said in a statement that Zus will help build out the parts of its infrastructure stack that can be commoditized, bringing its roll-out time from years to weeks and months. She added that its clinical value proposition will be improved because of the “downstream network effect that comes as a result of information sharing.”

A16z, which led the round, is an investor in Firefly Health, as well as a number of healthcare startups like Incredible Health, Omada, PatientPing and Cedar.

Julie Yoo, general partner at Andreessen Horowitz, said that Zus embodies its digital health stack thesis, which argues need for “infrastructure platforms that serve the large and rapidly growing population of digital health companies, such that each company no longer has to build the same underlying tech and operations components over and over again, from scratch.”

When asked about Zus’ differentiation, Yoo said that the company will create a community-based marketplace for digital health companies to set up and trade notes, which she thinks has not yet existed in the sector.

“If anything, one might say that the precursor to this concept was the More Disruption Please (MDP) program at Athenahealth, which makes Jonathan Bush uniquely qualified to build this more modern version of said concept,” she said. The MDP program was launched by Bush in 2017 with the goal of filling 200 seats in Athenahealth’s San Francisco office with upcoming entrepreneurs in healthcare.

Zus isn’t the first company to try to start an AWS for healthcare, and in fact there are numerous companies that all work on the different services that Zus wants to one day own, from administrative workflow to patient data retrieval. But, its holistic approach at a time when regulation is changing and investment is booming, along with an experienced founder with the right connections, could prepare it well for what’s to come.