Our investment in Grow: Behavioral health’s independent practice platform

The mental healthcare industry in the U.S. is at an inflection point: Patients can’t easily find help while therapists are overworked, underpaid, and frustrated with traditional employment options. Therapists are increasingly dissatisfied with the groups they are employed by and 80% are looking for a new way to engage with patients.

Launching one’s own practice is hard. Self-employed therapists must navigate complex payer relationships to offer in-network coverage, tap channel and referral networks to build their book of patients, manage burdensome administrative work, and cultivate a network of peers for collaboration and support. The industry’s antiquated practices are directly impacting patient outcomes and clinical quality.

Grow’s B2B2C platform enables therapists to launch their own independent practice and in doing so, enables therapists to expand access and better serve patients.

With Grow’s complete ‘practice-in-a-box’ solution, self-employed therapists can offer affordable insurance-covered care to patients without having to worry about patient acquisition, overhead, or other administrative burdens that often fall on independent private operators (e.g. EHR, scheduling, invoicing, payment collection, note taking tools). Grow also provides a community for therapists to engage and connect with other providers in the field. 70%+ of providers use the Grow Community weekly and many cite this feature as a reason for their success on Grow. 

For patients, Grow offers a convenient path to find the right in-network behavioral health provider, book time instantly on their calendar, and access confidential secure care either virtually or in-person. 

Team on a mission.

The idea for Grow came from CEO and Co-Founder Jake Cooper’s experience with the difficulties of finding in-network behavioral care. After many dead-ends, Jake decided to pay out-of-pocket for a provider not covered by his insurance. While he had the resources to tap a provider out-of-network, Jake knew most Americans did not.   

Jake partnered with co-founders Alan Ni and Manoj Kanagaraj, as well as a broader team with deep experience across technology, healthcare, and payments, to build a mission driven company which empowers therapists to launch their own independent practices that are: 1) covered by the largest number of insurance providers in the industry, 2) easily discoverable by patients, and 3) scalable due to full-stack supporting infrastructure. 

Our partnership with Grow.

We’re thrilled to announce that TCV has led Grow’s Series B. In this round, Grow has raised $75M in equity and debt capital from TCV and other leading investors including Signalfire and Transformation Capital.

At TCV, we look to partner with founders who are building category-defining, generational companies and we’re incredibly excited to partner with Jake, Alan, Manoj, and the rest of the Grow team on their mission to create the largest and most accessible behavioral health platform in the country. 


The novel digitization of healthcare data and the compelling opportunity for technology

The U.S. healthcare industry is undergoing a rapid technological transformation underpinned by the recent and novel digitization of healthcare data. Historically, the healthcare industry has operated in an offline fashion (e.g., paper records, phone calls, faxes, etc.), and the utilization of digitized healthcare data was largely limited to insurance claims. Today, healthcare generates ~30% of the world’s data and its data volume is projected to grow faster than that of any other industry.[1] At the same time, technology adoption within healthcare remains low; as evidence, consider that the financial services industry spends ~3x as much on software per year relative to the healthcare industry, despite being only one-third of the size.[2]

In our view, the proliferation of healthcare data is principally the result of three factors:

1. Ubiquitous adoption of electronic medical record (EMR) platforms

2. Growing availability of genomic data

3. Increased use of wearable healthcare devices 

The first followed the 2009 HITECH Act, which provided incentives for healthcare providers to purchase EMR technology platforms; accordingly, as of 2019, ~96% of healthcare providers had adopted an EMR, up from only ~8% in 2008.[3] 

The second is a derivative of the dramatic reduction in genomic sequencing costs over the past two decades – from ~$95M per genome in the early 2000s to only ~$500 today.[4] The resultant proliferation of genomic data has had a transformative impact on the medical field and led to a myriad of advances in treatment and MedTech, particularly around understanding how an individual’s DNA contributes to varying health and disease outcomes. 

Finally, the growing use of wearable healthcare devices (e.g., smart watches, blood glucose meters, etc.) has resulted in troves of real-time, patient-generated data that is increasingly being used for real-time patient monitoring and intervention applications, as well as in clinical trials to both expand patient accessibility and improve data capture. 

Until recently, all three of the aforementioned types of healthcare data existed either in an offline format (e.g., paper records) or essentially not at all (e.g., genomic and wearables data). Note that there are several other types of healthcare data consistent with this trend, including, but not limited to, lab, medical imaging, and social determinants of health (SDOH) – all of which are important and have their own idiosyncrasies. In our view, however, drivers #1 – 3 outlined above are the three most notable and encompass the broadest array of healthcare data; accordingly, this piece focuses principally on those three.

As a derivative of unsustainable growth in U.S. healthcare expenditures, coupled with a growing need to improve health outcomes, the healthcare industry has reached a profound inflection point. Against this backdrop, we have strong conviction that numerous category-defining, franchise technology companies will be built that utilize healthcare data to address the industry’s most ambitious problem statements and pain points, including increasing drug discovery and development productivity, improving diagnostic quality and care coordination, driving operational efficiencies, and improving the overall patient experience – all vectors which also improve patient outcomes. In our view, these technology platforms have the opportunity to drive an enormously compelling ROI for industry stakeholders across a myriad of use cases and applications.

Having said all of that, there are several foundational considerations that render healthcare data uniquely difficult to utilize. While the complete list is rather long, here are some of the more notable roadblocks:

1. Healthcare data exists in silos generally organized by data type (e.g., clinical records, insurance claims, genomic, lab, imaging, pharmacy, etc.)

2. Custodians of one type of data are unlikely to be willing to share it with other industry stakeholders (e.g., a provider with clinical data vs. an insurer with claims)

3. There is no ubiquitously utilized enterprise master patient index (EMPI) that can be used to pair datasets at the patient level; single data sources by themselves present an incomplete picture

4. HIPAA compliance and other regulatory considerations heavily restrict data access, sharing, and utilization rights

5. Different data formats and connectivity standards introduce added complexity and friction in terms of data sharing (though some recent industry initiatives are helping)

6. ~80% of healthcare data is unstructured (e.g., free-text notes, images, etc.) rendering it difficult, if not impossible, to use in its current form[5]

In our view, these challenges, coupled with the growing volume and diversity of healthcare data sources, present a unique opportunity for technology companies to deliver significant value to the healthcare industry. We sub-segment the technology companies that benefit from this theme into four buckets, including: 

1. Infrastructure and enabling technologies

2. Data analytics

3. AI / ML to drive decision-making

4. AI- / ML-enabled automation

Note that #1 and #2 are not mutually exclusive, while labeled and annotated training data are prerequisites for #3 and #4. Below we’ve shared a bit more about each category, as well as some representative vendors that fit into each.

1. Infrastructure and enabling technologies – Help connect, normalize, curate, and manage data across disparate sources and formats; examples include 1upHealth, Datavant, Health Gorilla, HiLabs, Innovaccer, Lifebit, Mendel, Ribbon, TetraScience, Tripleblind, Science.io, and Veda Data Solutions

2. Data analytics – Packaged, self-service analyses via an application layer and / or curated data delivered via an API; examples include Kipu*, Komodo Health, H1 Insights, OM1, and Truveta

3. AI / ML to drive decision-making – Use labeled / annotated data to train AI and ML models that help end users make better informed, more efficient decisions; examples include Aidoc*, BenchSci*, Deep 6 AI, Diagnostic Robotics, Iterative Scopes, Paige.AI, and Unlearn

4. AI- / ML-enabled automation – Use labeled / annotated data to train AI and ML models that automate business processes and workflows; examples include Syllable*, Abridge, AKASA, DeepScribe, Memora Health, Notable Health, and Robin Healthcare

* TCV portfolio companies

We further believe that technology companies across all four categories have an opportunity to differentiate and establish competitive moats along the four dimensions outlined below. To be clear, compelling technology platforms need not check all four boxes – some may only check one of them.

1. Unique access to healthcare data – This can be a derivative of business model (e.g., open / network-based system), via barter or give-to-get relationships, long-term data sharing partnerships, and / or customers contributing data, among other levers

2. IP that integrates, curates, and prepares the data for downstream use cases – This may take the form of technology tooling and / or organizational know-how (e.g., the process for cleansing the data)

3. Functionality that applies healthcare-specific contextualization – This often involves both platform functionality as well as clinically / scientifically trained personnel in order to ensure effective platform utilization by the end user

4. Software applications that deliver value in the context of specific business use cases and workflows

In closing, the U.S. healthcare industry is perhaps the last major industry to undergo digitization; it is also one of the largest. Against a rapidly growing volume and diversity of healthcare data, coupled with challenges and complexities associated with its use, we believe there is an extraordinary opportunity for technology to play a leading role in audaciously unlocking and delivering value across multiple sub-segments, functions, and applications in healthcare. Accordingly, we at TCV are incredibly excited to continue to partner with companies boldly seeking to utilize healthcare data in order to fundamentally transform both the development of novel medicines and provision of patient care, and, ultimately, to improve patient outcomes.


1 Source: RBC.

2 Source: Gartner. Size of industry measured in terms of contribution to U.S. GDP.

3 Source: HealthIT.gov.

4 Source: NHGRI.

5 Source: NCBI.

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The views and opinions expressed are those of the speakers and do not necessarily reflect those of TCMI, Inc. or its affiliates (“TCV”). TCV has not verified the accuracy of any statements by the speakers and disclaims any responsibility therefor. This blog post is not an offer to sell or the solicitation of an offer to purchase an interest in any private fund managed or sponsored by TCV or any of the securities of any company discussed. The TCV portfolio companies identified, if any, are not necessarily representative of all TCV investments, and no assumption should be made that the investments identified were or will be profitable. For a complete list of TCV investments, please visit www.tcv.com/all-companies/. For additional important disclaimers regarding this blog post, please see “Informational Purposes Only” in the Terms of Use for TCV’s website, available at http://www.tcv.com/terms-of-use/


Empowering physicians with AI to improve patient outcomes: Our investment in Aidoc

For investors deeply passionate about healthcare, there is no dearth of excitement and inspiration in contemporary times. Specifically, we are now seeing modern technology platforms being developed on the back of transformative progress in computer vision, computational technologies and methods, and the ability for systems to interconnect, in addition to sophisticated data modeling capabilities, among others. This innovation has served as the foundation for a new generation of healthcare software companies to take on massive industry challenges, including high-impact areas such as democratizing patient access, improving the quality of care, reducing drug discovery and development timelines, enabling frictionless payment and collections, and driving efficiencies in business processes and operational workflows. Aidoc is one such healthcare technology company with a vision to be the intelligence layer for medical imaging diagnostics and care coordination.  

Aidoc was founded in 2016 by CEO Elad Walach, CTO Michael Braginsky, VP of R&D Guy Reiner and CMO Gal Yaniv who met while serving in the Israeli Defense Force’s Talpiot program, an elite technology program focused on Artificial Intelligence (AI) and Machine Learning (ML) research. The company’s platform consists of 20 medical applications, including 15 FDA-cleared algorithms, designed to drive speed, efficiency, and accuracy of diagnosis in medical imaging and multidisciplinary coordination of care in the context of more complex episodes – stroke and pulmonary emboli, specifically. 

Medical imaging represents a massive component of overall healthcare spend – the U.S. spends approximately $118 billion on imaging services annually, and expenditures are projected to grow approximately 7% per year for the foreseeable future. For complex patient cases, clinical personnel across multiple medical specialties must be engaged in order to determine the appropriate treatment. Historically, this coordination of care across stakeholders has proven challenging, lacked systemization, and been performed largely via offline methods. As healthcare providers have introduced more multidisciplinary programs and increasingly look to standardize the provision of care across them, technologies that enable care coordination and provider collaboration across specialties have become increasingly important.

Aidoc’s mission is to leverage AI and workflow software to drive multidisciplinary care coordination and deliver the right diagnosis, at the right time, to the right physician. To that end, Aidoc has developed a technology platform that applies the company’s 15 FDA-cleared algorithms – with many more on the way – to a radiologist’s queue in order to prioritize and triage patient cases. Further, the company’s growing repository of millions of annotated medical images is used to continually improve its algorithms over time. Importantly, Aidoc’s AI is “always on,” and the platform applies the company’s algorithms to every case simultaneously, allowing cases in more urgent need of intervention to be elevated for review regardless of where they fall in the queue. Following triage and diagnosis, Aidoc’s software also enables clinical personnel to coordinate the downstream provision of care by facilitating information sharing and communication across multiple stakeholders. Finally, and perhaps most impressively, the company’s platform integrates seamlessly within the existing operational workflows and clinical protocols of its customers.

Aidoc’s customers include a number of large health systems in the U.S., including HCA, Northwell Health, The Mayo Clinic, and Cedars-Sinai. The company also has a meaningful presence internationally, with customers that include Antwerp University Hospital, Netherlands Cancer Institute, Sheba Medical Center, and Alfred Health, among others. Finally, Aidoc also has partner relationships with leading radiology service providers, including Radiology Partners and Everlight Radiology.

The company’s customers derive value from Aidoc’s platform in terms of: a) increased diagnostic efficiency, b) improved prioritization and triage of the most complex or urgent cases, c) higher-quality diagnoses and reduced diagnostic error-rates, and d) more systematized, streamlined coordination of patient care. The company’s compelling value proposition, coupled with its reputation for high-velocity, relentless innovation and above-and-beyond customer delivery and support, has engendered customer delight. As evidence, Aidoc boasts an average net promoter score of between 80 and 90. 

TCV’s healthcare team has spent the last several quarters prioritizing companies that provide AI technology across various applications for the healthcare industry. Most recently, this focus led to our investments in BenchSci, a provider of AI software for driving productivity in preclinical research for the life sciences industry, and Syllable, a provider of AI technology for provider business process automation (and soon payor and other healthcare sub-sectors). 

Our Series D investment in Aidoc, completed in partnership with our friends at Alpha Intelligence Capital, General Catalyst, Square Peg Capital, and Emerge Ventures, represents another illustration of our thesis, this time for diagnostic and care coordination use cases. The Series D funding is intended to help Aidoc expand the company’s AI and ML software platform into additional applications, rapidly scale headcount, and forward invest in future growth initiatives. We are particularly excited about Elad’s vision for both the business and future of patient care, in addition to the company’s recent momentum that has established Aidoc as an emerging leader in the category. Elad has also lined-up an impressive team of advisors and experts to advise the company, including TCV Venture Partner Anita Pramoda.

“Of the various AI and ML use cases in healthcare, Aidoc’s is the one that I’m particularly excited about – their technology immediately improves patient outcomes and drives efficiencies for clinical personnel,” says Anita Pramoda, TCV Venture Partner. “Exponential patient and provider value will continue to be realized as Elad and the team roll out new algorithms, software applications, and integrations. In the future, instant diagnosis of conditions will transform patient care as we know it, and most importantly, save lives.”

Value proposition and momentum notwithstanding, what also impressed us is the humble, high-learning, and customer-centric culture Elad and his team have developed that permeates throughout the organization. Starting with Elad, it was clear during our diligence that the Aidoc team is mission-driven and firmly committed to using their team members’ talents to develop technology that improves patient outcomes through AI-driven care coordination. The results speak for themselves – Aidoc is a top-ranked employer on Glassdoor.

“With healthcare institutions facing labor shortages and navigating difficult economic situations, the future is predicated on value-based care that is enabled by automation technologies like AI and ML,” says Aidoc CEO Elad Walach. “But AI and ML are not enough in singular use cases – they must be applied across the entirety of a healthcare enterprise in order to deliver value-based care to the extent that would make a deep impact – an intelligence layer covering the entire patient lifecycle. That’s where we believe our AI Care Platform will transform healthcare. Partnering with TCV – a team that truly understands the importance of value-based care – gives us the support we need to manifest our vision.”

We are off to the races in our partnership with Elad and the Aidoc team, and are incredibly excited to help build a category-defining, generational software company that helps improve patient outcomes through AI-driven care coordination.

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The views and opinions expressed are those of the speakers and do not necessarily reflect those of TCMI, Inc. or its affiliates (“TCV”). TCV has not verified the accuracy of any statements by the speakers and disclaims any responsibility therefor. This blog post is not an offer to sell or the solicitation of an offer to purchase an interest in any private fund managed or sponsored by TCV or any of the securities of any company discussed. The TCV portfolio companies identified, if any, are not necessarily representative of all TCV investments, and no assumption should be made that the investments identified were or will be profitable. For a complete list of TCV investments, please visit www.tcv.com/all-companies/. For additional important disclaimers regarding this interview and blog post, please see “Informational Purposes Only” in the Terms of Use for TCV’s website, available at http://www.tcv.com/terms-of-use/


Improving the patient experience with AI/ML software: Our investment in Syllable

Digitization of healthcare provider business processes and workflows is one of our healthcare team’s key investment themes. Our focus on this theme is a derivative of several industry dynamics affecting hospitals and physician practices, including reimbursement headwinds that are pressuring already slim operating profit margins, workforce shortages and high employee turnover, and a reliance on manual, labor-intensive, and / or paper-based methods to facilitate key business processes, among others. Put simply, across front, middle, and back office applications, we believe healthcare providers will increasingly adopt automation software to drive operational and financial efficiencies, increase workforce productivity, improve employee retention, reduce burnout of clinical personnel, and, perhaps most importantly, improve the patient experience.

In baseball terms, we believe the healthcare industry is in the “early innings” with regard to software adoption. While provider organizations have spent the last 10-15 years adopting electronic medical records (EMRs), they continue to lag other verticals in terms of software adoption for managing and / or automating various business processes. As one example, healthcare providers have only recently begun implementing customer relationship management (CRM) software platforms, while most other industries have had CRM systems for decades. To this juncture, automation software (often termed “robotic process automation” or “RPA”) adoption in healthcare has largely focused on back office applications – revenue cycle, specifically. However, we believe automation of front-office workflows through technology – healthcare’s “digital front door” – will have the most profound impact on the patient experience, while also driving significant operational and financial value for providers.

It is against this backdrop that we are delighted to lead Syllable’s $40M Series C financing in partnership with our friends at Oak HC/FT, Section 32, and Verily Life Sciences. Our investment in Syllable is intended to help Syllable expand its artificial intelligence and machine-learning (AI/ML) enabled software platform into adjacent applications and use cases, penetrate new healthcare customer segments (e.g., payor, pharmacy, etc.), rapidly scale headcount across all functions, and forward invest in future growth initiatives.

There has been a lot of “buzz” recently regarding the healthcare industry’s “digital front door,” which we define as simply the technology-enabled mediums via which patients engage with the healthcare system. This is largely a function of the growing consumerization of healthcare and corresponding emphasis on improving the patient experience, and numerous technologies have emerged to help facilitate digital interactions between patients and providers. Having said that, our research – and data from Syllable’s customers – indicates that the dominant modality for patient engagement with providers remains a telephone call; in our view, this is a derivative of the uniqueness of an individual patient’s circumstances and needs, in addition to the complexity of the healthcare system and its historically limited or non-existant digital channels. As a result, we believe the technology platforms best-positioned to automate front office workflows must offer solutions that address both voice and digital mediums.

Enter Syllable and its CEO, Kobus Jooste. Kobus founded Syllable in 2017 with an initial vision to build a software platform capable of removing high-friction barriers between healthcare providers and their patients. Prior to founding Syllable, Kobus spent several years in engineering leadership roles at Google, the most relevant of which was his leadership of the engineering team that developed and launched Google Assistant. Given Kobus’ background in conversational AI and natural language understanding (NLU), we believe that he is well-positioned to build a platform capable of automating both voice and digital patient-provider interactions. More specifically, Syllable’s technology platform leverages AI and NLU to automate inbound patient interactions with providers via phone, web, chatbot, and SMS text. As 95%+ of all patient interactions with providers presently take place via phone call, healthcare providers invest heavily in call center operations – anecdotally, some of Syllable’s customers field 15M+ patient phone calls per year, and invest hundreds of millions of dollars in their own call center personnel and operations. At the same time, providers are also investing significantly in digital applications to facilitate more efficient patient engagement.

Despite this level of investment, the healthcare industry continues to lag others in terms of consumer (i.e., patient) experience. As one datapoint, healthcare’s average net promoter score (NPS) is approximately 27; an NPS of 50 to 70 is generally considered “good.” As another, healthcare providers have call abandonment rates close to approximately 30% (per data from Syllable’s customers) – one of many reasons underpinning a poor patient experience. For providers, a poor patient experience negatively impacts their revenue from multiple vantages; for example, calls abandoned may represent lost revenue opportunities, and a poor experience with a provider reduces the probability of a repeat visit. Properly and efficiently engaging patients is incredibly challenging, as any digital mechanism for managing interactions needs to be highly approachable for patients, must incorporate healthcare-specific contextualization in terms of the intent of the interaction, requires immense scalability (e.g., large systems have 15M+ inbound phone calls annually), and, to reiterate, must facilitate engagement across both digital and voice channels.

That’s precisely the problem that Syllable is out to solve. Syllable’s technology platform leverages conversational AI and NLU technology in tandem with the company’s purpose-built digital applications to automate inbound patient interactions with healthcare provider organizations. Across the company’s current customer base and use cases, Syllable’s platform is capable of automating the majority of inbound patient inquiries, and those inquiries it cannot drive to a conclusion without human intervention are routed to the customer’s call center personnel for further triage. Common use cases include routing calls to the correct endpoint, appointment scheduling, and referral and medication management, among several others. What’s more – Syllable’s ML technology trains its AI on those interactions it cannot automate such that the company’s automation percentage improves with incremental volume and customer utilization. Syllable’s data suggests that its platform drives hard ROI for customers across multiple dimensions, including a significant reduction in call abandonment rates (to zero with Syllable’s platform) and wait times, a 2x+ or greater increase in first call resolution rates, and higher appointment scheduling conversion rates, among others – all of which result in an improved experience for patients.

Syllable’s compelling value proposition, coupled with its reputation for relentless innovation and top-tier customer service, contributed to engendering customer delight, and the company boasts an NPS of 80+. Its customers include numerous healthcare provider organizations, including Parkview Healthcare, Shannon Healthcare, New York Presbyterian, Weill Cornell Ambulatory Care Network, Houston Methodist, and Mass General-Brigham, among others – a particularly impressive roster given the company only began marketing its platform in October 2021. In 2021, Syllable interacted with 39.7M Americans in text and voice about primary care, specialty referrals, vaccinations, and general practice information. Based on Syllable’s sales momentum, the company will more than double its revenue in 2022, particularly as Syllable scales product and technology resources and continues to add to its go-to-market organization. 

CEO Kobus has assembled an impressive team of advisors and experts to advise Syllable on the healthcare industry’s needs and complexities, in addition to AI and ML technology. With this in mind, we are excited to have TCV Venture Partner Anita Pramoda support Syllable as the company takes-on new challenges in the healthcare industry.

“Syllables compresses the delay between needing and accessing care,” says Anita. “With Syllable, healthcare providers can now bring reliability, repeatability, and ubiquity to access – foundational tenets of good health. I’m honored to partner with Kobus and the entire Syllable team as they scale their platform and offer better care for all patients.”

Growth metrics and accolades aside, what perhaps impresses us most about the Syllable team is its unwavering commitment to approaching the healthcare industry with humility and respect. For a brief anecdote on this front, please refer to this segment with Joe and Syllable’s CMO, Adam Silverman, on a recent episode of the company’s podcast.

“Syllable is at a crucial point in its growth trajectory. As one of the most transformative platforms for health systems, our vision is clear. We want to help as many patients navigate hospital and primary care, while lowering the cost of access to care and the burden on front office staff and clinical staff,” says Kobus.

Syllable was also recognized as a most promising startup in healthcare for 2022 by CB Insights, picked as a leader in the private market from a pool of 7,000 companies – chosen based on R&D activity, proprietary Mosaic scores, market potential, business relationships, investor profile, competitive landscape, team strength, and technology novelty.

We are off to the races in our partnership with the Syllable team – including newly-appointed COO Catherline Krna, who joins Syllable from the Chief Administrative Office of Ambulatory Care and Service Lines at Stanford Health Care. We are incredibly excited to help build what we believe is a category-defining, generational software company that engenders patient delight while driving operational and financial efficiencies for healthcare providers.

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The views and opinions expressed are those of the author and do not necessarily reflect those of TCMI, Inc. or its affiliates (“TCV”). TCV has not verified the accuracy of any of the data or statements by the author and disclaims any responsibility therefor. This blog post is not an offer to sell or the solicitation of an offer to purchase an interest in any private fund managed or sponsored by TCV or any of the securities of any company discussed. The TCV portfolio companies identified above are not necessarily representative of all TCV investments, and no assumption should be made that the investments identified were or will be profitable. For a complete list of TCV investments, please visit www.tcv.com/all-companies/. For additional important disclaimers regarding this interview and blog post, please see “Informational Purposes Only” in the Terms of Use for TCV’s website, available at http://www.tcv.com/terms-of-use/.