OnSomble CEO Enderson Miranda

ONSOMBLE Inc., the Nashville adaptive-learning platform company serving the healthcare industry, recently booked consecutive profitable quarters and could soon provide a liquidity opportunity for some of its existing investors, before stepping-up efforts to secure a strategic partner and-or seek institutional capital, according to CEO Enderson Miranda.

Miranda told Venture Nashville the company now has about 30,000 users of its OnRole™ platform in healthcare systems.

In 2012, OnSomble acquired a 30-person healthcare consultancy known as Role-Based Practice Solutions (RBPS), then based in the San Francisco Bay Area, from which it served such institutions as Stanford, UCLA and others.

Since then, OnSomble has translated RBPS competency-assessment, role and management development, educational content and related assets into online offerings and, more recently, into offerings via its customizable platform as a service (PaaS) model. It is steadily enriching the platform with new content, tools and other resources, said the CEO, age 33.

OnSomble provides hospitals and healthcare organizations with customizable adaptive learning platforms for professional development, continued education, and individualized learning.

Today, OnSomble has 6.5 fulltime staff and recently logged breakeven-or-better results for 1H 2018, said Miranda, adding that he projects a profitable full-year 2018. Its headquarters is downtown at 145 Fifth Ave. North.

OnSomble has raised north of $5MM in capital since it was originally formed in 2007 as Nurse Co., by a group led by Shawn Mathis, who remains a director of the company.

Miranda said OnSomble has more than 100 friends, family and accredited individual investors on its cap table. No single investor has control of the company.

Though the company is not actively planning to raise capital, Miranda said a raise may be undertaken in the next year or two, in order to provide early investors a liquidity event and to fund growth.

Provided a transaction becomes possible "at the right valuation" and with one or more investors who can open doors to healthcare decision-makers and consultancies, the company would take a very serious look at the proposition.

Meanwhile, he said organic growth activity is ramping-up as the company enters new markets and penetrates existing client organizations more thoroughly.

Because RBPS for decades served clients based in the western U.S., OnSomble's current clients are also mostly in that region; they include: Providence St. Joseph Health Systems (California, Washington); City of Hope Medical Center in Los Angeles; Premier Health Center (Dayton); and, Oklahoma Christian University, Edmond, Okla.

With its business model and platform now validated by early-adopters based elsewhere, Miranda said he is now focusing heavily on landing OnSomble's first clients in the strategically important Nashville healthcare market.

Underscoring the fresh priority assigned Nashville, the company recently joined both the Nashville Health Care Council (NHCC) and the Nashville Technology Council (NTC).

The company has a seven-member board of directors who are highly engaged in the company, said Miranda.

They are: Gene Harker MD PhD, chairman (Indianapolis); Mark Abdu JD, serves as OnSomble legal advisor (Libertas Law, Sta. Monica); George Baker (Nashville); Shawn Mathis PhD, OnSomble/NurseCo founder (Nashville); Roxane Spitzer, RN, PhD (Stuart, Fla.); and, John Shryock (Nashville).

Its business partners include firms such as Quorum Health Resources, Galen Center for Professional Development, Creative Health Care Management, and Dale Carnegie Training.

Miranda said successful development of the company's current platform was mainly the work of Nashville-based DevDigital LLC, with support from Kernel Equity, a VC formed by DevDigital Managing Partner Peter Marcum and Kernel Equity Chairman Todd McCullough. Both DevDigital and Kernel hold minority stakes in OnSomble.

OnSomble banks with Pinnacle Bank and its accounting is with Larry Burton CPA, of nearby Antioch. Earlier Web and branding work for the company was performed by Nashville-based Golden Spiral, said Miranda.

Asked about competitors, Miranda said that the majority of his clientele also rely on complementary offerings from Nashville-based Nasdaq-listed HealthStream.

HealthStream Chairman and CEO Robert A. "Bobby" Frist Jr. yesterday said during a 2Q analysts call that the company is pressing ahead with plans to establish itself as a "full-SaaS platform," with reduced reliance on services revenues.

HSTM's market cap stood at $900.2MM this afternoon, with the stock trading at about 27.6 P/E (down from P/E 220 a year ago). HealthStream was founded in 1990 and IPO'd in 2000.

HSTM management this week reported it had more than $165MM cash and marketable securities currently, as well as an untapped line of credit and no outstanding debt. The company has about 4.8MM subscribers. More here.

In response to VNC questions about suitors, Miranda acknowledged that HealthStream, as well as Boston-based Press Ganey and San Francisco-based Collective Health might logically be viewed as among potential future bidders for his company or others in the category. Routinely, Healthstream acknowledges it remains open to M&A transactions. Related: JuiceAnalytics.

Notably, Press Ganey, which over the years has been mentioned among a handful of logical suitors for Healthstream, earlier this year acquired Healthstream's patient-experience line of business for $65MM cash. Meanwhile, Collective Health has raised about $267MM in private capital in the five years since its founding. Also, less than a year ago Franklin, Tenn.-based Eric Parmenter became VP-Sales and national lead for value-based care within Collective Health.

There are other players: In Healthstream's 2017 10K filing the company noted that it competes in one or more segments with companies including Cornerstone OnDemand, Healthcare Source, Oracle, SABA, SAP, Workday, symplr (Cactus) and SumTotal Systems; and, with healthcare publishers with learning management systems, including Reed Elsevier Group's MC Strategies, Wolters Kluwer, and Relias Learning (Bertelsmann). In the Provider Solutions business segment, HSTM cited MD-Staff and Cactus from symplr, among other large companies.

Miranda joined OnSomble as VP business development in 2012, while the RBPS transaction and integration were underway.

He subsequently rose to president and chief operating officer. In December 2017, he was named CEO.

Earlier, Miranda served nine years as managing director for NYSE-listed Sprint Corporation's Middle and East Tennessee business operations.

According to his LinkedIn, he is certified as a professional in healthcare quality (CPHQ); and, he recently earned the Master of Science (Msc) degree in Evidence-Based Healthcare from the University of Oxford Department of Continuing Education.

In 2015, he earned his Executive MBA on the global immersion track of the Owen Graduate School of Management at Vanderbilt University. He earned bachelor's degrees in both political science and business administration at Austin Peay State University.

Miranda is a native of Belo Horizonte, in Brazil's state of Minas Gerais, near Rio. He came to the U.S. as an exchange student for his Senior year of high school, in Springfield, Tenn., a community roughly equidistant from both Nashville and the Austin Peay campus in Clarksville.

In Brazil, Miranda's father maintains a law practice and his mother works with a local school system. VNC

. last edited 0659 26 July 2018