Start-up Dives - Dialogue
Virtual healthcare
I wrote about Voila last month, they are now live in the Greater Toronto Area. If you have opened Instagram in the area, you already might have seen their ads :) I am looking forward to trying out the service next week. Fingers crossed - hope the experience matches the expectation. Also, two weeks ago, I wrote about Pantonium and how Pantonium’s software is enabling public transit systems to move to ‘on-demand models’ and the same week Uber decided to position itself as a SaaS company for public transits. There is so much action in the world that one can never run out of things to think of and write about!
In today’s edition, I will be covering Dialogue a Canadian health tech startup that offers telemedicine or virtual care. Telemedicine isn’t new. What’s new is a pandemic that has accelerated trends including remote work, ecommerce and also telemedicine. According to Fortune, Telehealth use has skyrocketed during the outbreak—and the trend is probably here to stay. Virtual doctor visits jumped from ~12,000/week to more than 1 million/week during the pandemic.
Origin and the business
Founded in 2016 by Cherif Habib, Anna Chif and Alexis Smirnov, Dialogue has raised $53.5M and has been ranked as one of the Top LinkedIn Startups. According to Betakit, Dialogue had grown to over 400 clients, including Lightspeed, Hopper, and National Bank by June of last year. I am assuming by now, this would have become a much larger number. They operate in Canada and Germany and are hiring, in case you, or anyone you know is looking for opportunities. Here’s how they define their vision:
Dialogue’s vision is to deliver personalized care at scale. We make Canadian employees healthier by helping them access health and wellness professionals where and when they need to.
They are a B2B company that works with employers to provide healthcare access to their employees as a benefit. Here’s their pitch to the employers:
Dialogue offers a range of healthcare services to employees and their families. We work hard to keep individuals healthy, present at work, productive and happy. Through Dialogue, employees can chat with a nurse for any health or well-being related questions, consult a psychologist when they are stressed, chat with a nutritionist to lose weight, or consult with a doctor for conditions that can be managed virtually. We are a new part of your employees' benefits program. No more time wasted in waiting rooms, or conditions that go untreated because they simply don't have time.
Dialogue is a telemedicine platform and in the most basic term it is an application that allows an individual to consult a health professional within minutes via an app. They reach these individual customers through their employers and that’s what makes them Business to Business.
How does it really work?
So to understand the model let’s say that you work at a company called Hoppery. At Hoppery you receive several employee benefits that include health insurance, some lifestyle perks etc. Hoppery notices that you along with several colleagues take a day off once every two months to visit the doctor. They also notice that their insurance expenses are trending up because disability claims are going up primarily driven by mental health issues. Now the HR team at Hoppery starts thinking of providing proactive healthcare solutions to you and your colleagues to improve your wellness and reduce their expenses. This is when Dialogue comes in as a solution to provide virtual healthcare for Hoppery’s employees like yourself.
Dialogue provides progressive, premium and affordable healthcare, accessible on mobile and online, for companies like Hoppery. It costs employers about 15/employee per month to provide a solution where an employee can access a healthcare professional whenever they need one. These professionals are nurses, nurse practitioners, physician doctors, psychologists and care coordinators.
You go to the Dialogue app, answer a few questions asked by an AI bot that triage the issue based on your responses and directs you to the right next step - a doctor or a nurse that can help you and if you can’t be treated virtually it will direct you to a care professional who will help you navigate the physical healthcare system by finding a clinic and booking an appointment etc.
Don’t we already have free healthcare in Canada? Why do we need Dialogue’s service?
There are a lot of great things that can be said about the Canadian healthcare system. However, Canada is dead last in the developed world when it comes to access to primary care. 57 % Canadians can’t get same or next day access to primary healthcare. What happens when you can’t get an appointment with your family doctor? A lot of us end up going to walk-in clinics and Emergency Rooms. Turns out that ~40% Canadians have gone to ER to treat something that could have been treated by primary health care thereby creating an unnecessary burden on already stretched resources only because our set up isn’t the most effective one. Essentially three things can happen when you don’t get an appointment with your primary health care practitioner in time:
You would go to ER
You would do nothing and the issue will subside with time
You would do nothing and the issue transforms into something more serious because it wasn’t tended to in time
By the way, these primary care visits aren’t actually time taking - 80% of Canadians spent less than 20 minutes with their primary care professional on their visit, in fact 40% of these appointments last less than 10 minutes. However, most folks likely spent an hour waiting for their appointments. From the perspective of an employer, they lost half a day of work and the employee got 10 minutes of their physician’s time. It is just inefficient and this is what Dialogue is changing.
You speak with a nurse or a doctor virtually and then get a care plan or a follow up plan with the summary of the call to help you with the next steps and to keep a record of your chat. You can be referred for lab tests, x-ray etc if required but more than anything you don’t have to wait for days to access care and this is what I believe is the USP from an end user perspective.
What is exciting about Dialogue?
I am bullish on Dialogue and find the business to be really exciting.
Scope of telemedicine practice is quite broad. Upto 70% of all frontline care can be managed virtually including ENT, Flu, sexual health, dermatology and mental health. That’s a big market that is opening up to change at a pace that has been accelerated by the pandemic.
B2B - Dialogue is a supplement to your family doctor that is paid for by your employer. That takes away all the friction for the end user to use the service. Being part of a larger wellness strategy of an employer gives Dialogue the ultimate power to be successful. It needs to provide a good end user experience and a strong sales force to sell the product to the corporations. I do believe that proactive care and timely access to healthcare can bring down the insurance costs, reduce absenteeism and increase employee productivity. If Dialogue can provide this timely care, corporations will be willing to pay top dollar for the service and Dialogue won’t have to chase individual users but their employers who have all the right incentives to pay for the service.
Specialized programs - Apparently, 40% of Dialogue’s practitioner time was dedicated to mental health issues. Which in hindsight makes sense given telemedicine allows for a safe, anonymous way to access mental healthcare and reduces the barriers and stigma usually associated with seeking mental healthcare. So, Dialogue created a specialized mental health program that was driven by the feedback they were receiving from employers and the data that they were seeing. This ability to create specific programs driven by feedback and data is particularly exciting to me. This sort of ability allows businesses to succeed in the long run and Dialogue is clearly exhibiting it.
Additional Resources
Podcast - Telemedicine for Small Businesses (A lot of data that I have shared above has been taken from this podcast)
Interview - Anna Chif
That’s all for now :)
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