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2022 - GC3 “We’ll go further together”

Heya 👋🏽,

Raj & Pete again from Healthtech-1. We’re the startup automating away admin tasks in Primary care. Coming out of stealth, apples of opportunity rained down and the last time I wrote to you our hands, arms and the crevices between our very necks were filled 🍎! We realised we quickly needed another pair of hands to carry the load and today I write to introduce you to them 🙌🏽

Drumroll please 🥁. Joining as our Founding Engineer, we welcome Neil Chandarana to the team. Neil studied alongside Pete at Warwick University, and our paths have crossed fondly many times. An automation junkie, Neil automated much of his own job as an Options Trader at Barclays before founding his own AI/Data consultancy. Importantly, he’s a systems thinker, who communicates diagrammatically. Between the three of us, there are some deep skill sets and a more than touch of magic.

Growth Cycle 3 covered the 6 weeks between Monday 28th March & Friday 6th May. To keep up with public information, I’ll break convention and share some updates from the present too:

GLOSS ✨

PRODUCT

  1. ⚡️ Neil completed his test project by launching a lightning page for every GP practice in the country (~7,000). Scraped from public datasets, lightning pages are single page SEO/mobile optimised pages that serve up the critical info patients need, like how to book an appointment, or how to register. Find your GP practice’s here (https://www.ht1.uk/). Imagine being able to build a dynamic webpage based-off a single row in a spreadsheet? These lightning pages will form the foundation for a pretty cool growth experiment in 6 months.
  2. What’s a test project? When Pete and I founded our growth agency, we were close friends, but we’d never formally worked together. To test the relationship we completed a 3 week project, building an automated appraisal system for my parent’s GP practice (the foreshadowing 😂). It led to a co-founding decision based off so much more data on each other. We figured, there’s literally no better test of what it would be like to work together, than actually working together. Because interviews generally suck - we’ve continued this tradition to date. Every potential hire goes through a short paid test project. If there’s magic, they’re in.

  3. 🎚 Upgrading from batches, our automations now seamlessly switch between practice sites - The objective, is to go from high touch → low touch → no touch. We’re at low-touch, and edging ever closer to no-touch. But the jump to being completely handsfree is big. We’re working with highly sensitive data, and before letting go, we need to test our process thoroughly.
  4. 📊 Semi-automated registration reports - if we’re charging on a per registration basis, at a minimum we need to provide practices with an insight into their registration data. Here’s some initial feedback from George a GP Partner “Great to see items visualised which we’ve never seen captured eg. reason for joining the practice and the number of interpreters needed.”

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GROWTH

  1. 🤝 A deal made with Neil - It takes time to hire world class talent. You have to find alignment between heart and mind. During Neil’s test project we had a number of deep conversations that dived into our characters, what we value, and our vision for the future. To help we developed a model for assigning options that takes into account risk appetite, stage of joining, years of experience and current valuation. We’ve assigned an options pool, produced new employment contracts, and kicked off a HMRC valuation too. It’s been a process..!
  2. 🎉 9/10 of our LIVE practices have converted to paying customers. Our whole company hinged on the assumption we can build a product practices' value enough to pay for! In 10 months we’ve gone from idea formation to revenue generation, and the feedback has been immense “this product has been a godsend”, “it’s just freed up so much staff time”. The 10th, Sally’s practice has an extensive registration process that includes a few tasks that we don’t yet automate. We’re extending the pilot until we’ve included those features.
  3. 💰Won the London Business School Healthtech Challenge - The £10,000 prize will go towards the purchasing the infrastructure needed to scale our automations nationally. Excitingly, since the public announcement we’ve had 4 separate candidates reach out asking to join the team. What we’re building is starting to resonate!
  4. 📊 Automated 955 Registrations in April (up from 862 in March) - So wonderfully close to that 1,000 number! Thats, ~239 Monthly Liberated Hours (MLH)
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GRIT 😫

  1. 🐞We found a bug in our code - In total the bug affected 254 patients’ emergency contact mobile numbers. When adding an Emergency Contact who was not registered at the practice, the mobile number filled in by the bot was actually the patient’s own mobile number instead of the emergency contacts. We’d mixed up a single variable 🤦🏽‍♂️. This was our first big mistake. I remember having the dawning realisation whilst Pete was on holiday; I’d been trying to protect his headspace, but this was an exception. “Hey man, bit of an emergency 😅”. Then began a process of determining the size of the incident, adjusting the patient records and prepping the practice communications. We knew it was the right thing to do. But I still had this anxious pit in my stomach. The dark thought crept in; “We’re weeks before the end of our pilot, what if they lose faith?“. I clicked ‘send’. The responses came back quickly - "many thanks for this and for your honesty 🙂 completely understandable with the software being so new. Glad it's all sorted”, “Thanks Raj. For notifying and being so responsive in the Fix.” “Thank you for the update, great to see you spotted it and have already sorted it out.” We breathed a sigh of relief. The human temptation is to hide your mistakes, but by sharing them, you build trust and trust is our most valued currency. To borrow, a phrase from the incident.io team “transparency shatters the illusion of perfection: replacing it with a much more useful ‘things go wrong here, and we work hard to fix and learn from them’ attitude.
  2. ⛵️Not all smooth sailing - This cycle felt disorganised; holidays, incidents, test projects and public events had us in a reactive mindset. So much so that some of our pilots actually finished before I’d realised. “Hi Raj, I believe we have had 6 weeks of using your registration link on the website and we would like to review this. Are you able to send over some stats please – how many registrations have been completed since we went live on the website? How many start a registration form without completing it??”. I was immediately on the back foot. To compound, I knew that in some practices we weren’t directly working with the decision makers. So I couldn’t just send over a contract requesting they sign on the dotted line… Let’s just say there were a few late nights. We learnt that we need to better articulate the data quality benefits of our product over and above the staff time saving, especially in geographies with low net migration. An example; an inner city London practice can expect 30% of their registered list to churn each year. In these areas, staff time spent doing registrations is a BIG problem. This is not so true in the suburbs where it’s possible for admin staff to do registrations in the quieter periods of the day. What then is universally valuable? Detailed and accurate clinical records.
  3. 🥓 Raj got a grilling by skeptical CCG IT Lead - I’ve been quite enjoying the enthusiastic GPs that seem to randomly book into my Calendly. But what I thought was another excited customer, turned out to be a skeptical Clinical Commissioning Group IT lead. They came into the conversation with their compliance and risk hats on and not long after, the grilling began. Do you have a formal partnership with the clinical systems? What if a patient tries to commit fraud? What about the feeling a registration clerk gets about a patient? How can software replace human intuition? All very valid concerns, even if it was difficult to get a word in! Honestly, I don't think I gave the most prepared answers, but the conversation ended positively. We agreed to go on a process to officially answer these questions together, and we're meeting again in a few weeks. There’s a difference between knowing something to be true and having a bit of paper that rubber stamps it. In healthcare, we need rubber stamps.

Next ⏩ GC4 “👑 Compliance is King”

Whilst we are confident we’ve built a product GP practices love, the challenge is now building a product CCG & ICS (centralised NHS bodies) leads love. That means our security and compliance needs to be suitable for 200+ practices, and importantly, the next time I get grilled, I need to be able to articulate exactly how it's suitable. I should have every answer on the very tip of my tongue. To quote Dr.James Somauroo, “Facebook’s 'move fast and break things' doesn’t quite translate to healthcare”. Accordingly, Growth Cycle 4 will be called “Compliance is King 👑”.

QUESTIONS ❓

  • I’ve got a few ideas, but I’d love to know what you think; why has innovation in Primary Care/Health been so slow when compared to other sectors? Is it because users of products are often not the payers? IG and data security hurdles? Misallocated funding? Something else? (I'll summarise opinions in the next headline).
  • Cashflow wise - we're comfortable. Despite the economic outlook, our current mindset is rather than spending 3-6 months fundraising we should continue to bootstrap, directing our energy to new paying clients. Are we being naive in thinking that public sector spending will largely be immune to economic shocks? We’d love some challenge to this line of thinking! Are we missing an opportunity to move faster?
  • Do these emails resonate? How could we improve? Would switching to a Newsletter platform kill the vibe?