Akira

@dwalper Major congrats Dustin! Love what you are doing. Big Market, big vision & superstar team. Can't wait to see how you will attack the U.S. Market in the Obamacare era. There's lots of interesting things happening in the health space including in the US (e.g. Oscar Health). As a proud and local Torontonian, always excited to see a local start up flourish. Congratulations!

@aeroechelon Thanks Marvin! We're proud to be a Canadian team that thinks globally.

@dwalper Hey! This is a neat product, and I'm super enthusiastic of Canadian advances in healthcare and technology. Good things are happening here in the North! Still, just a quick note: can we please not use "open the kimono" as a phrase? There's better language out there – in this case, "launching" might have worked just as well. Thanks!

@ryanjamurphy Hey Ryan - thanks for the encouragement! :-) We want Canada to be a world leader in digital health - we certainly have the talent in this country!

Hey, @dwalper . With my http://heartin.net you can add big value for Canadian doctors. They can use Heart-In, which makes a revolutionary full-function but portable, miniature electrocardiograph at ultra-low cost ($240) with full remote diagnosis by Smart Phone or PC. We can sell to doctors by using while GP home visits and to consumers to prevent heart diagnostic. It's ready to using solution to grow customer loyalty and grow user's ARPU. Contact me alex at heartin.net for details

@d0b0 Hey Sam! Thanks for the questions and encouragement. So at launch we'll have two options - either employers can provide Akira as a benefit to employees, or you'll be able to sign up yourself on a monthly subscription. Pricing-wise it will be in the ballpark of a Netflix subscription, cancel anytime. Insurance is something we're working on - for companies that have Health Spending Accounts, it's am eligible expense which keeps it simple. For more standard coverages, we're working with insurers to get Akira covered in the future. Right now we just negotiate a rate with each company based on expected utilization. Doctors are compensated by Akira directly. At the moment these services aren't covered by provincial health insurance. We actually pay doctors for time rather than patient volume, so they're not pressured to churn through patients - we want them focused on providing the best possible care.

@darynakulya Hey Daryna - great question! The biggest learning lesson has actually been around the importance of text. During the week, many members work at a desk, often in an open office environment (we've indexed heavy on tech companies in our beta set). It can actually be challenging to find a good place to take a video call, particularly a sensitive one with a doctor. We weren't sure which people would prefer, but something like 60-70% of our consults have been conducted entirely by text. We've also found there are certain ingrained notions that take some education to change - for example, this idea that an appointment is necessary. We want to be on-demand, which means when you want to talk to a doctor there will be a doctor. That can be hard for people to wrap their heads around given the current state of the system :-) As for unexpected feedback - I've been amazed at the range of issues we've seen thus far. Really interesting stuff, and higher engagement than I expected. Over 20% of employees in our first beta companies have used Akira in the first 6 weeks (for real medical issues, not just to test the service - we take those out of our metrics).

@dwalper Interesting, I've found messaging option to be super convenient in the open office environment :)

@jjrichardtang Interesting question, JJ :-) We actually did a lot of research into what worked (or more typically, what didn't work) in Canada and elsewhere. Ultimately, it comes down to a basic premise: in order for a technology-powered service in healthcare to be sustainable, it must be fundable. For it to be fundable, it must be scaleable. Most failures have more than one cause, but the single biggest one we saw was poor choice of customer. Selling to clinics, or to hospitals, is just not a good business for small companies. Incentives are misaligned, sales cycles are too long, and the purchaser is often not the end-user. Another common failure mode results from too many uncontrolled variables - not selecting a narrow enough set of early adopters, not controlling for the issue of hectic clinic schedules, working with doctors who weren't comfortable with technology, supporting too many browsers with finicky video technology, etc. etc. I won't get into names on here (give me a shout if you want to talk about it over a beer), but the digital health space in Canada is littered with stillbirths. We've learned from those mistakes and have found a model that we believe will scale globally.

@askdaylen Great question! Doctor-on-Demand has taken the traditional appointment and moved it to video. Need to talk to a doctor? Book a video call, pay $40. Nothing wrong with that, the model works. But we actually want to rethink the assumptions underlying a medical appointment. A subscription to Akira, which by the way will be about 1/4 the cost of a single DoD visit per month, will get you unlimited use - whether you need a quick question answered or a full-blown assessment. Text or video. Most services are reactive. Akira will be subscription-based because we want to be proactive - we'd rather predict & prevent chronic disease, where possible, than wait for it to get really bad before dealing with it. This isn't just a doctor thing, by the way, it's a care team - a coupling of doctors, nurses, and algorithms. Some aspects of this are currently aspirational, as in the technology or research doesn't even exist, but others just involve better integrating the research into practice. Our platform is designed to make it easy for us to integrate clinically-validated diagnostic algorithms, treatment plans, and other tools directly into the doctor's workflow so they're always using the best available information. Our doctor app, code-named Zaius, is sort of like Slack for medical professionals. We even have plans for a Slackbot-style medical assistant in the works. So yes, we're just in Canada right now and there's a strategic reason for that. But our goal isn't geographic arbitrage on a model that's being done elsewhere - the homogeneity of Canada's regulatory environment and relatively clear rules actually make it a great place to develop this kind of advanced technology.

@alexputici Thanks Alex! :-)