How Abi Global Health, a medical micro-consultation service, is on the way to radically transform the first mile of healthcare. Interview with Kim-Fredrik Schneider, CEO of Abi Global Health.
Pandemic raised the level of telemedicine adoption and usage around the world. Governments waived restrictions and released reimbursement codes for telemedicine tech licenses and service offerings. Telemedicine services are experiencing a considerable market momentum and service providers are highly sought-after partners. Kim-Fredrik Schneider, CEO of Abi Global Health, a pioneering medical micro-consultation service, shares with us the company’s business model and key drivers of success, as well as what are the most profound strategic challenges of payers their solution is solving and how Abi delivers 10–20x higher engagement rates compared to app-based telehealth services.
Telemedicine has been available for many years, but its breakthrough came with COVID-19 pandemic. Governments have reduced barriers to entry to telemedicine and remote patient monitoring solutions. Health insurers have started to embrace telemedicine and other digital health solutions to offer better primary care, preventive & chronic care management to their members and reduce health costs. Advancement in technology (e.g., AI, machine learning) have also positioned healthcare chatbots and virtual diagnostic platforms as personal health assistants to provide initial diagnosis to patients accurately and advise on next possible steps. A global R2G survey in 2020 shows that 66% of telemedicine users reported that they will use the service more often in the future. New users as well as HCP acceptance of telemedicine services result in substantial business opportunities. With telehealth services becoming a multibillion-dollar market — the run for telehealth vendors has begun. Yet, the telemedicine adoption rate and usage around the world is still very low.
What are the reasons behind that? Are traditional telemedicine apps really reducing pressure on the healthcare system with the average of 15–20 min online video sessions? Can one receive trusted health advice from a doctor in 3–5 min using his / her favourite chat apps? Are healthcare payers the right ones to design healthcare journeys?
To dive deeper into this topic, we talked to Kim-Fredrik Schneider, CEO of Abi Global Health, a pioneering medical micro-consultation service that connects users with real doctors in a secure and compliant way inside the most popular chat apps (WhatsApp, Telegram, Viber, Skype, even SMS).
Research2Guidance: Can you please introduce Abi Global Health, share its story and the concept behind it? What does the service offer?
Kim-Fredrik Schneider: I founded Abi Global Health in 2016 together with Dr. Victor Vicens after we were brought together by a shared belief that healthcare should be convenient, easily available, and consistently excellent.
We saw an opportunity in Telemedicine to create an innovative service that has never been offered before — medical micro-consultations.
Our virtual health assistant, Abi, enables users to send health questions to licensed doctors from inside their favorite chat apps (WhatsApp, Telegram, Viber, Skype, etc. & SMS) anytime, anywhere. This way, our service truly meets people where they are. Each question Abi receives from users is classified by AI and Machine Learning algorithms to match them with the best suited available doctors. Within 3 to 5 minutes, the user receives an accurate answer from one of our doctors. Our goal is to use micro-consultations to radically transform the first mile of healthcare.
Abi alleviates the pressure on healthcare by reducing the time of physicians by up to 85%, compared to synchronous consultations via chat, voice, or video. 70% of our consultations prevent further medical interventions.
Research2Guidance: How did you come up with the idea of micro-consultations?
Kim-Fredrik Schneider: Our inspiration was the experience we had ourselves, Victor as a doctor and me as a parent of two young children. I would often ask Victor questions about my children’s health via WhatsApp, as many people who have a doctor friend do. We decided to re-create this experience for everyone, providing easy access to professional medical guidance from a friendly doctor.
Since both of us already worked in HealthTech, we were very aware of the many existing telemedicine companies. But we saw that the existing models still rely on 15–20 minutes of physician time for each consultation. Because of that they do not reduce pressure on the healthcare system and do not scale well.
The other issue we looked to address is the chronic under-utilisation of telemedicine. Even in the midst of the pandemic, utilisation rates for traditional telemedicine apps have been shockingly low.
Research2Guidance: That is an interesting point. Was “why don’t people use Telemedicine and how can we change that” the next key question you were faced with?
Kim-Fredrik Schneider: Yes. At that moment in time, chatbots were the hot new thing. Frankly, we were a bit sceptical about chatbots in general, but we saw an opportunity to solve a fundamental problem with the delivery of healthcare, which is that most people do not plan to need healthcare. You may have an idea of how many times you might watch Netflix, or order pizza in the next month, but how many times do you plan to need healthcare in that same month? The answer is “hopefully not at all!”. For people with chronic conditions, it is a different story, of course, but for most people, there is no anticipation for such a need, which makes it very difficult to prepare users for a service they do not expect to use.
We saw chatbots not as an end product, but more as a means to deliver our service inside these ubiquitous channels, like WhatsApp, Telegram, Viber, SMS, etc.
Our key assumption was that the reason people do not use Telemedicine is that it’s not easily available in the moment they need it.
With our approach, we make available a vast network of licenced doctors and an interface that integrates within chat apps. We didn’t just innovate the medium of interaction, we also radically changed the unit of interaction. We developed a highly efficient form of professional healthcare interaction, which we called micro-consultations.
The user is anonymous to the doctor, but the doctor is not anonymous to the user. This allows us to deliver a service which is compliant, secure, and highly convenient, as well as impactful, thanks to the fact that all answers come from a real doctor.
Research2Guidance: Just to be clear, a micro-consultation cannot be used for a sick note or a prescription?
Kim-Fredrik Schneider: Micro-consultations are not the formal practice of medicine. We are filling the gap between digital-only solutions and full medical consultations. This is an approach that has never formally existed before. Only friends and family members of doctors had access to this kind of service in the past.
Research2Guidance: What exactly does your business model consist of?
Kim-Fredrik Schneider: I think every start-up must have an answer to the question of “What is my business model and who is going to pay for my service / solution?”. Unfortunately, in the HealthTech space many startups have an amazing service, but they fail because they can’t figure out who is going to pay for it.
In our case, we knew from the beginning that we would focus on healthcare payers. We deliver an enormous amount of value to our users; we are a service doctors enjoy contributing to, but ultimately, our service makes the healthcare system more efficient and more cost effective, which delivers a profound benefit to healthcare payers, public and private.
We partner with insurance companies all over the world, bundling our service with their products to add value, improve engagement with their customers and improve the health of their customers. Our partners benefit from Abi, as it is a value-enhancing service people actually use. We help people avoid unnecessary medical visits and help make necessary medical interventions more efficient. Our service integrates seamlessly with whatever comes next in the healthcare journey; whether that means calling a nurse hotline, downloading an app for a video consultation, or making an appointment to see a doctor in-person.
We deliver the reliable health guidance only real doctors can provide, which makes our service stand out from online symptom checkers and other fully-automated services.
Research2Guidance: This is bold. You have chosen a straightforward, yet challenging path of partnering with insurers. Not a lot of health insurance companies were eager to pay for Telemedicine services in 2016!
Kim-Fredrik Schneider: You make a very interesting point. Our path is a straightforward and simple one, but it is very difficult to stay simple and not get pulled in a hundred different directions. Does your product do this, does your product do that, and next thing you know, you have a plate of spaghetti and you cannot figure out where one piece begins and another one ends.
Ironically, I think saying no to opportunities outside of our core vision helps you to define your value more clearly. By setting boundaries around the service you are providing, you are simultaneously creating clarity around its value.
Research2Guidance: How did you manage to convince payers of the worth of your service and the financial value Abi will bring to them?
Kim-Fredrik Schneider: I think that we have a lot of success with insurance companies because our service is built around solving some of their most profound strategic challenges.
Every insurance company in the world is currently facing 3 important challenges:
1) Customer engagement — When it comes to customer engagement, we compare insurance companies not to other insurance companies, but to the best customer experience that we have had from any company, and that is very difficult for them to replicate, because of some inherent aspects of sector. They understand that the way to improve customer engagement is by adding services people will actually use.
Because we deliver our service through channels people are already using, our engagement rates are 10 to 20 times higher than those found with typical digital health services. And health insurance companies clearly see the value in that.
2) Differentiation — Differentiation is extraordinarily challenging for insurance companies. There is very interesting data showing that there is no correlation between switching behaviour and brand perception in the insurance sector. Standing out in the crowd is a constant challenge.
In the Telemedicine category, hundreds of companies are offering the same thing (system checkers, video consultations), and then there is Abi. Abi offers a unique service which enables genuine differentiation.
3) Healthcare costs — The third strategic challenge is that healthcare costs are increasing faster than the GDP just about everywhere in the world. This is a problem for governments, and it is a problem for health insurers. Anything that can improve claims ratios is a priority.
Abi delivers cost reduction in 2 ways:
- By reducing unnecessary medical interventions
- By accelerating necessary interventions while keeping them within the insurance-company’s provider network. Delayed medical visits often create more medical problems and, consequently, more expensive treatments. This is why accelerating necessary visits is extremely valuable.
Once you figure out who is going to pay, you must also make sure that you are accurately expressing what your service does, and that you are delivering the value your partners need.
Research2Guidance: How many users do you have?
Kim-Fredrik Schneider: At present, Abi Global Health covers 7 million users, and our doctors can deliver around 150,000 consultations a month.
Research2Guidance: Which markets are you in?
Kim-Fredrik Schneider: At the moment, our service is available in 14 languages, delivering micro-consultations with doctors in 23 countries in Europe, Asia, North and South America, and Africa.
Research2Guidance: How do you decide which country to enter and do you have plans to enter new markets?
Kim-Fredrik Schneider: When we perform market assessment, we look at three things — the population of the market, its economic situation, and the growth rate of the health insurance sector.
Abi Global Health has been multinational from day one, and we continue to grow very quickly. By the end of the year, we expect to expand to between 30 to 40 countries.
Research2Guidance: How easy is it for you to “adapt” your solution to different markets?
Kim-Fredrik Schneider: Our AI already understands 80 languages. I would say that part goes quite fast. We always work with local doctors, so the medical side adapts itself naturally, and the last step is translating the materials around the interaction. We are able to launch to a new country in a matter of just a few weeks.
Research2Guidance: Are doctors required to be part of the healthcare system — working with specific health insurance companies?
Kim-Fredrik Schneider: The doctors we are working with are always locally licensed and work in a hospital or a clinic in their country. In fact, we insist that they are all practicing regular medicine. We believe it becomes a problem when you have a service with only call-centre doctors, or doctors who can only do Telemedicine, because this creates a very limited scope of practice. We want doctors who have experience with the full scope of medical practice — our service becomes one they contribute to and take care of in their free moments.
Research2Guidance: Who are your competitors?
Kim-Fredrik Schneider: Our service enhances and works alongside other forms of Telemedicine. Almost all insurance companies we partner with already have some other kind of Telemedicine — symptoms checkers, video consultations etc. Abi complements and enhances these services, so it is not a matter of an “either-or” but more of an “also-and” choice.
Research2Guidance: Can your solution be easily integrated with any existing digital health service / solution?
Kim-Fredrik Schneider: Yes! Using our Abi Widget, our micro-consultation service can be white-labelled and integrated with any other digital health service — app or website. We see ourselves not as a stand-alone solution, but rather as one that works very well in complementing other kinds of digital health services. In addition to our work directly with insurance companies, we also partner with other digital health companies to enhance the work that they do.
Research2Guidance: Partnerships are an important channel for innovation. What makes a successful partnership?
Kim-Fredrik Schneider: I would say shared risk, good, clear communication, and transparency, as well as doing the actual work you promised to do. And if, for some reason, you cannot deliver on that promise, you should be honest and say why it cannot be done.
Research2Guidance: What is your distribution strategy?
Kim-Fredrik Schneider: We work with our partners to deploy and distribute Abi.
There are two keyways to access our service. One is via a link that will open the user’s preferred chat app. This link can arrive via SMS, email, as a button on a website or a QR code offline.
The second way is to embed our service into another platform, as a Widget in an app or website.
We meet users where they are. If our partners already have strong engagement in their own app or website, we can embed there. If not, we can meet their customers in the chat apps they already use.
Research2Guidance: Can a user pay for a micro-consultation out-of-pocket?
Kim-Fredrik Schneider: Yes, it can be done through our website, but this is not our primary business model.
Research2Guidance: What are your challenges?
Kim-Fredrik Schneider: The biggest challenge is working with a large and conservative industry like insurance. We focus on partnering with the most innovative and adaptive companies in the sector.
We have recently also started working with government health providers, and we expect that to increase as well.
This is because we are fulfilling a profound need. It is basically two sides of the same coin — people go to the doctor when they should not, and they do not go to a doctor when they should. Both are linked to the inefficiency of accessing high quality care in the first mile of healthcare. And our view is that neither symptom checkers nor video consultations can fully resolve that problem.
Research2Guidance: And why is that?
Kim-Fredrik Schneider: Firstly, because symptom checkers only cover about 20% of people’s medical questions and there is very little evidence that shows they actually change people’s behaviour. They certainly serve a purpose in the healthcare journey, but it is of limited scope.
As for video consultations — these are very effective but difficult to use (you need a stable and secure connection, good lighting, etc.) and therefore have very low utilisation rates. Video consultation costs are very similar to the costs of seeing a doctor in-person. Each doctor who engages in video consultation is unable to engage in any other consultation, making them additive, rather than reductive to the overall burden on healthcare professionals.
Research2Guidance: In some countries and cultures, people, when given the chance, still prefer phone over video consultations. And although COVID-19 has increased the adoption rate of Telemedicine in some markets, it is still not that high.
Kim-Fredrik Schneider: Individuals may have their own communication preferences, but overall, there is approximately a 10 to 1 phone-over-video and a 10 to 1 chat-over-phone preference, around the world. There is strong public evidence of this which has been confirmed by our own experiments with offering users a range of communication options.
Research2Guidance: Has COVID-19 affected your business? As users, we had to change our behaviours and switch to Telemedicine …
Kim-Fredrik Schneider: Yes, we certainly saw a significant increase in utilization because of COVID-19. The pandemic began, our service was already live in Asian markets, and we observed how COVID-19 related-questions migrated from Asia to Europe as the pandemic itself migrated.
Recent analysis performed by the Data Scientists in our AI Lab found that questions regarding COVID-19 started increasing about a week before COVID-19 rates increased across the markets where we operate. This is something that we will continue analysing, as it appears that we may be in a position to actually predict public health trends by monitoring the frequency of certain types of questions.
Research2Guidance: The remaining question then is: Will behaviour change and usage of Telemedicine hold?
Kim-Fredrik Schneider: Our view is that if behavioural change is driven by the pandemic alone, much of that change will not last. All of us have seen an increase in our usage of digital services during the pandemic, but we have to ask ourselves “Is this a sustainable change or change driven solely by the unique situation in which we find ourselves?”. In our case, we had high utilization rates before the pandemic, and I am quite confident we will continue to grow after the pandemic as well.
Research2Guidance: What trends do you see in the Telemedicine space?
Kim-Fredrik Schneider: For the last couple of years, being “new and trendy” was enough. And the pandemic has to some degree extended the life of this trend. However, I think that healthcare payers will increasingly demand a true return on investment from Telemedicine. Being new will not be enough. Services will have to deliver tangible value.
I also think that, when it comes to video telemedicine, the shift will turn towards traditional providers who will increasingly offer video telemedicine, generating strong competition for incumbent video telemedicine providers.
The next few years will introduce a real separation of the wheat from the chaff and the hype from the real delivery of value. We believe we are on the right side of that equation.
Research2Guidance: What is next for Abi Global Health? Where do you see the company in the near future?
Kim-Fredrik Schneider: Over the next 3 years, we will expand to 100 markets and intend to make our service increasingly open to easy integration with other types of digital health platforms. Our view is that healthcare payers (both public and private) are the right ones to design healthcare journeys. We believe that we are a critical element in the healthcare journey, but we certainly do not solve every problem in healthcare.
Research2Guidance: Kim-Fredrik, thank you very much for your interesting thoughts and insights. We wish you and Abi Global Health’s team to stay safe and healthy.