The Cereal Entrepeneur
Getting to the nitty gritty of developing as a health tech startup in the UK, Anna Flockett interviews co-founder & CEO of Hospify, the 'whatsapp' for the health sector. A compliant and secure mobile chat platform designed specifically for use in UK & EU healthcare.
Digging into the importance of data security, how COVID-19 has accelerated their plans and important advice for fellow health tech startups, click play and join us for this insightful chat!
Cereal Entrepreneur.
Anna - Hello and welcome to startup magazine's podcast, the Cereal entrepreneur. I hope you're all well in the current situation that we're all stuck in. I'm your host for today and the editor of the magazine Anna flockett and we have an exciting episode ahead of us. As today I am chatting to James Flint, co founder of Hospify. Hospify are a communication platform designed specifically for health teams and patients to keep in contact. A little bit like WhatsApp. Of course being a health tech startup Hospify have been doing a lot of amazing work in the current COVID-19 crisis. James, first of all today, I want to welcome you and thank you so much for joining me. How are you?
James - I'm good. Thanks. Great to be here.
Anna - Well, thank you for joining us. And I thought maybe just start with it'd be a good idea to explain to our listeners a little bit about yourself, how hospify was founded and where the idea came from?
James - Oh, yeah, sure. Of course. The Hospify is really the idea came from two surgeons. My co founder Nevil Daster and an a mutual friend, a surgeon called Charles Andeca who's an old university pal of mine and he was working with them on a case in theatre. He Charles is a facial reconstruction surgeon, Nevil was a vascular surgeon. They needed a specific junior doctor to help with the, the operation and they couldn't find his number and traditionally, believe it or not, the numbers of people for particular, operating theatres and hospitals are kept on a red on a bar, a written list blue tacked to the wall of the operating theatre and that listed go missing. So they decided that it was about time to do something about this given that they both had smartphones, they set out to try and build a better communications platform for healthcare use. And they called me up they wanted somebody from outside the NHS to try and help he bought a bit of sort of commercial vision that wasn't, I guess, ingrained in their habits from within the industry. I'm a media technology specialist as a technology journalist for a long time and built lots of platforms, places like BBC and the telegraph. So I joined them, you know, because it struck me that really what they were talking about was building a media media platform is just doing it in a very particular way for a particular purpose and something I knew about. So yeah, we founded hospify back in 2014. Really?
Anna - Oh, wow. And how has the journey been so far? I mean, that's nearly all that's six years ago. Now. I haven't flown by does it feel like yesterday? Or does it feel like 20 years ago,
James - it feels like 20 years ago, to be honest. I mean, it's been a very, very long, slow process. I mean, I had no idea how long it was going to take. And I had no, I mean, I think that the downside of being an outsider was that I didn't understand how hard it would be in health. I think if i had I probably I probably wouldn't have started you know, fools rush in where angels fear to tread I think and it's proved really a long haul think that we spent the first year and I was full of the flashing fuses and First year, I kind of was really kind of working as a consultant for them. And we didn't really set out to build a messaging platform at all. To begin with, we thought we build something more like a LinkedIn more like a universal address book for health. But then we got on the Bethnal Green ventures incubator programme in 2015, after looking around doing some market research for a year, and then that was when we realised that actually what was going on in the sector was that people were just using WhatsApp to solve the problem of communication. You know, they did all have smartphones, like Neval and Charles, and so they were just using them even though it wasn't really sanctioned. And I think the penny dropped when we we found out about GDPR. I mean, this was in 2015. And nobody had heard of GDPR, then including US law, we found out the GDPR was coming in and we went to talk the Information Commissioner's Office and and we sort of realised that when 2018 came around, it was going to be a massive problem because everyone was using what's happened GDPR was clearly going to make it possible to use and health that's when we realised that there was going to be a gap in the market and we started to try go to solution. But even then, of course, you know, we couldn't get funding. And it was very slow. And we had to do a lot of work. So I was putting this concept and any kind of still took a long time convincing people that this was going to be a problem. You know, we every years, we just, you know, we just people would just go, Well, why don't we just use what's up? And we're like, you can't, you can't. And then of course, GDPR. And then it all started to get taken a bit more seriously,
Anna - of course. And I want to find out more about them challenges and the GDPR issue. But could you just explain to me how the app and the platform works?
James - Yes. So we try and make the front end of the free mobile app, free mobile app is as simple as possible, and as similar to WhatsApp as possible simply because you want to give people something they are familiar with. So yeah, there is a free mobile app, it's very important that it's free, you know that people won't use it if they have to pay for it. So you download it from the app store, you look you register, you can look in the directory for people who make a contact a bit like bit like you do on LinkedIn actually. And then you chat away and it's text messaging, group chats. Attaching pictures, very light, what's that with kind of two ticks for received and read messages and that kind of thing, the difference is really under the hood where we don't store any data. So while WhatsApp will store messages on server, and keep them around for a long time, and most of the platforms will do that they'll store a lot of stuff on the cloud Hospify we delete it all from Cloud after it's delivered. So we store it in the phone, and we delete it from the phone after 30 days. So we sort of joke really that it's a bit more like a professional version of Snapchat actually than WhatsApp. We're very big on data minimization. And that has two big advantages. One, it makes it really much easier to be compliant because we know where the data is, we know that we don't have it. And we know that it's on the phones and we know that it's gone after 30 days and we can enforce that as much as possible. But the other thing the other huge advantage of doing that way is it is very cost effective. You know, one of the big costs of running a message platform is storing the data and in a Compliance environment, you're also liable for the data, you store it. And that can ramp up the legal and insurance costs. By not storing the data, we actually really low the cost around the platform, you know, our kind of our Storage Cloud is actually the phones of our users. And that makes it possible for us to give away the platform for free to a lot of people. You know, we only pay for the message transit costs, which is kind of much lower than the message storage costs. Therefore, we can give away hospify and not go bust instantly while working out other ways to monetize it than sending advertising or sending data which of course, we don't do. That's basically the mobile app. I mean, there are other bells and whistles, enter the PIN code protector and it doesn't reveal message content on the notifications on your home screen and stuff. But that's basically the mobile line in nutshell. What we sell is something called fire hub. And the hub is an online portal that allows you to create your own hospify community. And this is much more there for targerted at clinical teams, or big patient groups or anyone who You know, surgeries, even insurers or pharmaceutical companies, you need to maybe have a big community, people need to communicate, whether it's for running a hospital, or doing patient outreach or doing or running a research trial, for example. So set up a hub you can do for free. For small ones, you can try it out. But then what it allows you to do is you send an invite to people who've got the app, they put a code in and they join your hub. And it's a bit like, I don't even use slack. But it makes it's a bit like running a big slack team. You can then form authorise groups. You can do broadcast messaging, you can give people a web app, which we're launching next month, which allows them to kind of, you know, people who are in your hub you can give them the ability to access images through a browser, and we and then we store them for longer. So then it becomes more of a fully fledged platform, the kind of thing you might be familiar with Microsoft Teams or Slack, something like that.
Anna - Perfect. And obviously, you've briefly mentioned the whole GDPR and the data, but what other sort of challenges have you guys faced along the way of building hospify
James - getting into health is difficult because there's never one box you have to tick there are boxes that you have to tick and tick and tick and tick. And there are different boxes for different organisations. And there are just many, many hurdles, many of which are bureaucratic, but many of which are cultural as well. And many of which are really visible until you trip over them. And so, you know, again, as an outsider to help, I've had to learn my way around that bureaucracy and culture from scratch, which has been challenging, delicate parts is only part of it, you have GDPR compliant, but then you have NHS information governance, which is quite similar, but it's not exactly the same. The NHS has its own parallel and Information Governance protocols. And so those have to be navigated and they have to be added to to. Then on top of that you have clinical safety risk. You know, anything that sells into health has to be assessed for clinical safety. So that's another set of guidelines which has its own protocols, then on top that the nice guidelines if you handle particular types of data, you can end up being classified as a medical device, which fortunately hospify is not classifications are changing. And it may be that one day we are classified as medical device in there a lot the standards around that are very, very stringent. Indeed, as I said, fortunately, we haven't had to deal with them. But we do have to be classified in a way that shows we don't have to deal with them. So we still have to have the classification from nice. So there's all of that. Fortunately, when we did one of the things we did early on was when we right when we started the company and got our first funding, we decided to get ISO 27 001 compliance, which is sort of international standard for data handling data security and how to structure your business and track all the data flows in and out of the business is very rigorous. I spent a lot of my time handling that and doing that. And that's great because it's given us a framework, which has allowed us to tackle all of these other frameworks. I mean, it doesn't cover all of the aspects. It certainly doesn't cover clinical safety risk, if you have ISO 27 001, and you take it serious and you run your business according to a framework like that, it makes it much easier to do a lot of these other standards. For example, with NHS and the NHS information governance, which has something called a data security protection toolkit, you know, I have to fill in a long form every year, quite a lot of that form just says, You've got to fill this in, if you've got ISO 27 001, you can just tick the box, and another have to fill in any more details because they're like, effectively, by having this big international standard, we've already fulfilled that standard. They don't need to double check us. So it's very, very handy because it you know, you've actually people will take on trust stuff that otherwise you have to prove. Yeah, you can fast track some of that a bit. And you also even if you do have to prove it, you tend to have most of the material already because you've been preparing it and it's up to date. So data standards are really important and they're right at the core of us. Our USP is data compliance and is particularly important for us, because unlike a lot of other messaging apps, you know, there's a lot of messaging apps in the market. And most of them are just focused on clinicians. And you know, they're really designed for clinical use only a professional use only. But we, right at the beginning of hospify, we made the decision that it was crazy to try and have a messaging app that would attempt to replace WhatsApp if the patient couldn't use it. So we've felt really strongly that we needed to make something that the patient could use. And that's why we have to make it free because patient will never pay for it. And also, is why we really, really, really focused on compliance because if the clinicians are to trust an app that the patient also has to can use, then it has to be absolutely bombproof in terms of compliance, and that's very difficult to do. And, you know, I think the huge icing on the cake for us was when we got the VPN, the first messageing to get NHS apps to library approval after a year of audit. And that was incredible because we are the One of the few apps that a patient can use, and they showed that we had done the capacity sector was done for the industry.
Anna - Yeah. Big tick against your name
James - Yeah, really huge. I mean, it really made the last five, six years of effort worthwhile. It was a really big deal for us
Anna - really good, feel good moment. And, of course, you spoke about all the kind of like hurdles and challenges is getting into the healthcare sector. How was it finding funding in that sort of area? Is it more difficult to find finance when you're in that sort of area with all the rules and regulations?
James - Yeah, it's incredibly hard. And I think that again, you know, I hadn't really appreciated how difficult it was going to be. So there's a couple of things about that, you know, what, on the one hand, all that compliance is a blocker. Right? And that slows you down as a company. On the other hand, you know, the other big challenges right and we talk about is the cultural challenge of selling into the NHS just because although you can do these compliance things at the same time, every trust and every GP surgery is its own business. You know, The Department of Health doesn't buy this. Every trust in surgery has to buy it themselves. And they all have to make their own decisions because they're all empowered to do so. So you ain't you both go through this every time on a national level. And then every time you make a sale, you have to go through it again at a local level with the individual institution. And this really slows down procurement, right really slows down sales. And then on top of that, there's the whole procurement problem, you know, the whole procurement architecture and that's really really bureaucratic as well, that's, you know, another set of regulations and frameworks. And investors know this right any any investor he's got any kind of experience at all. And as had as any experience in health, knows this and knows that the sales I can help is excruciating, is slow and it's very difficult to scale. And so they tend to avoid health, you know, you want what you tend to get is two types of investors. You get the investors who know health and won't fund you because they know health and you get the investors who don't know And get excited and then we'll see start to dig in and do due diligence on you and find out more about it, they get scared off. The investor the we look for is a very small subset of investors, they're very difficult to find the ones who know health, and want to invest it anyway. right because they do understand the challenges, but they know that if you do get in, it's a really big market and it's a really loyal market. So if you can overcome these problems, although it might take you a long time, that the rewards for for overcoming them and staying the course can be huge. And they can be also not just financially rewarding, but they can be morally rewarding, you know, because, you know, it's a really good market to service you know, it makes you feel good, you are helping people. And if you can provide people with a technical solution that saves time, that time is directly translated into better care. And that's a really amazing thing to do. So we we have to find those investors and they are difficult to find. But when you find them, you know, you find some amazing people because they are a bit more focused on the long term and a bit more focused on the social good. And we've had we've got some wonderful angels now who put a lot of effort into the company, and, you know, really have a have a bit of a different view to many investors who just focus on the bottom line
Anna - course. And, as you say, helping people I guess now more than ever, that is very, very relevant. Of course, with the recent outbreak of the Coronavirus. So many health tech startups have stepped up and increase their workload. And I believe this is the case for you guys, too. And it's been pretty transformational for you. Could you tell us about some of the work that you have been doing in the area with the Coronavirus and how it's been being the only messaging app to be approved by the NHS apps library?
James - Yeah, of course. So I mentioned the earliest slightly didnt I and I think that the timing of all that has been very good for us. So but it I think what's been particularly exciting transformational about the last couple of months for us is that you know, you you spend five or six years kind of trying to climb this mountain trying to convince people that it's worth doing you come up with a lot of scepticism from the sales side you know and in the investment side You know, it's been really difficult Neval and I had to do a lot of the work ourselves and you know, hardly been paid a lot of the time and, and then you go on going you carry on doing it because you believe it's worth doing and then something like COVID-19 happens. And suddenly everyone realises or sees instantly why it was worth it. You know, because in normal day life, it doesn't really feel is that much of a big deal. But when you know when the chips are down, actually health is absolutely crucial and health communications become absolutely crucial and suddenly the global economy is collapsing, but the one economy that is having money poured into is health It's a real indication. And it really shows why it's worth pursuing these kind of, or social impact kind of things. Because when the time comes, they are absolutely vital. So you know that that obviously has been transformational and we'd be cookie crumbled particularly well for us. Because yes, we we've been pursuing this NHS asets library sauna for every year, the audit and taken a long time. It's very complex. And we got signed off in late February, which is amazing. We didn't really know it was coming. But they they sort of suddenly turned around and said, Oh, yeah, now you're through. That was great. So we announced that a digital health rewired conference that will appear in February is really, really nice. Digital health conference I have to be very fond of. And we've got some press and that was great. And we also closed our funding round around that time, doing all the paperwork over January, February. So we closed our seed round and it was nice for our investors because they saw that we'd delivered on one of the big things we promised them and that was really great. Because we were pleased. But then of course, literally a week later, we were in the beginning of March and the COVID-19 of lockdown came in. And suddenly we found ourselves in the position of a being funded for the first time in our history really, and B having this national approval. And there really was no other kind, there is no other kind of national approval, the NHS doesn't really do much national approval of technologies, unless they're buying it like NHS.net email or something. And so, suddenly, you know, we had the whole industry turn around and go, Oh, my goodness, you know, we need something to use and, and what's out there, and of course, we were the ones with this stamp. So it meant that we just had an incredible upsurge of interest. And fortunately, we've been already trying to ask people because we knew we, you know, we had this funding coming in and we were trying to expand, and then we just accelerated that. So we've sort of tripled the size of our team. Brought on a extra development resource harder head of operations and converted a bunch of medical students into into our customer service support team, which has been fantastic. I think we've been able to scale up. And luckily, again, you know, we had the technology. As you know, we've tripled our user base more than 20 times and although, you know, you always have scaling problems. Actually, the app is scaled really well. We did a lot of work on it last year to to make it scalable. And it turns out that it's performed quite well under the pressure. Now we can do more, we've been pretty pleased with the way that the platform has performed. But it's Yeah, it's been crazy. It's been one of those sort of startup experiences where we've all been working well between March The first and the Easter break. You know, we will put in 15, 16 hour days, seven day weeks we have managed, it has calmed down a bit. Now it's levelled off a bit as pandemic kind of initial rush. And the the curve that everyone talks about is being flattened a bit. So now I think that there's a bit more process around throughout the country in place and everyone knows a bit more, what they're doing. And we've been able to take a little bit of a step back. And that's great.
Anna - Yeah, of course. And, of course, it's so amazing to hear someone who's doing such a good thing having great success, like it just, it's a feel good thing. How have you if you could just describe your World Wind last six weeks? How would you describe the experience?
James - Gosh, yes. I mean, I've, I've done some pretty crazy jobs in my time. You know, I used to run an international newspaper at the Telegraph and I worked for Wired magazine back in the.com, boom days. So, you know, I've done I've done some some quite high octane jobs. I've never worked as hard as I have in the last six weeks. I mean, you know, it was so crazy. I mean, you know, we're all working from home, right? Luckily Hospify was a remote team anyway, we've never had an office. We've always built the app and the company remote link. I don't know for March basically, I often just couldn't leave my desk from nine in the morning till one in the morning. My wife was very long suffering. She was literally bringing me food and leaving it for me because I often just couldn't leave my desk for hours and hours and hours. It was so busy. We were crazy things happen. We were just like a few days into this. And we heard var from Twitter from a tweet by Sonia Patel, the new NHS x CIO, that we were being rolled out a London Northwest, which is one of the largest trusts in the country, and got 9, 10 thousand staff and five sites in North London, we were being rolled out in the northwest at scale. And we heard about that from a tweet that she did. you know, and then so you know, and suddenly, we were like, Oh, my gosh, you know, we had support this roller and then we were on the phone to them the next day, and then up there doing a rollout within, you know, a couple of days on site. And that was the last day before the lockdown. And then we had to do the rollout remotely, where literally we heard about it from Twitter. I mean, that's how much the world has changed to do a rollout like that, in the past would probably have taken nine to 18 months of careful negotiation with the trust. And as a result of COVID it happened because the CIO of the Trust just just told everybody on Twitter that was happening. And and expected us and everybody else to just do it, which we did. And it was incredible. I mean, just incredible. You know, if you told me even three weeks before that that sort of thing was going to start happening. I just wouldn't have believed you. You know, it was a bit like one of the, you know, startup movies where, you know, you're a small team, you're doing some stuff, you're hacking away and then suddenly your world changes. And you go from asking everybody and begging favours to everyone just turning up and going, right? We want it now. Where is it? I have no courses. It's quite disorientating and exciting, but also terrifying and really weird as well, because you know, we're all stuck at home. And so my daily routine hadn't really changed that much other than it became much much, much more intense. And so it's quite strange experience. And I don't think it would make a great movie because we're all stuck at home so there's not much to film. So unfortunately, I think we'll see the movie of hospify not very visual atlas you can maybe watch my hair grow longer as my beard grow whiter as I cant get a haircut and be get more and more stressed. As I said earlier, it's calmed down a bit Now fortunately, I mean obviously we're still very very busy as doing they're working really long hours but that initial craziness as past but we're we're now just clocking up really nice user numbers every day getting a lot of interest in the hub we've had nearly 200 signups to the hub now people trying to free trial we've got we've made our first sales got some really nice interest I can't really talk about at the moment because it's it's not confirmed but from some quite exciting uses use cases of the hub and the app going forward. And you know, we're we're trying to get video in the app now we get a lot of requests to get video into the people can do live consultations with patients and that kind of thing. And we're working really hard on that and some other clinical features so we don't what we're trying to do now I think is go from that. Oh gosh is so incredible spike and see if we can make that try and make that sustain You know, when something crazy like this happens, it's really exciting. But it's also the danger that it's just a blip, you will run around, you spend a lot of money, and then boom is over, and it will go back to business as usual. And what we're trying to do now is just make sure we build a sustainable business out of this, you know, and make sure that we service customers, give them what they need. And actually, we're not reliable, which is the key thing. People can trust us and that we that we can just build build a sensible business. You know, I think that that's the challenge. Now, it's a slightly different challenge to the one of a month ago when it was just about scaling up quickly. But now it's more like sustaining it and maybe not so much about the scale. Now. It's more about making sure that you can deliver to the people who really want it,
Anna - of course, and obviously, you've just touched a little bit on this and making it sustainable and last longer. But do you guys have any other plans long term down the pipeline?
James - Oh, gosh, yes. Well, I think that's one of the strange things about this is that of course we did have plans and our strategy and and we've had one The jobs I've had to do over the last month is just, you know, basically throw that plan out the window and completely rebuild our business strategy, because now we sort of hit on all of next year's targets. And that's changing. You know, the way we're thinking about funding the way we're thinking about growth, the way we think about new features, you know, we've had to really reconfigure everything. And that's a lot of work at the best of times, you know, we're just trying to accelerate our business now. We've been a bit more ambitious about money, maybe the next funding round, you know, our growth targets more ambitious. We are Yeah, we're introducing features like video that we hadn't really planned to do for another six or nine months, we have a customer Help Desk. We never intended to have a customer Help Desk, but it was just needed. And we built one and roll that out really quickly. And that's actually proven really valuable. You know, it's proving one of the things that people liked most about us is that we've got this great help desk with a lot of students who are really excited about what we're doing and really helpful to customers and people can just get on email us or get on the phone to us and talk to us which is difficult to do with WhatsApp, right. So that's proving a real asset to the business, which hadn't really realised it would be. So I think that all that's happening and of course, we're also thinking about something we've talked about for a long time is was what if we could take a hospify but it would work in non health spaces, data protection is really important. In healthcare, it's also an increasingly important in other sectors. I mean, we're using zoom right, which is seen as huge growth, but also seen a huge kick back on its privacy. And it's a real nightmare, because you probably have, in fact, you know, we're actually having to consider not using zoom now for hospify because even installing the app, increased vulnerabilities in computers, and I'm actually having to consider starting to say no to zoom calls, you know, when we come out of this crisis, the likelihood is that there will be a pushback on privacy. You know, we all take the lid off, you know, to the I mean, you know, even the Department of Health approved WhatsApp, but it's been difficult for us because obviously people are carrying using it because the department has that they can use it for during the crisis. But after the crisis, we are going to see a return to privacy and we'll see another sector And then maybe there are opportunities for us there to take what we've learned in health. And maybe do a version of the platform, maybe with a different brand that you know, you could use your legal firm to protect, you know, your, your client confidentiality, for example.
Anna - Amazing. Finally, do you have any startup advice for any other startups that are in the healthcare sector? That may be just starting up?
James - You know, I think the piece of advice I generally give in health and I think it actually translates to other startups, too, you know, doing any kind of tech startup now is incredibly competitive and difficult. I mean, it's such a crowded space, and I think really the danger is always trying to do too much. You know, I think that you really need to find one thing that you can do really, really well and find out why that thing is needed, and why you can do better you can do it better than other people and why and how you can build some kind of moat around it, and you really know who's gonna have competitors, but you know, is it really easy to do what you do Can you can you can you do it in a way that is unique. And when you found that thing, you just got to focus on it to the exclusion of all else. I mean, we have been very, very focused hospify on just getting a simple messaging app platform out there for free. And you know, we one monetization option. And now of course, on demand, we're beginning to think about extra features like video, but it's very demand lead, you got to be laser focused on the USP know what you're doing know why it's different. No, you know, why it has a market and just keep at it, you know, you got to convince other people that you can do it and there is a market and that's really difficult. And if you do too much, if you try and do platforms too complicated, it has too many features, or tries to do too many things. You're really shooting yourself in the foot. You just need to stay focused, and especially during scale up it's really important to focus on the core of the business and you know, other features aren't working so well you just got to shut them off and be brutal? you know find what people want and give it to them and focus on delivering that really well.
Anna - Amazing. Well James, thank you so much for talking with us today. It's been really great learning more about hospify and your crazy journey these last six weeks
James - well I'm it's really nice to be asked. Thanks so much and go look at startups. This is great magazine. I mean, they've been done See you guys before and hopefully when we're out a lockdown I come to see you again. Do another event or something. And keep on keepin on.
Anna - Well, James, thank you so much for being on today's episode. It's been an absolute pleasure having you on here. Make sure you stay tuned for the next episode on the Cereal entrepreneur
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