Enabling Telehealth for Small Clinics with CallingDr

Key Stats:

Summary

The CallingDr team has been selected as a “Deal to Watch” by KingsCrowd. This distinction is reserved for deals selected into the top 10%-20% of our due diligence funnel. If you have questions regarding our deal diligence and selection methodology, please reach out to hello@kingscrowd.com.

The CallingDr founders are part of traditionally underrepresented groups in startup investing. 

Problem

Telehealth has been touted for decades as the inevitable “next big thing” in the field of medicine. However, this much-hyped approach has in practice proved to be something of a bust.

As of 2019, the vast majority of Americans reported that they either weren’t aware of what telehealth options are available to them or weren’t able to access the technology needed for this mode of healthcare delivery.

Things aren’t much better on the provider side of the equation. As recently as two years ago, 1 in 4 hospitals in the US still didn’t offer telehealth programs at any meaningful scale. 

The reasons for the slow adoption of telehealth are myriad. However, there’s widespread agreement about some of the major factors. One is the lack of awareness among prospective telemedicine patients. Another issue is the lack of affordability, particularly given the limited reimbursement coverage of telehealth by major insurance payers like Medicare. The final major hurdle is the high outlays (in terms of financial cost, time, and clinician buy-in) needed to integrate telehealth offerings into existing care workflows.

However, the COVID-19 pandemic has given the issue renewed urgency. Quarantine has compelled healthcare providers to explore new ways to make their practices virtual. Patients need a lifeline at a time when in-person clinic visits simply aren’t advisable.

Solution

CallingDr is a telehealth enablement company that is providing multiple digital pathways for patients and providers to connect:

• The core CallingDr offering is a Platform-as-a-Service (PaaS) solution that provides clinics with a comprehensive set of features and capabilities for deploying telehealth services. These features include secure messaging, remote monitoring, self-pay & co-pay options, and ordering of prescriptions and labs. The platform makes it easy for clinics to integrate and offer telehealth to their patients.

• Complementing the core platform is the FindingDr service. It operates as an online appointment-booking service that patients can use to find suitable physicians and facilities. FindingDr lets patients book visits (both in-person and telemedicine appointments) via a few quick taps on their phone.

• Finally, the company also offers “CallingDr OnDemand.” This is a pool of available physicians (covering Primary Care as well as specialties such as Pediatrics and Behavioral Health), so that patients with acute needs can match with providers for immediate virtual care.

The Team

CallingDr, and its parent company MyApps Corporation, are led by CEO Adnan Malik, an experienced technologist with a multi-decade career spanning major IT companies such as Seagate, Veritas Software, and Symantec. Prior to founding MyApps, he most recently served as CTO at an electronic medical records company. While there he created the firm’s ambulatory EMR platform, taking it through full certification as well as integration with major lab test and pharmacy providers.

The current CTO of CallingDR, Kashif Akram, also has deep experience with EMR creation, having previously worked at two different EMR providers. 

CallingDr’s corporate and advisory boards also feature multiple experienced physicians and healthcare providers who bring a variety of specializations to bear, ranging from pulmonology and cardiology to physiotherapy and family medicine.

Growth Plan

Prior to the COVID-19 pandemic, CallingDr was generating revenues that, while respectable, were not exactly dazzling. The company’s Form C filing indicates that its full-year revenues for 2019 were approximately $204,000. 

Unsurprisingly, the outbreak of coronavirus in March 2020 appears to have been a massively positive external shock for the company. CallingDr reported that it saw a 600% uptick in patient visits on its platform between March and May.

The CallingDr founders hope to extend this growth streak. – Indeed, certain elements of their go-to-market plan bode well for sustaining this accelerated pace of growth. In particular, the company has successfully integrated with a range of EMR systems – including some of the industry’s major platforms such as Athenahealth and Allscripts. This is an important milestone that was no doubt made possible by the team’s significant prior experience with administering EMRs. The company’s set of EMR integrations bestows meaningful enterprise value on CallingDr as a business. Compatibility with multiple EMRs already in broad use across the healthcare industry should greatly facilitate the process of onboarding new hospitals, clinics and practices as CallingDr customers.

Why We Like it

The Massive Healthcare Industry Needs Telehealth To Regain Its Footing – The most fundamental reason for bullishness about CallingDr’s business is simply the staggeringly massive size of the US healthcare market, which measures in the several trillions of dollars.

Perhaps ironically, the onset of the coronavirus pandemic has actually decimated healthcare spending – leading to painful layoffs across the industry. Although health clinics have been extremely busy treating acute coronavirus cases, the pandemic has forced them to postpone or cancel their most profitable non-emergency services, such as elective surgeries and outpatient visits. 

CallingDr’s three-pronged offering of telehealth enablement, virtual appointment booking, and pooled providers for on-demand remote care should resonate strongly with industry decision-makers. Healthcare providers are anxious to reconnect with their estranged customer base of socially distancing patients. The CallingDr suite enables that reconnection, which reverses the downward slide in revenues and puts healthcare workers back to work.

Partnering With Clinics Rather Than Trying To Sell To Patients – Although the rates of telehealth adoption prior to the COVID-19 pandemic were underwhelming, there were still some winners pulling away from the rest of the pack as of 2019. These emerging leaders included Teladoc (a public company with $14B market cap) and Doctor on Demand (a private company with unicorn aspirations, having raised at a nine-figure valuation in 2018). 

The CallingDr team has differentiated themselves by focusing on clinic partnerships, rather than trying to get individual patients to pay for a telehealth service. In contrast to services like Teladoc and Doctor on Demand (which charge patients $50 and up for individual appointments), CallingDr doesn’t charge patients anything. Instead, it monetizes by charging clinics or individual physicians for their use of the platform as a means to connect with their existing patients. This differentiation makes it much more likely that any given patient will be willing to use – and keep using – the CallingDr app.

Subscription Revenues Are The Key To Investors’ Hearts – From the standpoint of assessing CallingDr as an investment, its choice of a subscription-based business model would be regarded by many prospective investors as one of the attractive aspects of this opportunity. Subscription plans create streams of recurring cash flow that make a company’s revenue much more stable and predictable than non-recurring business models. The company’s current subscription pricing of between $50 and $150 monthly per physician would likely represent a very reasonable cost proposition to hospitals and clinics.

CallingDr’s successes in landing some early subscription-paying clients in 2018 and 2019 were likely one of the main reasons the company has had decent success at raising equity crowdfunding (starting with a successful $718K raise on StartEngine in 2019 and followed by its current raise on the Republic platform). 

Rating

It’s a sad indictment of the bloated, costly, complex US healthcare system that it took a full-blown pandemic to catalyze any meaningful levels of telehealth adoption.

But investors, like founders, should “never let a crisis go to waste.” Telehealth’s time has come. As we’ve seen in other industries that have been disrupted over the past decade once users get used to digital formats of service fulfillment (e.g. hotels, taxis, and food delivery), they tend not to go back. 

That’s not to say that locking up a dominant market position will be easy. There will be plenty of entities ready to compete with startups like CallingDr, as they all maneuver to seize market share during the coming telehealth land grab. Established, well-capitalized existing telemedicine innovators such as Teladoc and Doctor on Demand will throw their ample cash reserves at paid ads and other customer acquisition strategies. Meanwhile, enormous healthcare incumbents such as UnitedHealth ($280B market cap) will increasingly recognize the value of building out their own internal telehealth solutions – with varying degrees of involvement from outside vendors. 

However, smaller clinics have a real need for vendors who can provide an affordable yet robust solution that enables a practice’s physicians to stay connected with their patients during the social-distancing phase of the pandemic. Although there may soon be a glut of new market entrants trying to compete in this space, CallingDr may now have enough momentum (with its EMR integrations already in place and its roster of customer clinics steadily growing) to preserve or even extend its head start. Combined with its experienced team and attractive business model, that makes CallingDr a Deal to Watch.