Sid Viswanathan, Truepill, on building infrastructure for consumer-driven healthcare

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Sid Viswanathan, Co-Founder and President of Truepill

In this episode of the Pulse Podcast, we interview Sid Viswanathan, Co-Founder and President of Truepill. Starting with its pharmacy-driven APIs and since moving into telehealth and at-home lab diagnostics, Truepill has been building healthcare infrastructure for the modern (and future) world. This infrastructure is already working behind the scenes to power several consumer-focused healthcare companies, such as Hims & Hers, Nurx, and Levels. The company has attracted investments from Y Combinator, Oak HC/FT, Optum Ventures, and others.

Start to 9:00: Sid’s Story

• Early experiences: Sid’s first job out of college was within a rotational program at Johnson & Johnson, where he got to see how different parts of the business actually worked. One of his rotations brought him to the Bay Area, and once there, he fell in love with the energy and pace of innovation in tech. He decided to pivot into software and started a mobile business card transcription service (called Cardmunch) that captures business cards and creates contacts in the user’s phone, which he eventually sold to LinkedIn.
• Returning to healthcare: After a few years at LinkedIn, Sid was eager to go back to the drawing board for a new project. He eventually met his co-founder Umar, a pharmacist with whom Sid quickly built chemistry. After really digging under the surface of the pharmacy world, they realized how antiquated the tech stack was and how this led to a poor consumer experience. The two now found themselves on a mission to change that.
• Getting the right co-founder: Sid shared his thoughts on what made the pair such a great team. Beyond their natural chemistry, Sid and Umar balanced each other out in multiple ways. First was their skillset — in their case, a perfect combination of software and healthcare experiences to make Truepill succeed. Second is the idea of “founder-market fit”. Sid and Umar were working on areas that each found exciting, which ensured that they could easily spend a lot of time addressing the problem without getting bored.

Truepill co-founders Umar Afridi (left) and Sid Viswanathan (right)

“You’ll hear tons of stuff talked about product-market fit, but not a whole lot about founder-market fit… You have me, a software person, and Umar, a pharmacist. So, you have to do something in the pharmacy space otherwise Umar would get bored, and you have to do something in tech and product or I’d get bored. From that standpoint, the initial thesis of the company was very much aligned with our backgrounds.”

9:00 to 20:00: Diving into Truepill

• Elevator pitch: Truepill is a digital health platform that combines telehealth, diagnostics, and pharmacy infrastructure to power the seamless delivery of consumer health.
• The “aha moment”: Around 2016, when Truepill was being founded, there was a material shift towards telehealth such that asynchronous digital interactions with a provider could lead to care decisions like writing a prescription. Truepill’s “aha moment” was realizing the importance of pharmacy fulfillment in improving the customer experience. Rather than having patients go to CVS or calling independent mom-and-pop pharmacies in different states, digital providers could simply plug into Truepill’s pharmacy API to seamlessly fulfill that prescription. This was not only better for the customer but also enabled new digital health companies to scale more rapidly.
• Expanding the platform: Following its $75 million Series C, Truepill’s latest offering is at-home diagnostics through an expansive network of lab partners. Ordering a diagnostic test is the third most common outcome following a telehealth visit (recommending rest at home and writing a prescription are the top-2). Thus, especially in the world of the pandemic, being able to offer at-home solutions in the diagnostic space was important to Truepill’s overall mission.
• Lab testing has also been a major barrier to management of chronic conditions affecting millions of Americans, such as diabetes, high cholesterol, or hypertension. What stops prescribers from prescribing simple yet effective treatments like a statin is often a missing lab test. Thus, by offering API-based solutions to enable at-home testing, Truepill makes it more likely that patients receive the tests they need to get the medications they need.

“When you think about unlocking digital health for some of these conditions that affect hundreds of millions of Americans, lab testing is a very critical component to that. And when you combine that with telehealth as well as the pharmacy, we think you have the full platform to serve 80+ percent of healthcare over a virtual setting.”

• This all works the same way as the prescription fulfillment product’s APIs, with the primary difference being that Truepill does not own the labs but rather works with a large network of partners from across the country.

20:00 to 35:00: Consumerization in healthcare

• Consumerization leads to new platforms: A key theme throughout the interview has been how consumerization necessitates solutions that simplify complex workflows and that are easy to adopt — i.e., platforms. Sid offers two examples of recent consumerization shifts that support this trend:

1. E-commerce: The shift towards online shopping required retailers to have a digital presence in order to compete. Shopify offered a simple platform to make it easier to build online stores.
2. Tech: The demand for simpler financial tools for investing, sending money, checking balances, etc. fueled the rapid growth of new fintech companies. These companies needed a simple way to plug into existing infrastructure, and Plaid built a platform to meet that need.

• Consumerization in healthcare is no different: Sid believes we are in the midst of a similar shift in healthcare. Like analogs in other industries, this requires platforms that enable this evolution. Truepill aspires to be one of these platforms.

“If we’re in this consumer shift right now in healthcare, who is building that platform equivalent company? Who’s building to that vision? That’s what really excites us — looking at some of these role model companies that we aspire to grow to and become someday.”

• Looking ahead, one place where Sid is closely watching consumerization play out is within the health plan audience. Payers today largely have not been consumerizing their experiences, which resulted in threats from new players that are unbundling healthcare to improve the consumer experience.
• Of course, health plans understand this, and they are looking to bring at least some of these experiences back in-house where they are in control of empowering consumers. Platforms like Truepill help them piece together the infrastructure to deliver new experiences.
• For example, Truepill launched a flagship program with United Healthcare Group for Flu-COVID testing for senior citizens - 4 key points below:

1. Those exhibiting symptoms this flu season might be unsure if they have COVID and of what their next steps should be.
2. To get ahead of this, Truepill packages and delivers a kit that includes a Bluetooth thermometer, a COVID test, and generic flu medication (Tamiflu).
3. The thermometer is continuously collecting data that is coupled with access to dedicated providers who can guide the patient’s care experience and next steps upon new symptoms — i.e., whether to take the medication, take the COVID test, or see urgent care.
4. This program therefore enables an end-to-end telehealth solution that touches every part of Truepill’s infrastructure to help manage a highly at-risk population

• The role of APIs: APIs have already been enabling consumerization in healthcare (e.g., Ribbon, Particle), but the reason Truepill is able to execute partnerships like the one with UHG is that it couples this API layer with services. Sid believes this is critical to future directions of the company.

“Something that we’ve always embraced as a company is just making sure we combine the technology side of the APIs and the data with the physical of a lab test or a doctor visit. I think that might be a little different than a Ribbon or a Particle, which have built phenomenal businesses on just the API and data layer alone.”

35:00 to 43:00: Thoughts on Big Tech in healthcare

• Thoughts on Amazon: Sid believes that Amazon Pharmacy’s success would signal that consumers are finally realizing the experiences they have been demanding, which he is very excited about. However, he also believes Amazon would only meet one part of the healthcare experience people need, and other players are still likely to succeed in other key areas.
• Thoughts on Google: Sid is particularly interested in the role that players like Google will have. Today, Google is a key digital front-door to healthcare decisions since it’s the first place many people with a medical concern turn to. In some cases Google can be quite proactive in people’s health — for example, Googling “COVID symptoms” immediately brings up a unique “Take a self-assessment” button. Sid considers that button a sign of what the future of telehealth could look like.
• Sid’s vision is that companies like Truepill could partner with tech giants in the future to help manage the complexity of healthcare while delivering a high-quality, end-to-end user experience.

43:00 to end: Advice to aspiring entrepreneurs and healthcare leaders

• Sid considers this to be the best time to be in healthcare, and the current pandemic-related volatility is a tailwind for change in the industry, making it a great time to start a company. He again highlights the importance of focusing on the needs of the consumer, who are now more empowered than ever before.
• The software-side of what leads to a good consumer experience in healthcare is, in many ways, similar to that of other industries. Anyone with a strong background in tech or product design who has an interest in healthcare is encouraged to finally make that leap.

“If you think you can solve a consumer problem, now is the time where consumers are more empowered than ever…. If you’re a good product person or engineer that had a desire to go into healthcare, now is the time to come in.”

Regarding roles at Truepill, they’re hiring! They have over 50 open roles, and Sid encourages anyone interested in digital health to consider working at Truepill.