Along with Brandon Welch, Dylan Turner is the co-founder of Doxy.me, a telemedicine solution designed for healthcare providers and mental health practices of all sizes. The solution is HIPAA compliant and offers a secure platform, video conferencing, and virtual waiting room features. Most significantly, it is free.
Doxy.me has seen a surge in usage during the pandemic, experiencing exponential growth literally overnight. Turner and his team have been proactive in making their platform accessible for limited-English speakers, the Deaf, and Hard of Hearing.
Turner sees infinite potential for telehealth, particularly now that providers and patients from around the globe can be linked through language access. We spoke with him recently about all that he sees on the horizon.
Scott Brown: The perception from the outside is that telehealth has gone from a crawl to a sprint during COVID and social distancing. Is that the actuality for you?
Dylan Turner: We were doubling our usage every year after launching in 2013. Before COVID-19 we were doing 12,000 doctor-patient sessions every day. Stanford Hospital does 7,000, so we took some satisfaction from that. We felt like we were really making a difference. At the peak of COVID, we were just shy of one million doctor-patient visits in a single day.
SB: That’s incredible. What was it like to experience that exponential growth from the inside?
We’re globally based. As the pandemic hit, we saw it coming our way through our usage before it actually landed in America. We usually had about 100 providers sign up a day. In March 2020, we had 300 sign up on a Sunday, then 500 on Monday, then 1,200 on Tuesday, then 5,000, then 20,000, then 32,000 in a day. This kept going for a 14-day period. Your brain just can’t grasp it. We kept saying, “Double the server capacity!” We kept thinking it would stop, but it didn’t.
SB: You went from 12,000 to a million. Where do you see that settling once people have the opportunity to see their doctor in person again? To what degree is remote medicine here to stay?
DT: Most doctors have resumed seeing patients to some degree and we’ve settled around 550,000 a day. I think it’s here to stay at that level.
SB: You have a background in healthcare start-ups. What is it that interested you about the telehealth space?
DT: I’ve always seen myself as a bit of an underdog. I thought it was interesting when we were first starting this how people would point out what telehealth couldn’t do. They never seemed to think about what it can do.
Right now we’re at this point where they think of it as audio-video or text chatting. But that’s just the surface of what we’re able to do in a remote setting. If you’re hard of hearing, I can put closed captioning on the screen. With interpretive services like LanguageLine’s, we can bring in a caregiver from anywhere in the world to help a patient with the click of a button.
SB: Do you see parallels between the virtualization that’s happened in other industries and what’s happening in medicine today?
DT: Today it’s painful to go to a physical store. I have to go to my car, get out, and deal with people. I get the price – but is that a good price? What are the ratings? What do people say? Does it end up breaking?
I can go on Amazon, price shop, and compare. With same-day shipping, I can get it that day. That experience for the customer is so much better. We want to do the same thing with the provider-patient experience in the world of medicine. I envision this world where one day Doxy.me will be successful if a provider is thinking to herself, “Shoot, that next appointment is physical. There’s no way we can do it digitally.” That’s the day I’ll know we’ve done our job.
SB: If you were to extrapolate 20 years from now, what will telehealth look like?
DT: You think of these devices that we carry in our pockets – our phones – or the wearables used to track our steps. What if you could put your finger on your phone and a doctor could get your blood-oxygen content?
We can be really creative. The future will be an interesting combination of the technology people already have in their houses being used to connect with their providers in a seamless way. Technology will not replace providers, but it will make connecting with them easier. It will dramatically improve access to the best health care.
SB: Was it this sort of blue sky that drew you to telehealth?
DT: Brandon (co-founder and CEO Brandon Welch) came up with this idea because he was trying to find a simple telehealth solution in 2013 and there wasn’t anything. Polycom and Cisco were the big players. If you wanted to do telehealth, they’d ship hardware to your patients. They’d install it, download software with a CD, and register for an account - and by the way it’s $1,000 a month. To us this was insane because Skype and Facetime were already free.
I thought Brandon was crazy because he said he wanted to take on Polycom and Cisco and make a free product. But once you got it into hands of doctors and patients, they thought it was amazing. So I was mostly compelled by the customer.
SB: It sounds like your customers sort of pulled this product out of you.
DT: Twitter succeeded despite themselves. They say they made a million mistakes, but it succeeded because people were pulling this product out of them. We had that same experience. In a lot of ways I didn’t have a choice because people would call us up. I was mostly compelled by our customers’ desire to make it successful.
SB: You have an interesting pricing structure in that the product is free, at least at the base level. As I understand it, it was always free by design. Do I have that right?
DT: Brandon was frustrated that as soon as you slap HIPAA compliance on something, you had to charge $1,000 a month for it. It just so happened that Google had acquired a company that developed this underling peer-to-peer, end-to-end encrypted technology. They open-sourced it and baked it into the browser. This was 2011 and we launched in 2013.
We really were built on the shoulders of giants in that sense. Some other really smart people came up with the technology and gave it to the world. It enabled us to offer our product with little overhead.
SB: So how do you monetize Doxy.me? Is it through premium features? And did you have to convince your customers that you weren’t going to see their data?
DT: Yes and yes. In 2013 there was a lot of stuff going around with privacy. “Free” and “health care” never went together, especially in the United States. When we came out with a free healthcare product, we had so much blowback. I was on customer calls and had to answer those questions: What are you doing with our data? Who are you selling it to? It took us a long time to get people to understand we can offer this at the price point because of the technology we chose to use and the way we operate our business.
It was a deliberate choice that we wanted to be HIPAA compliant, free, and easy to use. You’re a business and we have to charge somehow, so we charge for premium features. Not everyone needs those features, though.
SB: A lot of what LanguageLine is trying to do is help democratize access to healthcare. Much of the promise of telehealth is that it will take what are traditional centers of health and make them more distributed. It can provide people in rural or lower income areas access to centers of health that they might never have had otherwise. Unfortunately, telehealth is also designed in English and therefore has the potential to have the unintended consequence of excluding some of those who by its design it was supposed to help. Is part of the goal of making your core product free to democratize access to telehealth?
DT: That’s exactly right. Absolutely. Our tagline is “Telemedicine for All.” Something Brandon is fond of saying is “We never want cost or complexity to be a barrier to getting the healthcare you need.” Right now our product can be used on over 8 billion devices with the click of a button. There’s no extra hardware or software. You click that link and can connect with a doctor. It works on a $50 Amazon Kindle with a Google browser. It’s very easy to use.
And we didn’t get it exactly right from the start in terms of access. For example, let’s say that someone is using sign language. Right now, video platforms automatically focus on the person who is making the noise. But if they’re using American Sign Language, there’s no noise so the camera doesn’t go to them. We’re working on that. We have an opportunity to make telemedicine right for people of every language, culture, or ability.
SB: Can you tell us about the process that was involved in bringing live, on-demand interpretation onto the platform?
DT: It goes back to what I mentioned about customers pulling things out of you. It was our customers asking for it. Then we found a great partner in LanguageLine to help make it happen. You made it easy for it to work and we have plans to make it even easier.
The integration was based off customer pain points in current workflows. Humans are always beautifully unsatisfied. Our customers said, “Please help us make this easier,” and (LanguageLine) did the heavy lifting. You helped us prove there was a lot of demand.
SB: Have you received any feedback on how the integration with LanguageLine is going?
DT: All the feedback has been really positive. Our customers like the ease of use. You guys built this page to allow this to happen really easily.
SB: If you look at North America in isolation, you see that one in five households already speaks a language other than English. Soon America will have more Spanish speakers than any other country, and 90 percent of our population growth is expected to come through immigration over the next four decades. We are becoming more diverse very quickly. Do you see it as an imperative for telehealth companies to speak more than one language?
DT: Without a doubt. We’re already planning on how we can do this. Our product is used actively in around 140 countries. But having our product accessible in multiple languages is just one aspect. What about the ability to receive care in the patient’s preferred language? That’s the most vital thing.
The customer experience touches all aspects. When they call your customer support line, are they able to talk to a human in their languages? When someone wants to ask about pricing, does our sales team speak the language? We’re making a concerted effort to have a plan because the future will only be more multilingual.
LanguageLine Can Help
LanguageLine created the language-access industry nearly four decades ago.
LanguageLine is able to get you connected to our team of 12,000 professional, on-demand interpreters via audio or video in 30 seconds or less. We do this in more than 240 languages. LanguageLine can also translate and localize your written content. We provide these services 24 hours a day, seven days a week, 365 days a year.
It all starts with a conversation. Please contact us via our website or by calling 800-752-6096. We would like to learn more about the opportunities that reside within your organization.
Learn more about LanguageLine for Telehealth.