Recall zShop, a response to eBay, was deemed a failure when launched in 1999. While the auction platform didn’t gain much appeal then, Amazon didn’t give up, and it subsequently transformed into a growing marketplace with thriving business today.

Also Read: Is blockchain the future of medicine in creating more secure healthcare?

With Haven being parked aside, the (re)emergence of Amazon Care signals their readiness to capture a sizeable market opportunity on their own, regardless of whether there is another partner. It is a testament to Amazon’s hunger not to waste a failure and to conquer “dreamy” businesses, which is defined by the following characteristics:

• Customers love it
• It can grow to a very large size
• It has strong returns on capital
• It is durable in time (longevity)

Home-based care gaining momentum

This led me to consider Vertex Ventures Southeast Asia & India’s (“Vertex”) portfolio, Speedoc. Speedoc is a virtual clinic and healthcare solutions platform that allows users to seek medical care and services from home.

Since its inception in Singapore in 2017, Speedoc has had a presence in five cities in Singapore and Malaysia. It had completed more than 110,000 visits and served more than 75,000 patients. There are 200 healthcare providers (and counting) who are serving the needs of the patients on the Speedoc platform.

We led the Series A round in Speedoc in Jan 2021 when people consumed teleconsultation in droves, given the COVID-19 backdrop. We thought teleconsultation had proven its traction, but the thesis of going a step further, sending care to the patients in person, which Speedoc aims to do, could be complementary and differentiating.

This thesis was met with some scepticism, but it is now beginning to show early shoots in Southeast Asia, given that a similar positive trend is happening in the US:

• June 2020, Heal raised US$100 million from Humana for the At-Home Care model.
• Mar 2021, Dispatch Health raised US$200 million, led by Tiger and Humana, to scale up its in-home medical care;
• June 2021, Medically Home raised more than US$100 million, led by Kaiser Permanente and an additional US$110 million before the year ended, led by Baxter International Inc. “Medically Home’s model is to unlock patients’ homes as safe alternative sites to receive high and lower acuity care across the care continuum in the comfort and convenience of their homes”.
• This month (Feb 2022), we read Amazon’s entry into the home health market.

What are Speedoc’s plans for the home-based care space?

Speedoc’s tagline is “Healthcare comes to you”. This relates to bringing care into patients’ homes, be it urgent care, acute care, preventative (such as vaccination or health screening), diagnostics tests (PCR at home), H-Ward or teleconsultation.

What is H-Ward? This refers to hospital care at home or HomeWard. An example will be when patients head to the emergency department at a hospital. Instead of being admitted to the hospital ward, they are admitted back into the comfort of their own homes (H-Ward).

Speedoc will provide the care and review patients both remotely and in-person (with qualified personnel) and partnership with the hospital.

• Will it grow to a very large size, and will patients love it? 

Southeast Asia accounts for ten per cent of the world’s population and 20 per cent of the world’s diseases. Public health expenditure in the ASEAN six nations is US$420 billion and is expected to increase to US$740 billion by 2025.

According to the World Health Organization, annual healthcare expenditure hovers around US$544 or around four per cent of GDP in ASEAN, which seems modest compared with the US, where it was 9.7 per cent in 2020 (or more than US$12,000 per capita).

Different research houses indicated that healthcare expenditure would continue to grow at a compounded annual growth rate in the mid-single digits percentages. However, the sky cannot be the limit, and governments cannot continue dedicating land, designing, building hospitals and care facilities and staffing them with healthcare professionals.

The paradigm shift would be to capitalise on citizens’ largest assets: their homes. Speedoc will bring certain types of care back into the homes through this home-based care model, supported by medical teams who can track the patient in person or remotely using various monitoring devices.

I believe there is still a need for hospitals in the future. However, the hospital wards may start to shift to be embedded within the communities in the form of H-Ward.

Secondly, instead of merely shifting patients from hospital wards to homes, the larger goal for healthcare should be caring for health (preventative) rather than ‘fixing’ health, i.e. to help people become healthier or maintain their health status than to treat them when they are ill.

By 2025, it is noted that two-thirds of the Asia Pacific population over 65 years of age will have at least one chronic disease, which, if left untreated, can account for high rates of repeated hospitalisations even though some of which could be prevented. While the end goal is to have healthy citizens, we can’t overlook managing those with chronic illnesses to retard worsening conditions.

A recent study found that COVID, along with a worsened economic status and inability to access care among the participants who had chronic illnesses, led to a worsened chronic situation for them. The Speedoc app will enable patients to access care via its teleconsultation platform, which can be escalated to a home visit, thereby granting access to care.

To cater to chronic patients who, despite being 65 years and older, have become more tech-savvy, thanks to COVID-19, Speedoc’s app will move beyond teleconsultation to engaging with patients. This will include gamification such as sharing responses, sending reminders and notifications and tailoring care to suit patients.

• Will it have strong returns on capital, and will it last? Democratisation and behavioural changes.

Airbnb changed the face of short-term rentals, where it magnified the supply of rooms beyond what brands could provide. In terms of market capitalisation, at the time of writing, Airbnb was valued at US$110 billion, which is slightly larger than the combined market cap of Marriott (US$57 billion), Hilton (US$43 billion) and Intercontinental (US$9 billion).

Also Read: What telemedicine and Health Tech holds across SEA amidst COVID-19.

Similarly, Speedoc, together with the likes of Medically Home and DispatchHealth, will magnify hospital care beyond the four walls of the hospitals by expanding the supply of virtual hospital beds.

It is worth noting that even though it is still early days, several healthcare players have begun to expand their coverage to include home care programs, such as Kaiser Permanente, the efforts by hospitals in Singapore (through partnering with Speedoc), and Allianz Life Insurance’s partnership with Speedoc to provide AllianzCare@Home.

Some people have expressed reservations concerning the cost associated with home-based care and its scalability. While on first impression, the cost appears high; compare these two scenarios:

• A pretty ill patient and the anxiety and stress brought forth to the family or caregiver of not knowing what to do while waiting for the ambulance to take the patient to the hospital and only to wait for (sometimes) a prolonged period, vs.
• Have a doctor/nurse respond to the sickly patient in their home within a reasonable time frame.

The latter seems to be a more preferred and less stressful option. Granted, it is hard to place a price tag when a doctor shows up and soothes the anxiety of the caregiver in the comfort of the patient’s home, but it is obvious that that option creates value.

We believe this is early days, but insurance players (in Southeast Asia) are likely to be evaluating and assessing this home-based care model and, in time to come, will broaden their coverage schedule also to include home-based care.

• Is it durable in time (longevity)?

Yes, helpful trends show that this ‘recover at home’ trend is here to stay.

• The proliferation of increasingly reliable and sophisticated wearables like the Apple Watch that can track a variety of vital stats and transmit needed information to the healthcare professionals
• Beyond vital stats, wearables can also monitor and analyse patients’ movements, allowing them to perform therapeutic exercises and recover at home.
• Miniaturization of large hospital equipment such as oximeter, blood pressure monitor etc

While we may still choose to head to the nearest general practice clinic for acute issues, with time and good user experience, we could morph our preference over to Speedoc since the platform provides a range of care services at our convenience and time.

Perhaps with time, instead of us waiting to consult the doctor or specialist, it could turn around where they will wait to treat us.

This article first appeared on the author’s medium.

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