Telemedicine in the Time of COVID-19: Savia Doubles Down on Relationships

By Tien Tzuo May 8, 2020

The current crisis is a massive forcing function, making us re-evaluate most (if not all) of the products and services in our lives. Last week we talked about how connected printers suddenly have a whole new meaning for families stuck at home. This week we’re going to discuss digital healthcare services. Telemedicine has grown relatively slowly here in the United States. Only about eight percent of the U.S. population took advantage of telemedicine services in 2019. But obviously that number is going to spike dramatically this year! 

The same situation is happening in Spain, where one company is leading a mass trend towards telemedicine. Dubbed in the Spanish press as the “Spotify of Salud” or the “Spotify of health,” Savia is a subscription-based digital platform dedicated to health and wellness. With an initial investment from MAPFRE, a $26 billion health insurance company, the year-old startup is being led by the company’s Digital Health Director and ex-Googler Pedro Diaz Yuste. I recently talked with Pedro to discuss Savia’s response to the COVID-19 crisis. 

 

Pedro, it’s great to talk with you in Madrid. But first, can you help me clear something up? I know that Spain has a widely regarded national healthcare system. Why did you see the need for a new healthcare service?   

It’s true that we have an excellent national healthcare system here in Spain, but it’s facing several challenges. First, we have an aging population, which is causing a lot of stress on the system. Spain is also divided into 17 autonomous geographical regions, and the quality of services tends to vary between them. And finally, like all national healthcare systems, we are dealing with budget constraints. As a result, many people choose to have private plans in order to access wider and quicker treatments. Around twenty percent of the population has some form of private healthcare coverage.

That being said, I can tell you that telemedicine is new to everyone, both the public and private systems. We’ve grown very quickly in just over a year to 120,000 users, but that’s still obviously just a fraction of the population. The potential for growth is enormous. Telemedicine has clear benefits in terms of the challenges that I just talked about: older patients can have doctor appointments at home, the services are the same for everyone, and there’s a lot of investment happening right now. Its time has clearly come.

 

Can you describe how Savia works?

Of course. We were inspired by popular digital services like Netflix, Spotify, WhatsApp, and Instagram when we built Savia. We wanted to create something mobile, on-demand, customizable, with freemium and paid options. We have all these great services in our entertainment, our work life, our social life. Why shouldn’t we have them in the most important aspect of our lives, our health?

The way it works is that you access our service through our app or website, and then you choose from dozens of areas of specialty: pediatrics, cardiology, psychology, gynecology, personal trainers, dieticians, etc. We have freemium and paid options with more features, and you can immediately get in touch with a health professional through chat, video, or phone if you need a consultation. You can be chatting with a doctor within minutes of signing up.

 

That’s amazing. So you launched the service last year, got a great reception, and quickly built up a substantial base of users. But then…wham, the crisis happened. I’m assuming you’ve had a very busy six weeks.

You assume correctly. We saw a huge surge in demand. There was an obvious need. Talk about a perfect storm for telemedicine: a health crisis coupled with a stay at home order! We had almost 100,000 teleconsultations from the beginning of the crisis, five times more than the previous period.

 

But then you did something really extraordinary. You made your service completely free to everyone. 

Yes. On the morning of Monday, March 16th, we had a meeting and decided to make all our services free for as long as the crisis lasts, and a few hours later we deployed the change to our application. It was a relatively simple thing to do from an IT standpoint — we use AWS, Salesforce, and Zuora, among other solutions. But more importantly, we felt it was the right thing to do for the country.

 

How did you accommodate all that new demand?

We’ve been helped by the fact that several hundred health professionals have donated their time since the crisis started. Many of them can’t work in the hospital because they’re recovering from infections themselves. We’re currently hosting around 3,000 consultations a day.

 

Wow. I’m assuming that most of these new consultations are COVID-related?

Not at all. It’s only about 20%. That fact that so many people are housebound means that they’re approaching us with a whole range of general health issues that they otherwise would have gone to the doctor for. We’re also seeing quite a large demand for psychological services, which is understandable. There’s a lot of stress and anxiety out there. It is also remarkable the fact that Spanish companies want to take care of their employees. More than 250 of them have decided to offer Savia services to their employees and families, now during the crisis and we hope also later, when it finishes, through the B2B service of Savia.

 

Going back to the decision to open up your service. What gave you the confidence to make such a dramatic move?  

Yes, we could have never adapted and scaled so quickly without the direct relationships we have with our subscribers. We knew things would get busy, but the fact that we could see how people were using our service on a minute-by-minute basis gave us the information we needed to take such bold steps. It would have been completely impossible in a traditional healthcare environment. It is also important to address that this decision is part of the generous €200 million MAPFRE plan to help during the coronavirus crisis.

 

Where do you see telemedicine headed? I’m particularly curious to hear your thoughts on usage-based services. Here in the U.S., people have been wondering why they need to keep paying such high monthly rates for their car insurance, for example, when they’re not driving as much. You’re also starting to see health insurance companies give discounts to runners and people who exercise frequently. Are you seeing the same thing in Europe?

You’re definitely starting to see it. Usage-based consumption is another new consumer expectation. Flat rates just don’t make sense anymore. I don’t get charged a flat rate for my electricity consumption. Why should I pay a flat rate for my health needs? When you think about it, the human body is constantly transmitting data, so this is an IoT story as well. Connected devices like wearables are going to play an increasingly important role in our health lives.

And in terms of telemedicine in general, it’s here now. It’s arrived. It’s not just for digital early adopters anymore. Once you try it, you’re never going back. It just saves so much time and effort: no more booking appointments weeks in advance that disrupt your workday. And it’s proving very popular with the medical profession because of all the flexibility it provides.

 

Thanks so much for your time, Pedro. Salud! 

Salud! Gracias, Tien.

 

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