Building a telehealth startup to change the face of health tech during and after COVID-19

Victor Purolnik
14 Sep 2020 | 12 min read

With COVID-19 acting as a catalyst for the digitalization of medical care, telemedicine is here to stay and prosper after the pandemic is over. How can tech health entrepreneurs use the moment to develop a telehealth product, a web or mobile application, that doctors and patients will love using?

Before delving into the details, let’s examine why telehealth will last longer than COVID-19 and what the available success stories are of applications that have thousands of booked consultations with doctors every day.

Why is it worth building a telehealth product now?

In the United States the regulations on online medical care have been loosened after passing $8.3 billion of an emergency funding following the COVID-19 outbreak. 36 states and the district of Columbia have already introduced “parity” laws, forcing health insurers to cover telehealth services in the same way they do with the insured physical visit to a hospital.

In Europe, in Germany in particular, it’s only been since August 2019 that the online dispensing of medication by doctors to patients has been legalized. Germany, once sceptical to telehealth, became more open to it providing patients with electronic health records. Denmark is another of Europe’s examples with the country’s government actively engaging in supporting telemedicine amongst doctors and patients to help take pressure of its medical care system.

Babylon Health, Kry and Min Doktor have raised €577m, €87m and €69m respectively over the last few years. European-based telemedicine startups have continued their international expansion.

With restrictions loosened, external funding available, and patients getting used to digital healthcare, this is the perfect time for entrepreneurs and investors to jump on the bandwagon.

Achieving a goal of bringing a doctor even to the least accessible rural areas and decreasing costs has never been so close with COVID-19 being a push factor making healthcare digitization on the rise.

Not all doctor appointments require a patient’s visit to the hospital, claims Bruno Cueva, a Co-Founder of mediQuo, a telehealth app having helped over 600,000 patients internationally.

In mediQuo we are focussing on asynchronous communication between health professionals and patients – a chat-based solution, while the majority of telehealth platforms are based on video communication and are not purely mobile as we are. With mediQuo doctors can take care of more patients and offer continuity of care staying in touch with patients after every consultation. We want to become the next Whatsapp in communication between patients and doctors. Before COVID-19 our company was growing steadily. Patients, doctors, and insurers perceived telemedicine as something important especially as medical costs increased. When COVID-19 came something that was important suddenly became urgent. We were growing at a high rate before COVID-19, but later not only sales increased, but also negotiations have improved. Suddenly, everyone wants to make use of telemedicine. The market for telemedicine will reach 277 billion USD by 2025. After COVID-19 both doctors and patients will understand the benefits much better and adoption will be higher. Bruno Cuevas Co-Founder, mediQuo
We are seeing a significant increase in interest for our tech platform. The feedback from landbased healthcare operator has been overwhelmingly positive as these operators are struggling to reach their patients during the lockdown. The future for telehealth is bright, even post-lockdown. Here, in South-East Asia, we see a lot of restrictions on the number of people that can enter a building at the same time. Some doctor’s offices are spacing out the appointments to avoid contact between patients. This will create significant schedule gaps that allow doctors to practice remote consultations. A number of virologists expect several waves of Covid19-breakouts over the coming months. The risk of further lockdowns is not averted. Regulation remains a challenge in the HealthTech space. However, regulators and operators are embracing telehealth as a means to continue serving patients whilst they stay at home. Countries like Singapore have a telemedicine sandbox. Japan has allowed doctors to carry out telehealth consultations for the first time. Theo Freybote Co-founder & CEO of MyDigital.Health

The key players of e-health solutions in the US are Doctor on Demand, Teledoc Health, MdLive, and Amwell.

The European map of startups developing telehealth apps is quite diverse – the UK is a home to Babylon, AdaHealth, MedicSpot, PushDoctor, Sweden to Kry and Mindoctor.


Babylon allows for booking text and video consultations with doctors. It has recently received $550 million funding and has accounted for over 2 million consultations with 1000 happening every day since the day the company was founded.

American Well (AmWell)

Amwell is a privately-held company founded in 2006 that connects patients, doctors and insurers in the United States. Only recently, on February 1, 2020 it received a venture round of 60m dollars.


KRY is a Swedish startup enabling patients to book video appointments with doctors, got the round of  87 million euro and is one of the more funded European telehealth startups. Kry has hosted over 1,200,000 consultations  so far.

Ada Health

Ada Health is an AI-powered telemedicine service. It helps patients identity symptoms and provides them with possible conditions. Working as a prescreening consultation Ada Health sends patients to the doctors where medical conditions require it.

Developing a successful telehealth app

If you don’t have any product design experience, you will find it hard to design a telehealth product that both doctors and patients will want to use and pay for. However, you are in the right place to learn about the challenges of developing a successful telehealth product and the ways to cope with them.

In 2016, Accenture released a report saying that two thirds of national hospitals in the US had mobile telehealth apps available for patients. However, only 2% of patients were actively using the platforms.

So what’s the difference between the telemedicine apps reaching 1000 appointments daily and other e-health platforms used only by a small fraction of patients?

One of them is undoubtedly, a better understanding of both doctors, patients as well as insurers and other stakeholders that will use and pay for your telehealth product. Even though these factors are also crucial and indispensable for launching a product, technology and funding remain secondary as a means to an end.

Lean approach to telehealth app development

So where should you start to launch a product that both doctors and patients want to use? First of all, if you haven’t yet read the book “Lean Product” by Dan Olsen and “Lean Startup” by Eric Ries, do it! This is a great introduction to developing products users love paying for.

Instead of investing a lot of money into building a complex product right away and finding out that no one wants to use it, get the feedback from your audience early in the process. Create a simple version of the product with a minimum number of functionalities – wireframes and prototypes – run interviews with users asking them for feedback and observe their interactions with it.

After that, brainstorm how to fit the user’s needs better with the product, introduce changes and ask for feedback again. With more such iterations you will get a better idea of what your users want and what needs you can solve better than your competition. This will help you get more clarity on your value proposition, achieve a product-market fit, and get ready for developing an MVP – minimum version of your telemedicine app to be used by doctors and patients.

Building a better telehealth app than those currently available

By understanding what app features bring the most value for doctors and patients, you will then put on production only the most important features therefore avoiding budget allocation on those that customers will not find useful.

For example, you may assume that adding a feature of a detailed doctor profile with a reviews option is the most important as it will help users choose the right doctor for a consultation and thus keep them more satisfied.

However, during the next user research it might turn out that reviews are not the most important aspect – patients and doctors can be concerned with the security of their personal data and that they are not sure about other telehealth app providers doing it right. This will help you refocus on the functionalities and prioritize feature development.

Remember that some development agencies choose a technocratic approach and will focus on shipping the product, but not on developing it in line with a lean approach. If you want any support in this domain, book a call with me – I will match you with either a tech agency that has a strong focus on product design or a UX expert that has  got a track record of developing telemedicine apps and can help you.

Possible app functionalities

Once you have identified your value proposition for your e-health app, then it’s  time to map out how your app will be able to satisfy them – by defining app functionalities. Packing your app with all possible features doesn’t guarantee your app success – we have already covered why in the previous paragraphs. Choose the minimum number of functionalities that are needed to create value for an end customer. Don’t spend much time on this task – build and show a simple prototype with these features to all stakeholders of your telehealth app – patients, insurers and doctors – and gather feedback.

Here are some possible app functionalities you can account for in your e-health app.

Patient and doctor profiles

To sign up to an app, a patient should submit his personal details such as full name, age, sex, medical history and other information to book the first appointment. While a doctor should fill in all the information about credentials, licence that needs to be verified, track record and others.


Search can include different parameters e.g. experience, specialization, the doctor’s availability and ratings – all necessary details to help a patient choose the best doctor.

Booking an appointment

A user should easily filter doctors, find the most suitable one and book an appointment effortlessly. This is one of the core features as it helps a user fit their schedule with a doctor’s availability.

Video conferencing

A doctor can show a patient how to use an inhaler, see wounds or incision sites and provide emotional support to help a patient get better. Video can help look for life-threatening symptoms – a patient’s lips going blue or identify low O2 saturation.


Some patients may prefer to avoid video communication and showing their face. For such patients having voice calls as a basic option to connect with a doctor is important. Make sure you cater to the needs of these users as well.

Document storage

Doctors and patients should have  easy access to documentation – e.g. for tracking prescriptions. This is important to ensure any data stored is accessible only by a doctor dealing with a patient’s case.


This specifically applied to the United States where doctors need to have a specific licence to offer services in a given state. By allowing for this function, the app can identify the patient’s location and find licensed doctors eligible to cure such a patient.

In-app Chat

Some users may prefer this contact more than other channels, possibly due to the urgency of the issue and in the case of questions that don’t require a long consultation.


The payment gateway should enable all the most popular payment methods for patients to pay the doctor’s invoices.

Ratings and reviews

Each doctor can be rated by patients to make it easy to identify the best-performing specialists.

The cost of developing a telehealth app

The cost of developing a telehealth app varies depending on the product complexity. If your product development is done according to Lean Methodology you can test your hypotheses about new app features fast, gather feedback from real users and act on it before investing a huge budget in deploying a complex software.

This approach helps generate savings and see progress with app development fast – with product increment deployed after each sprint (app. 1-3 weeks).

If thinking of a product MVP, you should count with the development process taking around 3 months and budgets ranging from 10k to 30k USD, when working with tech agencies from Eastern Europe.

If you need any further help with estimating costs, let’s schedule a call to discuss your needs and project goals – I will do my best to advise you on your individual case.

Security of telehealth application

Your telehealth application should protect sensitive information of users and use encryption of personal and health information. The application should comply with different regulations, often unique for countries you want to launch your app on.

When operating on the US market the application should comply with HIPPA  (The Health Insurance Portability and Accountability Act), passed by Congress in 1996. The HIPPA regulations require you to ensure a system for data protection so that only authorized individuals can have access to sensitive information processed and stored within the telehealth application. In turn, in the EU space your application has to comply with the Data Protection Directive and e-Privacy Directive. You have to research and comply with national legislation regulations if you want your product to be used on different markets.

So how can you ensure your data is secure? The more experienced your tech team at ensuring security the better it is for you in both short- and long-run. Even the smallest breach of security can result in depleting trust of users and destroyed reputation. That is why work with developers who have had a track record in developing solutions requiring strict security measure before.

How to monetize your app

There are several ways of monetizing your telehealth app.

Annual membership

A annual payment set up to use the platform – might apply for both – patients and doctors.

Monthly fee

Monthly recurring payment for using the platform, either with an annual contract or one month cancelation period. Rates for both might differ.


Consider selling the core functionalities and add-ons of your apps to other businesses – in this way, they save money on developing a product and its maintenance, and you can choose the following options of franchise monetization:
– lump sum – one-off payment

– royalty fee – renewable payment for using a software

– franchise renewal – payment to continue the contract or getting important software updates

Per-minute charge

Charge patients for each minute of a doctor’s consultation – a share of the earned amount from a consultation.

Per-consultation charge

No matter how long the consultation is, you charge only once per consultation. The price would range for different specialists and experience.


To sum up, there are already a lot of telehealth startups that have validated the need for such solutions on many markets. To make your telehealth product successful, you have to start with examining the needs of your customers and understanding your unique value proposition.

You won’t be able to do it alone if you don’t have technical experience in it. If you do have it, you will still need someone who has had experience developing similar solutions and could share know-how with you. That is why you need help in the initial phase of product design of your telehealth product as well the iterations stage. Get matched with a tried-and-tested tech agency with an experience in developing telehealth solutions within 72h.

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