Lessons learned from Onelife Health’s founder about how to do the go-to-market in the women’s digital healthcare market: Interview with David Schaerf

As the leading analyst and strategy consulting company for the digital health market, we have been exploring the developments of digital health and the way new technologies disrupt and reshape different market segments such as diabetes, respiratory, health insurance since 2010. Our new market study is concentrated on sizing the global women’s digital healthcare market, providing an overview of key market players’ strategies and evaluating trends that will have an impact on future market development.

Advancement in mobile technologies and innovative digital solutions incorporating AI, machine learning, big data disrupt also women’s healthcare market and present a great opportunity for market players to create more personalized value and interactive state-of-the-art user experience, help women better manage their health and well-being in real-time and play invaluable role in women’s disease prevention.

The women’s digital healthcare market comprises software, diagnostics, products and services that leverage technology to address specific women’s health issues and improve women’s health. Some examples of women’s digital healthcare market solutions are related to fertility, family planning, childcare, etc.

To enrich our analysis and validate market opinions of the current status of women’s digital healthcare market, we also delve into interviewing different market players.

Recently, we had a chance to talk to David Schaerf, Founder and CEO of Onelife Health about the company’s journey, their international experience and lessons learned, as well as what defines the success of a digital health solution and what are the most efficient distribution channels for digital health providers.

Enjoy the interview

Research2Guidance: Could you please share the story behind Onelife Health?
David Schaerf: We founded Onelife Health in 2014. Our vision and intention were big – to make healthcare more human and transparent by providing tools that empower patients to have a better view of what their health status is and improve the conversations they are having with their doctors. Since this vision was rather high level we set out to look at different areas and an ideal niche where we could launch our service and have a big positive impact on people’s lives.

In those early days we started talking to many doctors and to people who have chronic and life-threatening diseases, such as diabetes or cancer. An obvious choice as those are big markets where our service could ease millions of patients’ journey and help them self-manage their conditions.

And during those initial conversations with healthcare professionals, we stumbled on the female health and pregnancy space. It was a bit of luck that we were talking to some doctors that would mention to us that there were a lot of issues in this supposedly safe area. Although in the 1st world we don’t have high child mortality and we don’t see or hear of any issues in the media, under the surface there are many problems. The doctors and midwives are simply overwhelmed, the mothers-to-be have 1001 questions and in the time between the monthly check-ups a lot can happen. Additionally, we quickly realized that there are some bad horror stories where a critical detail was overlooked and was then left undiscovered for one or two months, leading to terrible outcomes.

Pregnancy at its core has a positive tune and is a beautiful experience in a woman’s life, yet there were enough issues and problems we could address with our digital solution and have a big impact on the patients’ lives and support more positive outcomes at lower costs. This reassured us that pregnancy was an ideal starting point for us.

Research2Guidance: A very interesting start you had. What was your service offering?
David Schaerf: Once we had the initial product vision we dove deeper into this market and grew the team with this focus. We analyzed every aspect of it, and we saw the need for an intelligent and a smart companion that will help and guide the woman all along her journey. At the same time, we saw that doctors and healthcare professionals also needed a digital assistant to have an efficient conversation with their patients.

To draw you the initial picture we saw – Pregnancy is a life changing experience that has a very big impact on woman’s life both emotionally and physically. The interaction between the doctors and midwives in the hospitals at time could be so inefficient that in some cases it leads to really bad results but in most cases, it leads to a woman going online and googling symptoms. As a result of this research, the woman could “diagnose” herself and be scared, so she calls her doctor or goes directly to the doctor. This leads to waiting rooms being full of patients, the doctors being overwhelmed with women having so many questions that need to be addressed and at the end the women realize what they have read online is not true for their particular case.

Stepping on this huge problem we have decided to build a companion service in the form of a digital app that will allow women to have a daily companion with them at all times. The doctor in this case doesn’t have to do anything. Our digital solution Femisphere allowed women to enter data in a smart diary. The data is not just stored, but also analyzed. We had a risk assessment that could establish if there were patterns that could indicate that something could be going wrong, potentially. Femisphere is also rich in peer-reviewed medical and lifestyle content that help our users to understand how their body is changing, what they can eat or the ideal sport they can do, such as yoga. The app also allowed the patients to connect with their doctor if they would like and activate notifications reminding the users to keep track of vitals and symptoms. There was a lot of great value in the Femisphere app.

At the same time our vision was to connect healthcare professionals with mothers. So, we developed an app for healthcare professionals called itouch. It allows doctors and midwives to connect with their patients to understand what symptoms they are experiencing between the check-up appointments and allow them to communicate and send data in a secure way.

This new kind of interaction based on patient-generated data allowed a more efficient care and better quality of treatments, particularly for risk pregnancies. For example, if there was a pregnancy risk, like gestational diabetes, the doctor was able to set up a certain reminder for the mother to track her blood sugar and diet.

More recently, we added professional one-to-one coaching to our solution to introduce a more human touch within the companion app. This is a success story in the sense that “having your own personal coach within the app, who is there to answer your questions and help you day to day, guiding you through your entire pregnancy”. The mother could use a video chat or just text chat with a variety of coaches. This was received very well as just interacting with an algorithm can be quite cold.

Research2Guidance: What countries were you concentrating on?
David Schaerf: We started with the German speaking version for the DACH region. We added an English version and an Arabic version over the course of 4 years. We also had some international experience – we partnered with a health insurance company in the UAE, which generated great insights. We also spent some time in the US analyzing the market. However, we decided against starting in the US in parallel because we wanted to remain focused on the German market.

Research2Guidance: It will be interesting to know what were the differences within the UAE market – in terms of usage, content, etc.?
David Schaerf: The UAE market and the German market are quite different, in many ways. We completely underestimated that. Not in terms of app usage per se. Our partner, a health insurance company used the platform to directly engage with their members, which at that point was unthinkable for a German insurance. This partnership led various product adaptations that also benefited our German partners and users.

There were two main differences – In Germany, you have a very structured approach to pregnancy. You have guidelines, certain number of prescribed appointments that need to be taken and there is a lot of regulatory framework around it. In the UAE, there was a good framework for pregnancies, but it was rather unstructured leading to various cost and outcome issues.

For us was also interesting that there were demographic and dietary differences. We saw a very different view on the population with a much higher rate of gestational diabetes – this is a temporary form of diabetes arising throughout pregnancy, which if treated correctly can disappear after the pregnancy. In the UAE there was a rate of 30% whereas in Europe it is below 10%. This is a huge difference and we focused on providing better care for this patient group together with our partner.

And of course, the second point is the very sensitive cultural difference that impacts how healthcare is delivered, which we also underestimated. There is a different way of how doctors treat women and pregnancies. For example, a doctor can’t physically examine his patient as it is allowed in Europe, so this alone brings you certain ineffectiveness and stigma. A pregnant woman can’t ask certain questions because she may be embarrassed due to her religion and value system.

So, we found out that our app provided a new channel that helped the users to experience more control over their pregnancies with the knowledge they are acquiring. The app provided room for building trust between the users and their healthcare professionals by creating a safe space to address the needed questions and get professional answers with less embarrassment and stigma about certain questions.

Now looking back, I must admit some little details there were amusing. For example, coaching women how to breastfeed and showing a video or pictures of how to perform breastfeeding correctly were quite a big taboo. Respecting the culture was important to us, so we had to work around these issues and create a more tailored solution without showing, for example, nakedness, yet still the solution should be valuable for our users. The whole experience was very interesting, and we learnt a ton from dealing with such a different market.

Research2Guidance: What a journey! So, what is the current status of Femisphere and itouch apps? And congratulations on your awards.
David Schaerf: Thank you. Yes, we won several awards which is always nice and helpful to boost morale and market awareness. We regularly won awards like 1st prize at Hauptstadtkongress Startup Slam or the German design award for best app design in healthcare.

Unfortunately, at present our service is no longer available online. They do exist but are inactive. As a company we had to stop our operations due to a funding round that failed to close in time, for mostly internal reasons. We hope and believe there will be a continuation to the story under a new brand or possibly with a slightly different service focus.

Research2Guidance: What lessons have you learned and/or what would you have done differently?
David Schaerf: This was an exciting journey for me personally with lots of invaluable learnings along the way. As I digest these five years, I still revisit key moments and decisions and reflect on how they impacted our journey. I’m sure the rest of the team also had a steep learning curve that they will be able to use in the future.

There are a lot of things that I and the team did well, and of course there are things that we could have done differently. I think when we started in 2014 the German healthcare market was in a very different place. Today in 2019 the environment is different, and the big players are finally starting to address the big issues and market needs.

I am rather happy that we focused on B2B and reimbursement early on, which helped our business model gain traction early on and help our cash flow.

We also made some good and bad choices when it came to the product. At the beginning our vision was too big and our product value was not tangible enough. Initially I think we should have focused even more to understand the market pain better. In other words, starting from a smaller place and build rapidly from that.

I think we started off in a good space and our challenge was to articulate in a crystal-clear manner what is the one problem we are solving with our service. However, we were addressing multiple problems at the same time and that was not quite clear to the user – from the patient’s side, but also from the professional’s side. Being more focused on one thing and moving step by step could have built a better relationship with our users and increased the value we are providing to them.

Research2Guidance: What are the major trends in the women’s digital healthcare market?
David Schaerf: The trends in female health are very similar to the current trends in digital health overall. I think the amazing success story of apps as we know them is coming to an end as the large platform companies copy popular features from smaller app developers. However, there are new user interfaces coming out that have huge potential. For example, voice assistants like Alexa will have a lot of impact in healthcare and of course female health as well.

One problem that we quickly saw and that any app developer will tell you – it is extremely hard to build lasting engagement with your users. It is very hard to get the users to continue to engage with your service, to interact and to provide you with information and feedback. This is one of the hardest things in app design at it will get even harder in the future. In addition, companies like Apple and Google of course are not making it easier with the way their app store business models are.

With the rise of new interfaces that will be available on your phone but also in your car and home, you will interact with smart digital services in a faster and more engaging way. Right now, I think voice has the biggest potential and I firmly believe that it will have a huge impact on digital health overall, but also on female health. Think about, for example, a period tracking app that requires you to spend a couple of minutes every couple of days manually inputting data in your app. Although it’s quite fast and only takes one minute of your day, it is very much the same act over and over. If a user can do it via different interface that is more dynamic and providing value the moment you engage with it, I think it will increase the stickiness and it will have a big impact on keeping a regular routine and behavior.

The second trend is of course AI, and specifically machine learning is very interesting. The amount of data that has already been collected by health apps is enormous. Imagine the challenge developers are having to make sense of this data and turn it into valuable insights?! Data analysis has a lot of heavy lifting involved and they must work extensively with the data to make sense of it and provide tangible value to their users. To achieve this, one must have a complex algorithm that scans through the data, to understand it, to come with an intelligent way to see patterns, to produce takeaways from those patterns in order to bring value. So, machine learning will help companies to be a lot more efficient and create a lot more value to users, doctors and the healthcare system. There is a lot to be learnt from the data and medicine can benefit hugely from the insights, once unlocked. So, the impact is and will be huge on new drug and therapy discoveries as well as on the way medicine is practiced.

Research2Guidance: What defines the success of a digital health solution?
David Schaerf: In my opinion what defines a successful digital health solution is the health outcome. If you can produce positive outcomes for the patient and on top of that for the healthcare stakeholders (e.g. doctors, insurance who are paying for the entire thing) then you are on to something. We all know healthcare is very expensive and it is a trillion-dollar industry. The way healthcare is currently set up economically is not sustainable and it is going to implode in the coming years if there are no significant changes made. Digital health solutions add more transparency and efficiency into the system making them an ideal part of the solution.

All the app services that can provide a positive impact on the outcomes (e.g. more successful therapies, reduced cost, empowering patients to manage more effectively one’s everyday health condition, reduced times and processes) will succeed because they are providing value to the system and to the patients. So, the question a digital health solution provider needs to ask is “Is my app/solution tangibly producing positive outcomes that I can demonstrate to the various stakeholders involved?” If the answer is “Yes”, then the company can build on that. And if the answer is “No”, then the company is not where it needs to be and should continue searching for ways to make more impact.

Research2Guidance: What are the most efficient distribution channels for digital health providers?
David Schaerf: I would say it depends on the market. If we look at the German market specifically, where most of the services are reimbursed by the health insurance, I think digital health should be monetized in a similar way.

We monetized Onelife with a B2B2C approach. We were partnering with insurances and healthcare providers helping them to provide personalized value through apps to their members via our platform and digital health service. Our solution allowed partners to tailor the app to their own services and brand and allowed them to reduce cost and build better relationships, while not having to develop inhouse. The partnership helped us to build reach in a cost-effective way and achieve a bigger user base than we would have been able to using just classic B2C marketing tactics like Facebook.

For a small company / startup having a partner with an already known brand, with own large clients’ base is a huge step forward. Of course, there is always the traditional way to create awareness and reinforce credibility, gain market share through different PR strategies and advertisements, but it might take years to reach a certain level of brand recognition, one needs a substantial budget, and still the end result might not be satisfactory.

I believe the most efficient distribution channel is through partnership with different stakeholders.

Research2Guidance: Would you like to share a topic that we haven’t touched but you feel is important to be talked about?
David Schaerf: One issue that I have seen in the last years and in a market like Germany is the lack of data standardization. The problem that we have in Germany vs. a market like the US is that data is locked in various places and it is really hard to get it out. Even though the patient has regulatory and legal authority on his own data, it is quite a challenge to get access to the data. There is also a lot of strategic interest on the corporate side to keep things the way they are, slowing down initiatives to democratize health data.

I would really welcome an open data standard for healthcare data, which is similar to the way healthcare data is treated in the US through HIPAA (Health Insurance Portability and Accountability Act of 1996). I think this will boost the number of successful healthcare apps we have in Germany and the number of doctors being open and happily working with new tools to provide innovative services to their patients, which of course will drive better health outcomes. I think on a regulatory / on a government level there needs to be a push forward to standardize healthcare data and ensure availability of APIs.

Research2Guidance: Thank you for your time and for all the insights you have shared with us, David.

About Onelife Health

Onelife Health is remodelling women’s healthcare by offering accessible and relevant medical information and enhancing process optimisation via an intelligent companion and personal coach app, Femisphere, and a digital care platform, itouch.

Femisphere guides mothers between doctor visits and connects them with healthcare professionals when needed. Users have access to professional one-to-one coach, certified content & recommendations, while doctors can follow patients’ progress and make therapy adjustments if needed. itouch enables intelligent doctor patient communication that allows medical professionals to provide an optimal level of care, while saving time.

Onelife’s apps have been featured by Apple multiple times in various markets. Onelife Health worked with hospitals and insurances and partnered with leading organizations like the WHO and UNICEF.

Due to a failed funding round the company had to cease operations at the end of 2018 and the company assets are currently for sale. For more information: https://www.onelife.me

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