R2G Digital Health Leader Interviews with Dr. Joshua Liu, Co-Founder/CEO, SeamlessMD

The healthcare industry is grappling with the challenge of delivering cost-effective, high-quality care while navigating increasingly complex patient pathways. Outdated tools often leave patients unsupported, increasing the risk of complications, readmissions, and prolonged recovery. These inefficiencies not only compromise outcomes but also drive up costs, placing additional strain on health systems. In light of these challenges, how does SeamlessMD help health systems digitize and optimize patient care journeys for both providers and patients?

As health systems transition to value-based care models, they face immense pressure to cut costs, enhance care quality, and improve patient satisfaction. Patients, in turn, often experience gaps in care due to reliance on fragmented tools such as paper instructions or verbal guidance, leading to confusion, missed interventions, and extended recoveries. Addressing these challenges demands scalable, effective digital solutions that can streamline care delivery and empower both providers and patients.

In an insightful discussion with Dr. Joshua Liu, Co-Founder and CEO of SeamlessMD, we delve into how the company is reshaping digital patient engagement and remote monitoring. We explore the business and operational model behind SeamlessMD’s success, its scalability and long-term value for health systems, and the company’s strategies for enhancing patient engagement and navigating future growth.

Enjoy the interview!

Research2Guidance: How did you start SeamlessMD, what problem do you solve, and how do you solve it?

Joshua: I began my journey in the clinical world during my medical training in Toronto. Although I didn’t fall in love with any particular specialty, I became deeply interested in addressing broader challenges in the healthcare system, particularly around improving cost efficiency and quality. Midway through my training, I conducted research on preventing hospital readmissions, which sparked my fascination with using technology to enhance the patient journey, specifically, helping patients stay healthy at home and avoid unnecessary hospital visits.

In my final year of medical school, I met a couple of brilliant engineers in a startup incubator and we launched SeamlessMD to tackle these challenges in patient care.

As for what SeamlessMD does, I like to use a travel analogy. Imagine driving from point A to point B. In the past, we relied on paper maps, but now we use GPS: it’s faster, safer, and more effective. Healthcare journeys, like those involving surgery, cancer treatment, or chronic disease, are far more complex than travel, yet we still provide patients with outdated tools like paper and verbal instructions. Patients often lose or forget these instructions, and healthcare providers feel like they lose visibility into what happens once the patient leaves the clinic or hospital.

This disconnect can lead to worse health outcomes and higher costs for the healthcare system. At SeamlessMD, we bridge this gap by providing a digital care journey platform.

Research2Guidance: Interesting. Can you explain in more detail how the platform works and the impact it has on patient care?

Joshua: Think of it as a GPS for patients navigating complex healthcare journeys like surgery, cancer treatment, or chronic care. For example, if you’re about to have major heart surgery, your hospital might provide you with access to SeamlessMD on your phone, tablet, or desktop.

In the days leading up to surgery, you’d receive reminders, for instance, when to stop taking blood-thinning medications, when to stop eating or drinking, and other important steps to prepare. After surgery, the platform guides your recovery with educational resources, such as videos on recovery exercises.

When you’re back home, SeamlessMD prompts you to track your symptoms daily, e.g. your pain levels, how you’re feeling, even uploading photos of your surgical incision. Meanwhile, your healthcare team can monitor your progress through alerts and dashboards that are fully integrated into the electronic health record. This allows them to catch potential problems, like infections, much earlier.

By supporting patients in this way, we’ve seen better health outcomes, higher patient satisfaction, and reduced costs for the healthcare system.

Research2Guidance: Is SeamlessMD based in the USA or Canada?

Joshua: We are a Canadian-based company, but we currently serve hospitals and health systems in both Canada and the U.S.

Research2Guidance: What is your business model, and how does it support scalability and long-term value creation for your partners?

Joshua: Our business model is B2B: we partner with hospitals and health systems.

What sets us apart is our enterprise platform, which supports over 150 conditions and surgical procedures across various specialties, including orthopedics, women’s health, urology, chronic care, mental health, palliative care, and cancer, unlike other solutions that focus on single specific area.

This comprehensive approach is crucial for scalability, especially for larger health systems. They don’t want to manage 100 different applications for each specialty, they need a consistent experience for both patients and providers across all conditions, procedures, and treatments.

Another key to scalability is our integration with major electronic health record (EHR) systems, like Epic, Oracle Cerner, and Meditech. We’ve established turnkey integration partnerships, so our platform connects directly with the EHR and patient portals like Epic MyChart. This alignment with the IT strategies of hospitals and health systems allows us to scale effectively, both clinically across specialties and technically through seamless integrations.

Research2Guidance: Digital health tools often face adoption challenges, particularly among non-tech-savvy patients. How do you ensure that patients follow the instructions and adhere to their care plans?

Joshua: Fantastic question. There’s a lot to unpack here.

First, engaging patients effectively requires a multipronged approach, as no two patients prefer the same method. Some use smartphone apps, others prefer desktop browsers or patient portals. SeamlessMD is accessible across multiple channels: apps, text, email, and patient portals ike Epic MyChart, ensuring we reach patients wherever they are.

Beyond that, we focus on closing the loop with patients. For example, if we send a reminder to stop blood thinners before surgery, we don’t stop there. The platform asks patients: “Did you stop your blood thinners on time?” If they say no, we follow up with, “What made it difficult for you to stop?” Whether the reason is forgetting, being too busy, or something else, we capture this context and share it with the care team, helping to identify and address barriers to adherence and improve patient outcomes.

Our median patient adoption rate is 75%, and several of our health system partners have achieved adoption rates of over 90%.

Additionally, healthcare staff must be fully engaged in promoting the tool. Patients are more likely to follow instructions when their doctors recommend them. The content of the digital tool must also align with the care team’s guidance to prevent confusion. To ensure clarity, we make sure all content is written at a 6th-grade reading level and meets accessibility standards, including the platform being color-blind tested and screen-reader friendly. Lastly, we support family and caregiver involvement, allowing loved ones to enroll alongside the patient to provide better care support.

Research2Guidance: Can you highlight a particular case where SeamlessMD has made a significant impact?

Joshua: Sure. One of our partners, MultiCare, a 12-hospital system in Washington state, has implemented SeamlessMD across 11 clinical areas, including orthopedics, spine surgery, women’s health, urology, and endoscopy (e.g. colonoscopies). Fully integrated into Epic and MyChart, they’ve achieved remarkable results: increased profit per patient, reduced costs, shorter lengths of stay, fewer readmissions, lower mortality in some clinical areas, and fewer cancellations for procedures like endoscopies.

By guiding patients appropriately and keeping a close eye on them, not only do patients feel safer, more confident, and less anxious, but we’ve also seen significant improvements in outcomes and financial metrics. This combination of better clinical outcomes and measurable ROI has been key in demonstrating value to our clients.

Research2Guidance: While your solution having over 40 clinical studies and evaluations showing positive results certainly helps demonstrate value, how do you navigate situations where the clinical improvements don’t always align with financial objectives or incentives?

Joshua: One of the challenges in healthcare is when the right clinical approach for a patient doesn’t always align with the financial goals of a healthcare organization. Some outcomes are easier to align with financial objectives, such as reducing a patient’s length of stay. If we can get a patient home safely sooner, it’s better for them, as hospitals are high-risk environments for infection. It’s also beneficial for the hospital, especially in the US, where hospitals are often reimbursed a flat rate for stays. The quicker discharge reduces costs, and the hospital has a higher profit for that patient stay.

However, there are other situations where it’s more nuanced. For example, preventing readmissions is typically better for the patient, but whether it’s financially beneficial depends on the payment model. In value-based care models, preventing readmissions may help hospitals penalties and improve financial performance. But in traditional fee-for-service models, readmissions may bring in more revenue, so preventing them might not always align with the hospital’s financial goals.

That is why, we engage with hospital leadership early to understand their financial targets and priorities. By aligning clinical outcomes with their financial goals, we create win-win solutions. Doing this homework upfront ensures everyone is on the same page and aware of the financial incentives.

Research2Guidance: Most partnerships in digital health fail. What makes a successful partnership?

Joshua: From our experience, successful digital health partnerships require total organizational buy-in, particularly from top-down leadership. A common pitfall we’ve encountered is when a clinical champion, like a physician leader, convinces you that improving specific clinical outcomes will automatically lead to organizational support. The problem is, you might implement the solution, prove the results, and a year later, you discover that the leadership team wasn’t really interested in those metrics. They might have different priorities or incentives, and because they weren’t part of the initial decision-making process, they don’t feel emotionally invested in the innovation.

To make a partnership successful, we’ve learned that you need three types of champions from the very beginning:

• Clinical Champion – This is essential for clinician buy-in. Without clinical support, nurses and doctors won’t engage with the solution.
• Executive Champion – You need someone at the C-suite or VP level who not only supports the initiative but is emotionally invested in it. This ensures executive-level support and alignment across the leadership team.
• Operational Champion – This is typically a department director or project manager who handles the day-to-day operations and ensures the solution is effectively implemented. They are responsible for educating staff, onboarding patients, and ensuring that the innovation is properly integrated into the workflow.

Having all three champions ensures a successful partnership.

Research2Guidance: As healthcare transitions to value-based care, how is SeamlessMD adapting to meet the evolving demands of payers and providers in the digital health ecosystem?

Joshua: I honestly wish the shift to value-based care was happening faster, because I believe it’s crucial for improving clinical outcomes, and it’s something that aligns well with what we do. There are some value-based models that are growing, particularly bundled payments, which have been around in various forms since the 1990s. About a decade ago, we started to see more voluntary bundled payments in the U.S., and five or six years ago, mandatory bundled payments were introduced for procedures like hip and knee surgery. Starting in 2026, they’ll expand to include surgeries like spine, cardiac, and colorectal surgery procedures.

In addition to bundled payments, value-based care models are gaining traction in chronic care management, such as for diabetes, hypertension, and heart failure. These models, particularly in accountable care organizations (ACOs), require providers to meet certain targets for reimbursement.

SeamlessMD helps healthcare providers navigate these requirements and improve clinical outcomes, which is essential for success in these models.

That said, not every healthcare organization is fully committed to value-based care yet. So, while we focus on improving cost and quality metrics, we also recognize the need to address the non-value-based care objectives that some systems still prioritize. Our goal is to be flexible, helping organizations adapt to both value-based and traditional care models, ensuring we can deliver value across the board.

Research2Guidance: Many digital health companies fail to scale or sustain their impact. What do you think they’re missing? Just recently, primary care player Forward abruptly shut down its operations, even after raising over $500M.

Joshua: Indeed, I have two thoughts on that. One major challenge for healthcare tech companies is that there are many “vitamins” in healthcare and fewer “painkillers.” What do I mean by that? A vitamin is a solution that’s nice to have: it’s helpful, but you won’t be in immediate pain if you don’t use it. On the other hand, a painkiller is something people desperately need to solve a huge, pressing problem. They will go out and buy it immediately because it’s urgent.

The reality is that many people start companies in healthcare because they’re passionate about solving a problem, but that problem isn’t always seen as urgent by enough people. So, to many, your product ends up being a vitamin, not a painkiller. If you create something that people are truly desperate to solve, however, they will be willing to pay for it. This challenge is more common in healthcare, where there are lots of altruistic people who want to solve problems and create vitamins, but discover later that the issue isn’t big enough to generate enough demand or funding.

We see this a lot when selling to hospitals, for instance. Hospitals operate with small margins and have limited flexibility in their budgets. They may wish they could buy 100 different new innovations, but they can only afford 3 this year and those 3 have to align with their top 3 priorities. This is a common challenge in digital health.

The second issue is that many digital health companies that raise a lot of investment money try to scale too quickly. The reality is that businesses need to achieve positive and sustainable unit economics eventually. Some companies, however, have grown to be gigantic will still losing money, betting heavily on growth, without a clear path to profitability. The business model simply isn’t sustainable.

Of course, venture capitalists may not care as much, since their business model expects most investments to fail, with a few highly successful ones making up for those losses. But in healthcare, where we’re affecting patients directly, the stakes are much higher. If a company fails, it’s not just an inconvenience, it can leave patients and healthcare teams stranded. So, I believe that sustainability and durability are crucial in healthcare. We need to have a higher standard for making things work. Sometimes, too much funding too fast can actually be detrimental.

Research2Guidance: What are the biggest challenges SeamlessMD faces when scaling its platform across diverse health systems in North America?

Joshua: For us, the biggest challenge is that improving quality outcomes and patient experience isn’t always the top priority for many health systems. As you may know, many organizations are currently focused on other priorities. In the US, for example, health systems are placing a heavy emphasis on patient acquisition as they try to grow. Additionally, there’s a strong focus on addressing clinician burnout and workforce shortages, especially when it comes to retaining healthcare staff.

Our job is twofold:

1. Promote the importance of quality and patient experience: We continue to advocate for the value of improving clinical outcomes and enhancing the patient experience to ensure these remain important priorities within organizations.
2. Evolve our platform to address other priorities: We are working on adapting our solutions to help healthcare organizations achieve their broader goals, such as retaining patients and reducing the time clinicians spend on administrative tasks.

Ultimately, the challenge is staying relevant as health systems shift their focus. Quality and patient experience are always important, but from a financial and operational perspective, other priorities can sometimes take precedence. Our goal is to support these diverse needs while still delivering value in quality improvement and patient care.

Research2Guidance: What are the most significant trends shaping the digital health market today, and how is SeamlessMD positioning itself to capitalize on these trends?

Joshua: One of the key trends we’re seeing is the ongoing digitization of the patient journey.

Traditionally, the focus has been on two points: the start and the finish. At the start of the journey, a lot of effort has gone into digitizing processes like online scheduling, chatbots for initial access, and similar tools to bring patients into the healthcare system. Then, at the end of the journey, there’s been a strong emphasis on digitizing billing, payments, and post-care follow-up.

But we’re now seeing a shift toward realizing that the entire journey needs to be digitized. What’s really crucial is digitizing the middle part of the journey, which is where the patient spends most of their time. For example, if a patient is going through surgery or cancer treatment, the whole process, from preparation and education to symptom monitoring and post-operative care, needs to be managed digitally to ensure a high-quality experience and better outcomes.

Our team is focused on this trend: creating digital tools that guide patients through every stage of their journey. It’s about helping patients not just get into the system and pay their bills, but ensuring they receive the support they need throughout the course of care. Ultimately, patients care more about getting better than how easy it is to make a payment and that’s where we come in. We’re helping to close that gap and improve the middle layer of the patient experience.

Research2Guidance: What is ahead for you and your team?

Joshua: Exciting times ahead! While we already support many of the major health conditions and procedures that health systems focus on, there are still areas we plan to expand into. For example, we haven’t yet added transplant care to our platform, but that’s on the roadmap. We want to eventually support all the conditions and procedures that a patient might experience, even those on the edges that may not be the highest volume or currently the biggest focus for health systems.

Additionally, we aim to expand our support across the entire continuum of care. We currently work with hospitals and health systems, and we’ve begun collaborating with home care providers. Ultimately, our goal is for SeamlessMD to be the one platform used by all care teams: hospitals, primary care, home care, and other community health organizations to deliver continuous, coordinated care for patients throughout their entire health journey. That’s the big vision being the platform that supports every patient and care team at every stage of the patient’s life cycle.

And lastly, global expansion. We want to set our footprint in Europe and Asia.

Research2Guidance: Joshua, thank you so much for this insightful and engaging conversation. We wish you and the entire SeamlessMD team continued health, success, and a vibrant year ahead.

ABOUT SeamlessMD

SeamlessMD enables health systems to digitize patient care journeys with automated reminders, education and symptom monitoring – leading to lower length of stay, readmissions, and costs. Patients are engaged via smartphone, tablet or computer and are guided step-by-step with reminders, education and progress tracking across pre/post-surgery, oncology, chronic care and more. Providers can remotely monitor patients and access insights to elevate the patient experience, improve clinical outcomes and lower costs. SeamlessMD can be directly integrated with EHRs such as Epic, Oracle Cerner, Meditech and Allscripts. 40+ clinical studies & evaluations have shown SeamlessMD to improve the patient experience while reducing hospital length of stay, readmissions and costs. Health systems such as Atrium Health, UAB, MultiCare, Thunder Bay Regional and William Osler Health System use SeamlessMD to improve patient satisfaction while reducing hospital length of stay, readmissions, and costs. In 2023, KLAS Research recognized SeamlessMD as the Top Solution to Improve Outcomes.