Build vs. Buy vs. Partner - How We Built Plum Telehealth

In product management, the question of build vs buy vs partner is a classic dilemma that product teams face. When companies aim to grow their businesses by introducing new products, this question becomes even more relevant. The first step to resolving this conundrum is to understand the market and customer needs deeply. Product teams can narrow down the best approach by clearly understanding the problem.

At Plum, we are no strangers to this quandary, especially when we decided to build our Telehealth offering. In this blog post, we'll share our experience of how we tackled it and how that paid off. But first, let me give you a primer on our Telehealth product and how it started.

Telehealth: A virtual primary consultation product

Plum Telehealth was launched in 2021 as emergency relief during the second wave of the pandemic. Right from the beginning, we recruited top-notch physicians to provide quality care to our members in need. Post the second wave; we noticed that our customers preferred virtual primary consultations as a more efficient alternative to physical doctor visits. Consequently, our consultations increased tenfold, necessitating the addition of more doctors and specialities to the network. Given this phenomenal growth, we wanted to create an unparalleled experience for our customers and doctors.

Our vision for the new and distinctive Telehealth experience was to enhance the entire customer journey, from selecting a doctor to video consultations to obtaining the doctor's prescription. We aimed to provide a seamless onboarding and offboarding process for doctors, along with efficient appointment tracking, roster management, and payouts.

Partnering

Partnering with established players is often considered low-hanging fruit when introducing new products or services. It provides a quick way to test the market and achieve product-market fit (PMF). Moreover, partnering can offer valuable insights into operations and customer problems.

We initially kicked off our journey of Telehealth by partnering with one of India's leading healthcare providers to offer doctor consultations. While this partnership brought essential features like appointment booking and video calling, it also posed some serious concerns.

One of the biggest concerns was the secure handling of customer data. Plum takes great pride in the safe and responsible management of customer data, and partnering with an external entity raised some doubts about the alignment of motivations.

There were other points of contention too. Our partner platform wanted to send its marketing content to our customers, which could have compromised the user experience. We also had no quality control over the entire Telehealth experience.

After partnering for a few months, we knew this was not our route. We decided to walk the more challenging path of building our own upgraded Telehealth experience, where we could ultimately ensure a seamless and secure customer experience.

It is worth noting that many of our competitors and peers still rely on partners. While it may seem like the easier option, in terms of time-to-market and costs, it often comes at the price of compromising user experience and customer privacy.

Buying

While considering options for Plum's Telehealth offering, buying a market solution seemed like a viable alternative to partnering.

However, we soon realized that no product in the market could meet all our needs. The heart of Telehealth operations is a doctor practice management tool with rostering capabilities, prescription generation, and video support, among other features. We did experiment with a few off-the-shelf solutions, but they were either very expensive or rigid in their ability to integrate with a platform like Plum.

Moreover, the scalability and reliability of the platform were also significant concerns since the daily consultations were rapidly increasing, and so was our network of quality doctors. In such a scenario, customization and later maintenance of the purchased product could become a burden in terms of engineering effort and cost. Hence, buying a market solution was not prudent for Plum's Telehealth offering.

Building scrappily

We then decided to take a different approach and experiment with our in-house team of doctors specially trained for remote consultations.

This decision was primarily influenced by the success of Project StepOne, a non-profit network of doctors and volunteers providing teleconsultations to COVID-19 patients nationwide.

https://twitter.com/getplumhq/status/1635172703983513602?s=20

We wanted to start fast and went the scrappy route, launching our telehealth operations with no-code tools such as :

Calendly for scheduling appointments
Google Sheets for rostering
Google Docs for prescriptions, and
Google Meet for video consultations.

Over the next 1.5 years, our team handled an impressive 50,000 consults with a group of 50 doctors and a 3-person operations team. This achievement was a testament to the market need and showed us that we needed to enhance the customer experience with a telehealth upgrade.

Building fully from scratch

Considering these factors, the decision was made to build the entire telehealth platform in-house, allowing complete control over data management strategies and security measures.

It is essential to acknowledge that by making a build decision, we would have to solve the following product and engineering challenges:

Data security and privacy: Ensuring that patient data is secure and protected from unauthorized access is a significant challenge when building a telehealth platform. This required implementing robust security measures in Plum telehealth, such as encryption, secure data storage, and access controls.
Scalability and reliability: Building a telehealth platform that can handle many patients and doctors while ensuring high availability and reliability is a significant engineering challenge. We used cloud-based infrastructure and implemented load-balancing and auto-scaling solutions.
Video conferencing: Video conferencing is a critical component of Plum Telehealth, and building a high-quality, low-latency video conferencing solution can be a significant engineering challenge. We considered using open-source solutions like WebRTC but decided to use one of the popular third-party video conferencing API providers to reduce our build time.
Interoperability: A telehealth platform must integrate with various electronic health record (EHR) systems and other healthcare systems, which can be a major engineering challenge. We overcame this by using open standards, such as FHIR, and by implementing APIs allowing easy integration with other systems.
User experience: Building a telehealth platform that is easy to use for patients and providers is essential for the success of our platform. We conducted user research, testing, and feedback to improve the user experience.

Summary

The all-new Plum Telehealth, built from the ground up, now brings a range of features to provide a seamless and secure user experience.

To highlight the key features;

Appointment booking, video consultations, and prescription delivery- now all on one platform, the Plum app
Choose your doctors by filtering for the language spoken and gender
Instant access to digital prescriptions and easy-to-book follow-up appointments
Completely secure collection and management of customer data

What's coming next?

As we grow, we focus on creating a comprehensive healthcare platform prioritising our users' well-being. Our product and engineering teams are working on some exciting new preventive and primary-urgent care features. These features will make the Telehealth system more robust and enable us to impact 300,000+ lives this year.

If you're a Plum Telehealth user, write to us here with your feedback. We're all ears.

And if you're not yet a Plum Telehealth user, get started by downloading the iOS and Android apps.