Vincent Keunen talks about doing business with American hospitals and pharmaceuticals, and how the American medical sector is one step ahead of Europe when it comes to open data.
Belgian entrepreneur Vincent Keunen is the founder and CEO of Andaman7, an app that allows patients to access all of their personal medical information on their mobile phones.
Andaman 7 is a Belgian firm with an office in San Francisco. I had a talk with Vincent about the opportunities that lie ahead, against the backdrop of both the COVID-19 crisis and the current policy push towards open data in the medical sector. We also discussed the difference between doing business in Belgium versus the United States.
A personal recovery story
Jo: Let’s start with the beginning. How did Andaman7 come about?
Vincent: I am an engineer by training. I used to develop IT systems in Belgium. In 2014 I sold my IT company to create an app that would help patients access their medical records. I had been diagnosed with leukemia in 2007. I was fortunate enough to recover well and have been able to keep myself healthy with medication.
Three months after my treatment for leukemia, my son of ten was diagnosed with bone cancer and had to undergo treatment for a period of two years. His right leg ended up being amputated. With the app, I aim to accomplish two things at once. I want to help patients access their personal medical records easily, themselves. This was often lacking when my son and I were being treated. I also want to use part of the proceeds of this venture to fund research into bone cancer treatment.
Managing your own protected health information
Jo: Tell me about the app. What is it’s value proposition exactly?
Vincent: The app allows patients to collect and store all their personal medical information on their smartphone. We are talking about what Americans call protected health information, which the app stores in a HIPAA compliant manner, but also information on their nutrition, sleep patterns, etc. This information is then useful to them to monitor their health. They can also share any information they wish with their physicians.
As I said, the records are stored locally, so there is no data security issue. You can not hack into my system to access the records of the users. You would have to hack into every single one of their phones.
Jo: What does it cost to use the app?
Vincent: The app is completely free for patients. Revenue is generated through collaborations with pharmaceutical companies. Many countries, including the United States, want pharmaceutical companies to report next to clinical evidence patient-reported outcomes (PROs). We help pharmaceutical companies collect those PROs. Most of the time these are quality of life studies where the doctor recruits the patients that will furnish the reporting.
Jo: Tell me something about your user base.
Vincent: We have tens of thousands of users in Europe and in the United States. The app is available in more than twenty languages. Granted, those numbers might not look spectacular at first glance, but we are closing agreements with pharmaceutical companies every month now and they are very happy with the costs we save them.
Jo: Where do you get your funding from?
Vincent: Mostly private investors, people from my network in Belgium. We have raised 3 million euro in the last few years. We owe these business angels a lot of gratitude for believing in the project from day one.
A welcome push for open data
Jo: How do you stack up against your competitors?
Vincent: Our approach is pretty unique because we allow two way communication between patients and their physicians, as well as hospitals. People can pull information from the medical providers that threat them but they can also upload information themselves onto those same systems.
Jo: There is a huge push for improving the efficiency of the healthcare system in the U.S., how do Washington’s political priorities impact your business?
Vincent: You are right. There is a huge bipartisan push for more patient centrality, in order for anyone to be able to have access to their records at all time. In fact, in this regard, the United States is ahead of the European countries who are much more conservative about providing access to medical records. The federal policy thrust towards open data is an important tailwind for us. President Obama mandated that hospitals keep their data in Fire format a few years back, whereas Europe does not even work with Fire yet.
Andaman7 can gather and pull in all Fire records. 85 percent of all American hospitals, labs and medical offices use Fire, so the potential to scale is enormous. And I expect more rules to be implemented within the next few years that will continue to force hospitals to share more data, not only with patients but with other medical providers.
Help in a pandemic outbreak
Jo: How could the app help contain or mitigate a pandemic outbreak such as COVID-19?
Vincent: No single app can prevent a pandemic outbreak from spreading, but Andaman7 can be of great use to doctors’ offices by prompting people to report how they feel. So you could ask them daily to report whether they are feeling feverish. This app can also make it easy for any authorities to warn the citizens of pending dangers, through a text message or even a video message. In the last few weeks we have activated an in-app Pandemic Module which is specifically tailored to the needs of services aimed at containing a pandemic outbreak. The module can be put to use right away for all the applications I just listed.
In pursuit of growth in America
Jo: Angelos Angelou, founder and CEO of International Accelerator in Austin tells European start-ups that they need to grow in the U.S. first before attacking any other foreign markets. Would you agree with that?
Vincent: Well yes, of course. You have a homogenous market here with 300 million people. You can reach all of them in English. Legislation, at least as far as it applies to what we do, is pretty uniform across the different states. So for the same investment in marketing you will yield more results on the American market than you do in Europe.
Jo: Does the cultural difference between the U.S. and Europe affecting how you operate in this market?
Vincent: The culture is of course much more entrepreneurial in the U.S. Hospitals are more open to working with vendors. So I would recommend that European entrepreneurs use their home market as a lab, a playground so to speak, where they can test things out. Once the product / market fix is completely tuned, they should try their luck in the U.S.
A pivot from serving hospitals to pharmaceuticals
Jo: I will always advise clients to not just try to conquer ‘the’ American market but to slice it up in different segments and focus on one segment at a time. What route to growth did you take in the U.S.?
Vincent: It took us some time to figure out what would work. First we tried to enlist hospitals, but that proved to be impractical. Each hospital has its own purchasing department you must deal with and that simply did not work. So then we pivoted and started focusing on pharmaceutical companies, to offer them PROs and real world evidence.
People will sometimes conflate PROs and real world evidence, so let me explain the difference with an example. If a patient reports that he or she is no longer feeling a stomach ache after taking medication, the absence of the stomach ache is a PRO. Real world collection is anything the patient will report beyond the PRO. This can be self-reporting (the amount of hours slept for example) but it can also be data that is fed into the system through a wearable device, so it could be monitoring a patient’s heart beat. Andaman7 can collect data from both Apple and Android devices although I have to admit that everything runs a bit smoother on Apple.
Jo: As a Belgian company in the United States you will have been eligible for support by AWEX, the Walloon agency responsible for trade promotion. Were they of any help?
Vincent: I am very happy with the support we received from AWEX. A grant we obtained through them actually allowed me to hire a full-time marketer, so yes, that made a big difference. AWEX also helps us be present at the trade shows that matter the most to us, HIMSS for example, where they buy space and allow us to plug into their booth.
Of course, I think it would make sense to integrate FIT [The Flemish counterpart of AWEX, Jo] and AWEX and create some economies of scale. Belgium is a small country, I am not sure whether having these two agencies work next to one other makes much sense.
Jo: To which degree is the country brand of Belgium a help to you?
Vincent: It helps a little bit. Some people have visited the country, that creates some rapport. But the country brand does not move the needle for us.
Jo: If you were to give advice to Belgian and other European entrepreneurs about launching in the U.S. what would that advice be?
Vincent: The best advice I can give is that prior to opening an office in the U.S. you need to be there regularly. Travel to the U.S. and expand your network. Use the resources that are available to you like the Chambers of Commerce. The many accelerators are another example. We ourselves are part of JLabs, the Johnson and Johnson accelerator which offers us a tremendous amount of know-how and contacts. Don’t try to do everything all at once. Yes, it is good to be very ambitious, but you need a lot of focus as well.
Jo: Are your American customers that much different from your European ones? Vincent: You need to talk numbers and get straight to the point with your American counterparts. Even in the health sector it is all about money. So how are you helping these medical providers actors maximize a profit? The answer to that question is the crux of the matter.In Europe, talking business with hospitals is taboo. They call themselves ‘not for profit’ and reject a business discourse, which is of course very hypocritical because they are also concerned with their bottom line. Half of the hospitals in Belgium are in financial trouble.
Did you enjoy this interview with Vincent Keunen?
You might also like our interview with Angelos Angelou where he talks about why European start-up companies would do well to move to the United States as soon as their product or service is ready.