Parents of young children are painfully aware of how often their kids are exposed to germs at daycare, school, the playground, storytime, etc. In fact, it’s estimated that children under the age of 6 average six to eight colds per year–from September through April–with symptoms from each lasting roughly 14 days.
Dedi Gilad, an Israeli entrepreneur and father of two, was at his limit. He says it was a nightmare when his eldest child went into kindergarten. Gilad and his wife repeatedly ended up going back and forth between their Tel Aviv home and their pediatrician’s office, in what felt like “every other week,” Gilad says.
Most of the time, it was a mild issue that didn’t require hospitalization or even medication, but still, the concerned parents wanted a doctor’s sign-off. There, sitting amid a crowded office of sick kids “sneezing all over you,” says Gilad, he envisioned a better, less irritating solution. He wanted something that cut down on the hours spent to and from a clinic, but also mainstreamed the entire process for a working parent.
“It really takes such a long time, and you know it’s going to end with a very simple resolve by a clinician,” says Gilad.
Gilad previously led technology organizations and interdisciplinary R&D groups in Israeli healthcare, so he decided to lend his experience to what was slowly driving his young family crazy. “I have an engineering background,” he says, “so I asked myself: How can we do this differently?”
Making Doctor Visits Virtual
In 2012, Gilad and former colleague Ofer Tzadik cofounded Tyto Care, a telehealth company reimagining pediatrics with a portable device for parents to inspect their own children, then loop in a doctor to analyze the results. The $299 kit consists of a modular device with a stethoscope, otoscope and special camera, which can survey the heart, lungs, ears, and take high-resolution pictures of the mouth and throat, skin, and eyes. The device also features a built-in thermometer and pairs with an app that offers a symptom checklist and guides users through securing the best images and recordings.
Tyto Care basically allows the average consumer–untrained and without any medical background–to run the technical basics of a pediatrician visit (stick out your tounge and say “ahhh”) at home. The user then shares the images and recordings with a clinician who handles the diagnostics via video chat. The kit received FDA clearance in late 2016.
“In 90% of cases, it’s very simple symptoms for which [parents] usually schedule an appointment with a clinician, often two days later,” explains Gilad, who now serves as Tyto Care’s CEO “It’s not urgent. For this kind of situation, Tyto Care can be a perfect fit because you do the first vetting.”
At the same time, Tyto Care is not recommended for situations in which children have an extremely high fever or show severe signs of distress. The app clearly recommends when kids should go straight to the hospital, and stresses that parents use their own judgment.
Tyto Care is not a full telehealth service. It does not offer the physician network; rather, it’s a technology that can be bought by consumers whose doctors have already subscribed to the service. Basically, Tyto Care is a B2B-to-C company that simply offers the technology and provides the remote handle. In that sense, services vary depending on one’s health plan. Currently, telehealth is reimbursed by most plans, and Tyto Care consultations are charged as simple doctor visits. Some plans additionally cover the $299 initial kit cost.
Krista Oliveira , a mom of two in Long Island, New York, says she frequented her pediatrician “pretty much once a week or once every other week” for six months in 2017 when her 2-year-old daughter suffered from recurrent ear infections. The constant medical care took a significant toll on her schedule, which required her to travel an hour each way to the doctor’s office.
When her doctor recommended Tyto Care, Oliveira quickly jumped on the opportunity, despite her husband’s initial concerns. The pediatrician assured the nervous couple he had vetted the technology, which requires a dose of parental “common sense,” she says.
“It’s been awesome,” raves Oliveira, whose “visits” are now reduced to 10 minutes. “It also made me more proactive with [my daughter] and really understand what you see when you look at [a child’s body]. It makes you a little more intuitive.”
Battling The Stigma Of “Telemedicine”
In the last year, Tyto Care grew to 65 employees and established offices in both New York City and Tel Aviv. Gilad says that the startup plans to grow other budding verticals: TytoClinic will essentially transform offices, schools, and nursing homes into remote clinics through an expanded collection of inspection tools (like a blood pressure cuff), with an emphasis on rural areas and flu-ridden school sites. TytoPro is a more comprehensive package designed specifically for clinic professionals that need higher-res, longer-lasting equipment (with such features as an extended battery life). TytoHome, meanwhile, services the chronic population, such as kids with asthma, patients with chronic obstructive pulmonary disease (COPD), or individuals living at home with disabilities.
Tyto Care is also adding more capabilities–to both the device and the app–in an effort to replicate a doctor’s visit. “The vision of the company is to really take primary care practice from face-to-face to remote,” says Gilad. Already, the company has several new device attachments and FDA-cleared sensors in the works, which it will reveal in the coming year. In addition, Tyto Care has conducted three clinic studies, all pending acceptance in publications.
Data is another area of focus as Tyto Care collects information from ear, throat, and sound exam recordings to create a data platform. Exam data is sent through an encrypted secure network and is stored on a HIPAA-compliant cloud. This database of basic symptoms will eventually be leveraged by machine learning to provide clinicians with patient insight, and, as Gilad explains, to fulfill a rather lofty company evolution mission: bring diagnostic-level testing to the home.
“It might not be a full diagnostic, it can be decision support–making the interaction much more effective and giving insights for the clinician of where to intervene,” says Gilad.
As words spreads of its use, Gilad hopes more employers will invest in the kit in an effort to reduce time spent traveling to clinics. Still, for Tyto Care to effectively compete, it needs to battle the stigma of telemedicine, which is still viewed as “less than” a traditional doctor’s visit. A recent survey found that nearly half of consumers would feel less comfortable during a telehealth visit versus an in-person diagnosis, while two-thirds weren’t even sure telemedicine was covered by their insurer.
“The first year was to prove that this technology can work flawlessly and very effectively and can be integrated into the system,” says Gilad. “Our challenge is how to push growth in this market, to really start showing a larger level of utilization in adoption.” Ultimately, he explains, “we are controlled by the pace of the health organizations.”
Since its FDA clearance, Tyto Care partnered with 35 American health organizations, including established names like American Well, Miami Children’s Health System, and Allied Physician’s Group. In Israel, the service is carried by Clalit Health Services, the country’s largest healthcare provider.
Moving forward, the cofounders have grand plans for Tyto Care. In January, the company announced it raised $25 million in its most recent funding round, led by Ping An Global Voyager Fund, an investment offshoot of China’s largest insurer. (Other investors include Cambia Health Solutions, Walgreens, Orbimed, Fosun Pharma, and LionBird.)
Tyto Care may have begun with children’s medical care, but expansion goals cover a wider variety of patients, ranging from the elderly to the average cold-ridden patient. The company also wants to venture into more countries in the coming years in order to make the doctor’s visit a little less painful for everyone on the planet.
“Our main focus is the youth market, but we are gradually growing outside of youth,” stresses Gilad. “We are not a service just for children, we’re [catering] to all.”