With over a million patients under his belt and over $10 million raised in funding, Egyptian entrepreneur Amir Barsoum is now taking his healthcare app to Jordan and Lebanon. In a talk with Valentina Primo, the founder explains how they digitised one of the country's most underserved sectors.
If we read between the lines, what can the story of Vezeeta - the HealthTech app that ranks as one of Egypt’s most successful startups - tell us about the Arab world’s most populated country? The answer, according to its founder Amir Barsoum, is opportunity.
“The problem healthcare markets in the Middle East are facing is that there is no protector for the industry. If you look at healthcare in the US, insurance companies are the protectors; they guarantee that there is no abuse and patients are well treated, while for markets like the UK you find it’s the government doing so,” says the entrepreneur. “Here, patients are left on their own and that ends up in abuse, in careless treatment and overpriced or severely under-delivered treatment.”
In a country where public expenditure on health in terms of budget stands at 5 percent of the GDP, according to WHO, and out of pocket spending rises to 62 percent, his startup, Vezeeta, is striving to take on that role, allowing patients to book and rate doctors based on the quality of their visit.
Founded in 2012, the online platform has been making waves not only in the Egyptian startup scene but also regionally, having expanded to Jordan and Lebanon. With 5,000 physicians on his platform, and 110,000 bookings per month just in Egypt, the startup raised $10.5 million in funding and was listed as the Middle East’s top 5 startup by Forbes.
Barsoum, whose experience in healthcare spans from McKinsey consulting, to multinational pharmaceuticals like Astra Zeneca, co-founded the company - initially called Dr. Bridge and focused on B2B- with Ahmed Badr in 2012.
“At the time, it was purely focused on building medical records, solutions and software to clinics and private doctors,” he recalls. But surprisingly, the B2C brand ate up the B2B brand, he explains. “If you really want to drive the train at rocket speed you need to make sure that the main beneficiaries are the primary beneficiaries, those who have the biggest pain. That’s why we launched the B2C; but we never thought for a bit that it would be this successful,” he recalls.
Despite the difficulty in getting the first customers, the entrepreneurs broke into the industry by working very closely with physicians. “The sweet spot of the business is the consumer and the tough spot is the B2B,” Barsoum says. “I guess that’s the biggest reason of our success; we are really strong when it comes to educating doctors and healthcare providers and getting them to use our software, while building a product they like using. After the huge wave of car-hailing app firms like Uber and Careem entering the market, this has educated most of the market on using technology, and indicated to them that there is a value there not to be missed.”
How was the process of getting your first funding round?
I guess we are very lucky. We started in April 2012, two co-founders and a venture capital which was basically TDF (Ziad Mokhtar and Tarek Asaad). We told them we had this idea in mind; that we were going to jump ship from our senior corporate roles, but that we have families and we needed to have salaries. We told them we we’re going to invest big sums from our own pockets but that we also needed investors with us. We got $1.3 million from them and $300,000 from us, so a total of around $1.6 million.
What do you think was the turning point where it started booming?
I guess we put aside revenues for while to focus on adoption, and just started thinking about what business model and what product would start making users, whether they are consumers or patients. I guess that was the true turning point: we moved to a pay-as-you-go model rather than having flat fees to the doctors, which added a massive number of doctors. The second big thing was going mobile-first, which made a huge difference in our path to creating very serious momentum in the business.
You probably know the healthcare industry like few others in the country. What would you say is the main challenge?
The most pressing challenge - and what the government is also thinking about very seriously - is the lack of serious insurance platforms that actually help guide patients through healthcare. It is a hugely out of pocket industry; most markets have already emerged beyond this point. You need insurance firms to build a mature industry in healthcare specifically.
Insurance is a must and it’s a big thing, I am very happy hearing that the National Insurance Law is going through, lets see how its execution goes because execution is very difficult. The other big problem is we always say that healthcare providers (hospitals, diagnostics, doctors) are not close to each other in their quality. You can find some of them that are top elite global standard level and others who are really, really bad - there is nothing that really standardises the quality of healthcare providers, and this is the other major problem.
Any industry needs what they call the protector. This is why we believe in the role of Vezeeta; by introducing rating and reviewing we’re actually empowering patients because it fills in as the protector for patients to access healthcare respectfully, rightfully and efficiently when it comes to the cost.
Egypt has a very particular social landscape. How would you illustrate the health spectrum; how do you think they are managing to cover the needs of 100 million people and growing?
About 60% of the market is private, but the rest of the 40% is mostly tertiary capped; so oncology and things like that, you would see it more like 80% to 20%. Egypt is a highly populated industry; you know one interesting statement is that you can make more money here if you are a healthcare provider in a low socioeconomic area than a high one? Despite the ticket of the visit is much cheaper, you could make like 50 visits a day in a low-income area. But in Heliopolis or Mohandessin or Zamalek you would make 10. So at the end of the day that’s another way; high population serves well to still provide healthcare to the poor because of their numbers.
And it doesn’t affect the quality of the visit?
It definitely does, but at least they get access. Most doctors in Egypt, where we have 110,000 private clinics, 20% of those are in socioeconomic areas A and B+, the vast majority are in the B, B-, C, D and lower.
You recently launched in Lebanon and Jordan, and are now looking at Saudi Arabia. Was it difficult due to the cultural differences?
We look at our business from patient culture, healthcare provider culture and industry landscape. So I would say Saudi is very similar when it comes to the first two culturally (patient and healthcare), but with differences when it comes to the industry landscape. They have a mature insurance business, and much more advanced hospitals. When it comes to Jordan, I would guess the industry landscape is very similar, but interestingly enough, the patient culture is very similar and the healthcare culture is very different, so they are more advanced, more techy. In Lebanon, the industry landscape is like copy-paste form Egypt, but the culture of the patients is very different.
What were the obstacles to entering those markets?
People, talent. This is the biggest obstacle for startups, I remember my days in AstraZeneca I’d go to my office and I’d have one medium-size decision each day and every month there is one big decision. But at the Vezeeta office, everyday I have like 7 to 8 big decisions and like 30 medium sized decisions. So if you ask me what is the biggest thing, it really is talent; you want somebody who would be capable of evaluating the different options in every decision and be able to decide which of them to take.
You focused on growth early on; what is your goal now?
I guess it’s the same, growth remains the primary objective for us but I would guess another very important objective is to make sure we are solving more pains. We are coming very serious about the waiting times at clinics, very aggressive and very serious; we are investing a lot of time and space. We are also coming to play a lot in the services and operations sector, which is a big ticket when it comes to the healthcare spending of patients, so we are beginning to introduce discounted offers on that. Also, the rating and reviews on that the doctor doing this particular service in this hospital, so how much money you can get and what its rating is, is also another very big thing we are coming to the market with this year.
The fact that one of the most successful Egyptian startups is in the healthcare industry is unique and has a huge impact. What does that say about the change that startups are bringing to the country?
It’s super exciting; you see the social impact and you see how you are transforming the way people find doctors, whereas before they would ask their families or parents, while now it can take them just one minute. When we initially started we thought: you know what? This is not a company for branding; we are here to fix a problem in healthcare. We though that most probably, because we are operating in healthcare, nobody would really talk about it. But I think the severity of the the pain we’re solving is the reason the company has grown.
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