Scouting Report-CirrusMD: Effective Physician-Directed, Text-Based Virtual Care

The Driver:

On March 31, 2021, CirrusMD raised $20 million in Series C funding and is set to grow and expand their mission of bringing physician-directed virtual care services via a telehealth messaging platform; connecting patients directly to a real doctor in less than 30 seconds. Securing a VA contract and including telemental health services (with a continuity based healthcare plan), CirrusMD is quickly answering the surge in demand for telehealth services at a competitive price point. The firm’s latest round of fundraising was led by Blue Venture Fund, with participation from 7wireVentures, Drive Capital and the Colorado Impact Fund bringing the total funding to $45 million according to PitchBook.

The Entrepreneurial Insights:

Changing healthcare is a very slow process for a good reason, if you break something in healthcare then people get broken.
In healthcare you want to be a camel (not a unicorn). You need to be ready to go long distances with very little water.
Entrepreneurs need to favor intelligent design over show of hands. Intelligent design is more important than user testing/feedback etc.
Be ready for the entrepreneur dilemma: am I on the right track or is this not being executed properly?

The Story:

CirrusMD, co-founded by Blake McKinney, an Emergency Room (ER) physician. We spoke with Blake McKinney, MD co-founder and President of CirrusMD to get his perspective on the company and the company's growth trajectory going forward. He stated the idea for the company was crystalized when as an ER doctor he noticed that patients were experiencing long wait times which resulted in frustration and communication gaps. The large majority of these were situations where patients didn’t need to go to the ER or were in the ER only because they could not get the correct treatment earlier. Overall he was seeing preventable issues, which ultimately resulted in patients being treated at a high cost site or for a preventable condition putting an increased burden on healthcare services and professionals. Dr. McKinney also noticed that many patients do not have access to a medicinal expert in their inner circles and aren’t able to distinguish whether their problem requires an actual ER visit or a visit with a primary care physician. Colorado-based start-up, CirrusMD, is a telemedicine platform that uses text messaging to allow patients to directly text a doctor to determine if ER services are necessary. CirrusMD eliminates the concept of a virtual “waiting room” altogether because they quickly connect a patient to their doctor within 30 seconds (and are contractually committed to responding to patients in under 60 seconds). This automatically boosts patient satisfaction, eliminates unnecessary ER visits (driving down healthcare costs and associated costs). More importantly, patients are subjected to timely care and treatment; improving health outcomes overall. According to McKinney primary care volumes are currently up 200% year-over-year mental health volumes are up 300% year-over-year with revenues currently doubling year-over.

The Differentiator(s):

Since texting is asynchronous, CirrusMD doctors can effectively handle 10-12 patient encounters per hour (vs. 3-4 for synchronous video or telephone visits) allowing CirrusMD doctors to efficiently manage much higher patient volumes. While the large majority of visits are resolved by text, the CirrusMD does have the ability to handle video telemedicine visits, though that happens less than 5% of the time and tends to be where state laws mandate a video visit for it to be counted as a telemedicine visit. McKinney also noted that texting can be a very effective diagnostic tool as doctors can come 85% closer to the patients’ diagnosis just by listening to the patients through text (before touching the patient or taking clinical assessments). He noted that “it is not about severity every time, often it is about promptness” optimizing text messaging is a way to immediately begin diagnosis and care delivery thus facilitating quicker treatment. For example, text compares quite favorably with patients visiting an actual ER doctor at a brick-and-mortar facility where patients often spend hours waiting before actually being seen and eventually diagnosed. In addition, McKinney stated that CirrusMD had specifically rejected the idea of online waiting rooms as they can cause frustration for patients and negatively impact the patient-physician encounter. Similarly, he felt that the industry had done itself a disservice by employing chat bots to triage patients as it creates a negative experience for patients and can impact the patients level of trust in the care they are receiving. Importantly, while some studies have indicated that telemedicine and virtual care can actually increase the cost of care by requiring in-person follow up visits, CirrusMD reports that their resolution rate is at 83%, meaning that patients who have seen a CirrusMD clinician do not touch a brick and mortar physician within 14 days.

The Big Picture:

CirrusMD is a true telehealth platform that demonstrates the efficiency for both patients and providers of asynchronous care. For example, McKinney noted that Target Corp. was a client and his doctors will often have visits initiated by employees at their convenience, like while they are on breaks or other times that would not be conducive to scheduling video or telephone. Examples like these showcase a value-based approach to healthcare that can allow for best practices (convenient easy-access, rapid attention to an issue when it first presents resulting in more appropriate, lower cost of care). Moreover, by allowing patients to chat with a doctor at home or work on their own terms, visits to high fixed cost facilities can be eliminated, as can the burden of transportation and time away from other responsibilities. Not only does this result in happier and healthier patients, ultimately this leads to doctors reporting higher levels of job satisfaction as well as spending more time on direct patient care and less on administrative tasks.

CirrusMD Announces $20 Million in Series C Funding; Telemedicine Startup CirrusMD Raises $15 Million to Connect Patients with Doctors