Episode 6

How a Personal Health Experience Led Crystal Adesanya to Launch Kiira

The telehealth service gives primarily college-age women access to physicians and healthcare professionals, 85% of whom are people of color.

Picture courtesy of Kiira.

Shereen Abdulla

Podcast Host

Published

17.03.22

During her college freshman year, Crystal experienced severe abdominal pain. Facing finals and unable to quickly get into the school clinic, she resorted to googling her symptoms, but an erroneous diagnosis landed her in the hospital. 

That unfortunate experience became the genesis for Kiira, a telehealth service which gives primarily college-age women access to a network of physicians and healthcare professionals. 

On this Rise of the Next episode, Crystal talks about her journey and what differentiates Kiira from much larger telehealth companies–one being the fact that 85% of its clinicians are people of color. 

Subscribe here to episodes of Rise of the Next on major streaming platforms.

 

TRANSCRIPT

Shereen Abdulla

Crystal, welcome to Rise of the Next, it’s wonderful to have you on the show.

Crystal Adesanya

Awesome. Thank you for having me, Shereen.

WHY CRYSTAL’S FOUNDED KIIRA

Shereen Abdulla

My absolute pleasure. So, the focus of today is to tell everyone about Kiira Health, which is a company that you founded out in the US having moved there from Nigeria. And I believe that Kiira was born out of a health experience you personally went through in college — why don’t you tell us what happened?

Crystal Adesanya

Kiira was, like you said, built out of a personal health experience, and it’s all about increasing access to resources for young women, because of something that I experienced that I know is very common amongst young people, regardless of where you’re from or who you are. A big experience for me, being a young college first-time goer that was away from home for the first time, experiencing new things and really navigating school, which is — the first reason why you’re in school is to be successful and graduate and all of those things, but also, it’s a new environment and experience where you can’t have health issues. And, a lot of times, we’re not equipped for those things because we’ve never really navigated healthcare independently.

So, my experience is very common in the sense that I didn’t quite grow up talking about health issues or talking about women’s health, specifically, and things like that. I come from a super conservative background, so not a lot of information in regards to what could happen to you in certain situations.

So, in that time, I was recently sexually active, in a new place, and just started googling all my symptoms because, well, Dr. Google was the cheapest and fastest way for me to get health information. One specific time, when I had pain in my abdominal region, I went to the health center at the time, at my school, to book a visit, and I couldn’t, and it was right around finals — which, as you know, if you’re a college student, that tends to be a very busy time — and I didn’t quite have the time to go back and find a physician and all of that stuff. So, I just went back to Google and I found a solution, which I ended up self-medicating for.

And a few days after self-medicating for that, I had extreme pain in my stomach, and I actually passed out and was rushed to the hospital for emergency surgery for a condition that was very different from what I was Googling and self-medicating for. So, being an international student, there are a lot of complications that come with being away from school for a long time due to a medical reason. So that did affect my academics to the extent that it did. And then, coming out from that experience, I started really asking questions. So, a lot of people who are my age, my peers, around what is their experience with their healthcare, and learning in that process that there’s this resource and that resource, and I was like, “Why didn’t I know about these things?”

And it came down to a couple of things around lack of access being a big problem, but also, being a person from a diverse multicultural background, not quite having that representation in the health center, as well, was a big problem. And, through my customer discovery, the whole question just became: how do you improve this situation and solve for this problem by really connecting folks to doctors that they can talk to and answer questions instead of Dr. Google?

So, we developed this app that was essentially very simple. It was like a ask-a-doctor type app where you could chat with an expert and answer the questions that you have. Mostly health educational resources, but pointing you in the right direction versus just Googling and finding everything from cancer to all the ridiculous things you can find.

So, like I said, when we first launched, we started the ask-an-expert platform. Essentially, we had launched this product in 2020, in the beginning of 2020. And, this was around February, we did a launch party around introducing this to the public after doing a 2,000 patient pilot program in the previous year. Then, a lot of the feedback we were getting from our users was, “Hey, I want to order prescriptions. I want to talk to the doctor,” beyond chatting, beyond the text pieces. So, we did have it in our roadmap to develop a virtual clinic, just to solve for that problem, which is access to health care 24/7, so that folks are not left by themselves and Googling at nighttime, but instead, they can talk to a provider at any time of the day.

Covid, I would say, was a huge catalyst around accelerating the emergence into the virtual care space as a telemedicine provider. So, what happened — as a team, we decided now we have to build our own telemedicine platform because our users are asking you to connect with doctors and get prescriptions and things like that. And, it was at a time when a lot of the reasons why our young population was seeking care through Kiira were termed as non-emergency, non-essential, so you would really not even be able to go into a clinic or health center to seek that kind of care. So that was the big reason why we decided to do this.

So, our team ended up building our technology platform for telemedicine in-house and we developed this new version of the app that included chat and visits. One of the big things around going into telemedicine is that we had to be licensed in different states to be able to provide care for our users. At the time, we were licensed in, I believe, New York, and then we got licensed in California, and as of today, we’re licensed in about 35 states in the US. So, we’ve grown rapidly around being at the places where the people who need our product are — and the big reason why we did that was because we were thinking through a lot of young people, specifically students that we serve, were traveling to different places to seek — I guess, I wouldn’t say seek care, per se, but to study with the changing dynamic around covid and virtual learning and all these things. So, as they’re going to different places, when they do need care, they need to be seen by providers who are licensed in the state where they are.

KIIRA’S TARGET CUSTOMERS

Shereen Abdulla

Kiira targets young women specifically — what age range would that be?

Crystal Adesanya

We do target young women in college and beyond, so within the ages of 18 and 30. The reason why we decided to start with that age range of 18 and college was because we really believe in the idea of catching people young. How do you introduce positive experiences of health care into a young person’s life so that they can develop the habits of advocating for themselves, seeking care promptly when they need it, getting education around their care that is not necessarily only related to sickness but more preventative care and wellness, and things like that? So, our goal, essentially, is to start at that age and continue to work through the different life cycles of a person, and find ways to, when they graduate, they continue using Kiira, and then when they get to their first job, they use Kiira, and then when they have the first baby, they use Kiira, and continue to go that way. That’s the way we decided to capture that demographic and make a real positive impact.

HOW KIIRA IS DIFFERENT THAN OTHER TELEMEDICINE PROVIDERS

Shereen Abdulla

I would have just missed your upper age limit to be called a young woman. *laughs*

Crystal, the telemedicine market in the US is dominated — big names like Teladoc, MDLIVE, Doctor on Demand, Amwell — they all would have also experienced an uptick in visits because of the pandemic around when Kiira was established in 2020. How does Kiira compete?

Crystal Adesanya

So, there are a number of things that you touched on there. Yes, telemedicine did expand and explode during the pandemic and there have been a lot of bigger players in space for a longer time. And the big thing is — I have a lot of respect for those folks because they’re the pioneers for this work that we’re doing. Getting telemedicine into the hands of people has been a challenge for a number of years. The adoption was slower back when they had started, when people did not feel as comfortable talking to their doctors, viewing their phones, for example. A lot of people are used to going to see a doctor in person, and things like that. So, it’s changing that behavior, which had been started by these players that you mentioned, which is helpful. And then, in the pandemic, people didn’t quite have a lot of choices around seeking care. Like I said, a lot of those things are termed non-essential, so you’re not walking into a clinic to ask for birth control anymore, or walking into the clinic to say, “Hey, I have a slight headache,” or whatever it is, because of the risk of getting Covid.

So, there was a lot of adoption from the medical side with physicians feeling more comfortable doing telemedicine visits, as well as users now learning this new method of seeking care that is convenient, whenever and wherever they need it. So, I think that paved the way for a company like ours to really play in this space. However, we are focused on women’s health, and our goal is to increase access to health resources, specifically for multicultural women. What that means is, the differentiator so to speak between us and any other telemedicine company within those spaces, like the ones you mentioned, is that there are broader, general telemedicine resources for people. Ours is this specific demographic; I try not to call it a niche, per se, because there are many things that we do within the space, but we are very focused, and focused on things that include human and culture-centered care that go beyond just “Hey, see any doctor.” It goes to a place of: Who do you want to talk to? Who do you feel comfortable talking to? How do you talk to providers who understand the racial, social, and cultural nuances of healthcare? And how do you make sure you’re creating an environment that is safe for them.

Technology is a big piece of it, but the service is itself. So we turn ourselves into the more high-tech, high-touch; meaning that we are providing a high-level of technology in our services and a seamless method of signing up, going through the platform, doing your health assessments, doing all those things and developing a habit of seeking care. Also, coming there and being like: oh, wow, I see doctors that look like me that are on this platform that have the same types of experiences as myself as well; who might not look like me but are trained to culturally think through the way they address me; the way that they ask questions about my health and gain trust in this relationship. But I think those are the bigger things that we’re focused on that go beyond just the delivery of telemedicine itself.

KIIRA’S TARGET MARKET SIZE

Shereen Abdulla

And how big is the market that targets young women, let’s say the ages of 18 to 30, as you reference them?

Crystal Adesanya

So, we discussed that, based on the reproductive health range, you can go down from 15 to 34 and beyond. So, opening that a little wider. Our focus for young women in college is specific towards that college age, and there are, I believe, about 5,000 colleges and universities in the US. There are about 20 million students and 56% of those are young women, with colleges having a majority female population. In the world, that’s the balance and the way we look at it. So, that’s how we look at that demographic, specifically, as we target those folks.

And, like I said, there’s this — when we think about the women’s health market, it’s a 40 billion dollar market, and that’s just scratching the surface. And for us, we’re capturing that early demographic as well, as they grow into different stages, from a preventative perspective. So, it’s not geared towards the demographic that has been detailed for a long time, which is more pregnancy, postpartum, and fertility, those types of things. That makes the market really large for us when we think about Kiira really being a market leader when it comes to working with young people, specifically because, I believe, that’s an area that folks have not spent a lot of time in, and tends to be overlooked and underserved. And, yeah, that’s where we’re playing.

KIIRA’S MARKETING STRATEGY

Shereen Abdulla

Speaking of targeting and capturing this group of young women, how do you market to them?

Crystal Adesanya

So, it’s a couple of things. We don’t actually market directly to college students; we have relationships and partnerships with the colleges and universities themselves. The question — a lot of times in healthcare it’s: who’s paying for your service that you’re providing the population. And the reason why a lot of people tend to shy away from that college young age is because they’re like, “A college student, doesn’t want to buy a health care product or service, they would rather spend it somewhere else, and they would rather wait till they’re sick and they’re really crawling and dying, like in my case, before actually seeking care a lot of the time.” I would say that is a lot of the time, but not all the time, because these days we see a lot of young people who are truly advocating for themselves, and that is what we leverage in our networks to spread the word about Kiira internally within campuses. But the main customer, in the sense [of] who is buying this product, is the college and university themselves. So, we provide Kiira as a solution that is working in tandem with college health centers and college administrators to improve the way they deliver care to their students. That is the way we think about who cares about this population and who would want to pay for a service like this to be delivered to a young person.

The reason why we officially have kiirastudenthealth.com, which is our student health platform, and we have Kiira Health — kiirastudenthealth.com is geared for colleges and college students, specifically, and the idea around having the two products came from a place of there are people who don’t go to the schools that we’re partnered with who want to use this service, or different schools. We’ve had people that come and be like, “Oh, we don’t have — our school does not provide here, we don’t see it on your list, but I want it.” And we typically will tell them, “Yes, you can get it by becoming a member on your own and subscribing to one of our plans.” So that’s the way we’re able to still capture them. And with the changing landscape of telemedicine and visits, and even college itself, like college health, a lot of people are not going to college as they used to. A lot of people are taking semesters off, or graduating earlier, or whatever it is, because things have changed and how you receive learning has changed a lot within this period that we’ve experienced as a nation, as the planet, at this point.

So, when we think about it, how do we continue to capture those folks, even if they’re not in the colleges that we’re partnered with, or they’re not in school at that time? So, they can also use Kiira Health by themselves to continue working with the physicians that they’ve grown to trust and love, and everything else. And their friends who are in schools that we do not offer it to can gain that level of care that they’re raving about.

KIIRA’S STUDENT AMBASSADOR PROGRAM

Shereen Abdulla

I believe there’s a program Kiira runs called the Kiira Student Ambassador program — how does that fit into this model that you just described?

Crystal Adesanya

Yeah, so it goes back to the reason why we have Kiira student health as a product, and when we work with a college or university we do job postings for the ambassador program, and a bunch of different things that give their students access to mentorship and resources, and things like that. Also, like I said, there is a growing squad, so to speak, of young people who are true advocates for their own health.

HOW KIIRA BUILT ITS NETWORK OF PHYSICIANS

Shereen Abdulla

Now, as far as the providers on the Kiira platform go, what was the hardest part of building a network of providers? And, by the way, are they all OB-GYNs? 

Crystal Adesanya

So, no. On the care platform, we provide primary care, gynecology, and mental health resources. A big piece of what we were able to do in the beginning — like I said, we had started with a platform where folks were just answering questions. So, as an entrepreneur, as a founder, I spent a lot of time talking to physicians and clinicians, so to speak, and asking them, “Hey, would you want to provide this type of education and care to this demographic?” And you would see that a lot of people who are physicians, or would be doing this type of work from an impact perspective, as well. So, it goes beyond getting paid to deliver. Care is more like, “I want to be part of changing the future of health care for young people and I want to be a part of Kiira to be able to do that.” So, that is the initial driver for a lot of them, and what we saw during the pandemic, when we went beyond the chat piece, was a lot of clinicians who are looking for a better work-life balance, and folks just thinking through. If you have any friends who work in the health space, you would know a lot of them were doing travel nursing and all sorts of things in the pandemic. And that goes to tell you that a lot of them were looking at one, to make more money, to do it flexibly from wherever they wanted to. So, Kiira is one other option for them — we bring on those clinicians as independent contractors and they can work at any time they provide us with their schedule, and things like this. So, it was flexible in that way. 

However, we did see a big uptick in people signing up to become Kiira clinicians. We saw hundreds of applications at the beginning of the pandemic, and for us, it was like: woah, okay, now we have to make sure we’re super selective of the types of clinicians that we want on our platform, as well as making sure we are matching, based on, like I said, a lot of the pieces include — 85% of our clinicians are black or brown, making sure we’re matching the clinician base to our user base and making sure there is that representation, as well as doing the proper training to bring them on board. So, we use different platforms that spread out, like our job applications for clinicians, all the time. So, it’s constantly running and we’re constantly getting applications for clinicians, but we make sure we’re matching the supply to the demand, and that’s really how we handle it. 

CRYSTAL ON THE IMPORTANT OF BUILDING TRUST IN HEALTHCARE

Shereen Abdulla

Interesting. Speaking of the demand, how do you build trust among prospective users?

Crystal Adesanya

I think, yes, a big aspect of getting folks to use your platform is trust, and the way we’ve done our own homework to ensure the trust is making sure, like I said, we have that representation and the types of clinicians, and we provide resources that are beyond the actual care. A lot of people come to the care platform to get educational resources, read our blogs, and learn about how to do different things. We also have a podcast called The Kick It with Kiira podcast, where we share information about your health and about general things that are happening in the Kiira ecosystem. So, when you do come on the podcast, it’s not like — oh, this is a group of doctors who are going to take care of me and that’s it; but it’s like, these are real people that I can relate with and communicate with and learn from in that respect.

So, when it comes to our messaging and the way we inform folks about how to take care of their health, what to be thinking about, and things like that, and offer up free resources — because, at the end of the day, when you offer free resources to a person and they gain from that, then that gives them more confidence to come and work with your paid resources, and that is one thing that we’ve understood, really well. One of the big things that we do to gain trust is when a person does sign up to do a free trial, whatever, on the Kiira platform, we do a 15-minute health assessment where we go through their health records and find learnings around what is your lifestyle and everything else, and this is not a doctor’s visit, that is more like tailored questions, it’s more like getting to know a person.

And that is something that is a level up from what we see our competitors doing, which is that everything in healthcare seems to be really transactional in nature. For us, it’s more like — okay, how do we learn from you? How do you get comfortable with us? How do we give you advice on what to do? It’s like, okay, have you seen a doctor? Have you ever done a telemedicine visit? This is what to expect. Have you done something like a mental health visit? Do you want us to speak to a therapist? Learning those things about that person in those 15 minutes, and then sending them off on their way with the tools they can use to navigate the Kiira platform, or any other platform, for their health. We realized that once you do that, people tend to be more excited to use the product and then they tend to ask more questions and their curiosity goes up, and then their engagement with your platform goes up, because, like I said, it goes beyond sick care. It’s more about prevention, and education, and everything in between, and I think that’s a big way that we do gain trust in potential and new users. 

KIIRA’S SUBSCRIPTION MODEL

Shereen Abdulla

Crystal, as you alluded to, most of the other players in the market are very transactional in their approach. Why did you decide to apply a subscription revenue model for access to health care?

Crystal Adesanya

So, it’s a number of things. We have a new layer model that we’re developing that even removes one layer of that subscription. The reason why we have a subscription model is to be able to bring the general cost of care and make it lower. So, for example, if a person is a non-member, they will be paying a little bit higher when it comes to the actual visit, versus the members; they get a discount on every single visit that they do. Some of our membership plans do come with visits. So, when you’re thinking about the average co-pay versus the cost of the care of membership-over-cure, that’s where it falls in.

Our membership is not just, “Hey, become a member of this thing, and then pay a bunch of money when you have a visit.” A lot of our membership plans do come with visits included in that membership that you have, be it one visit a month, or two visits a month, or the basic, which has unlimited access to chatting with experts, and then you can pay the cure-a-member fee to be able to do a visit. We think about it that way because there’s a lot of folks who have insurance who are using the care platform as well because we do accept insurance. So, it’s a combination of do you want to pay that c-opay for your insurance or do you want to pay with Kiira. And the way we think about it is for the uninsured and underinsured people who might not be able to gain this type of care. So, if you’re uninsured and you want to talk to a doctor, you can most definitely come on the Kiira platform, gain one of the membership subscription plans, and be able to have access. So that’s a big thing around our reasoning around making sure we had those models for people to choose what works the best for them, be it like, I guess, if they’re frequently talking to a provider. I think one of the examples is mental health; for example, there are folks who want to do a mental health visit every single month, or once a week, and things like that. So, bringing down those costs with those models allows them to gain access to that versus going somewhere else and they have to pay hundreds of dollars to see a therapist. A lot of people tend to not gain access to that because of that reason.

CYSTAL’S JOURNEY BUILDING KIIRA

Shereen Abdulla

And, Crystal, what are some of the challenges you faced building Kiira?

Crystal Adesanya

Challenges, huh? There are many challenges. So, my background is not in healthcare, and my background is also not in tech. My background is in business and econ. I have experienced a lot of challenges when it comes to gaining certain relationships within the healthcare space. One of the big things that I did at the beginning to solve for that was I spent a lot of time talking to physicians, like I said, and gaining their trust and building relationships and credibility that way. In terms of: what is your experience with healthcare today? How are you delivering care to your patients? And how can I build a solution that makes your job easier?

So, because this is a two-sided type of environment when you do need to gain the trust of the clinicians to be on the platform, and then you need to gain the trust of the users to use the platform. It’s identifying the needs of those two people, and that was a big thing. We’ve been fortunate to be able to get a really strong network of clinicians and solve that problem. So, I always say, it is my job as CEO to rally a lot of really smart people to get things done, not necessarily having the degree to do it, because there’s a level of business savvy that you lose when you are in those types of roles, versus when you’re trying to build a company that pulls those great talents together. That’s one thing.

And I guess the second challenge that I had, in the beginning, most definitely, and then this is a challenge that is very common among women, and specifically, women of color being under-funded and overlooked, was: how do we get money to build this company? And, in the beginning, it was very hard. I would say, we bootstrapped for the first entire year and a half, and in the second year, I spent a lot of time doing pitch competitions and getting non-diluted capital to be able to build the app. I have seen a lot of our male counterparts who haven’t built anything as close as we have, or don’t have the evidence or anything like that, who raised a lot of money really quickly. We didn’t have that luxury, and, it became a question of: where do we gain resources and how do we get that credibility? So, doing those competitions and being on those stages allowed me to be able to be in front of people to really speak about what we’re doing. That, in itself, attracted investors and users to us to be like, “Oh, wow, we heard about this awesome thing that you’re doing, and we want to participate, and we want to help you.” So, I really put myself out there, because I realized that there was this huge barrier for a person like me. I checked off all the boxes, I’m an immigrant, I’m a woman, and I’m black. So, it’s a lot more challenging, but I think one of the things that was a good thing for us, post doing those competitions, was participating in accelerator programs, one being 500, and getting credibility that was associated with the program, and gaining those mentors and relationships, and meeting other founders that look like me. I was like, “Oh, it’s not just me, I’m not alone, and we can relate, and we can learn from each other, and we can grow and really hit our goals.” Being in those environments, even, lets you do a lot more than you thought you could, because you’re like, “Oh, this founder is that and we’re in the same cohort? Wow, I want to learn from you.” And then that’s how, slowly but surely, we were able to pass those hurdles, raise some money and really make some impact. So, yeah.

WHAT’S NEXT FOR KIIRA

Shereen Abdulla

And are you looking to expand Kiira beyond the US?

Crystal Adesanya

So, that’s a question that I get a lot of because I’m an immigrant. I think, being from Nigeria — I was having a conversation with someone recently about this, specifically around right now. The driver for Kiira at that stage was a lot of young people who were on their phones and using their phone every day, and not really communicating with the world really, but communicating through their cell phones. When I think about growing up, back home, we didn’t have that luxury, even till today people are not on their phones 24/7 because they have to pay for data, it’s not unlimited, there’s no electricity, those types of things. So, I think there are a lot of hurdles that need to be alleviated first before doing something like this, because then you now think about, “Okay, how do I do this in the meantime, when it’s not — there’s not that connection,” connectivity itself is still a problem. So, just thinking about synchronous and asynchronous methods of providing health care is important, and that’s the way I’ve started thinking about it, at least. How do you make sure folks can gain the same level of care, whether or not it’s being done right away, in front of them, where they are? I see a future where we do extend beyond the US into different populations, but, for right now, we are trying to expand nationwide and then we would have — potentially, we could think about other plans beyond that. But, as of today, we’re sticking to being nationwide first.

Shereen Abdulla

Crystal, thank you very much for hopping on the show and sharing with everyone what the Kiira Health platform is all about, as well as your plans and where you’re headed. I appreciate it.

Crystal Adesanya

Awesome. Thank you very much.

 

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Shereen Abdulla

Podcast Host

Shereen Abdulla has more than 12 years of experience in innovation management and entrepreneurship in the financial and tech industries. She has helped foster startup ecosystems across the Middle East to bring together founders, investors, corporations and government entities, and consulted on corporate innovation. Shereen holds a BSc from the London School of Economics and an Executive MSc from Columbia University.

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