21.06.2021Cyprian Łakomy

Physitrack: A telehealth platform that grew during the covid-19 pandemic

“The remote patient-therapist relationship is here to stay”, says Nathan Skwortsow, CTO and co-founder of telehealth platform Physitrack.

Physitrack enables patients to connect with their physiotherapists, follow the prescribed exercise plans, and track their progress. Prograils has been in charge of the platform’s development since 2018. Now, Physitrack’s co-founder and CTO Nathan Skwortsow talks about growth during the pandemic, the key role of customer service in that process, and future plans. It's a success story!

Telehealth has benefitted from the covid-19 pandemic. Only in March 2020, the number of visits to the four biggest telehealth providers in the US rose by 154%. How has the global situation affected Physitrack?

I would say we have doubled in terms of users and traffic, so it’s been massive! I think the market has gone fast forward 4 years. For example, Physitrack was never present in Italy, Poland, Indonesia, and lots of other countries. All of the sudden, these countries woke up and opened new markets for us. It sped up deal-making.

Due to the pandemic, the remote patient-physiotherapist relationship is becoming more accepted.

You don’t have to be present in the person all the time. It’s enough if you see each other once in a while, and then do your exercises at home.

It’s something that we have seen coming, but what would have taken up to 5 years in some countries.

What was the biggest challenge then for your system during this period?

Many of our users work on old Windows machines, running our platform through remote terminal servers. In light of this, one of our biggest challenges was customer support, training and edge cases. E.g. some hospitals use firewalls that block UDP traffic. We had to organize tech training for them to make sure they know how to use the platform under the new circumstances.

A funny story about one of our customers was that every Friday the connection quality would degrade. He was working from home and we kept asking him about the potential sources of the issue. At last, it turned out that it was when his partner started watching Netflix that the video quality was suffering. Some other users experienced video-quality issues every time they ran the microwave.

Apart from the acceptance of a remote patient-provider relationship, are there any new trends you have observed?

The remote patient-provider relationship is here to stay, albeit in hybrid mode, where a patient will see a provider and their relationship enhanced via an online platform. It’s no longer a trend, but a permanent behavior. Like online shopping, once you get used to the convenience, you will order from the web more often. That’s the best we could hope for.

The more people get used to this hybrid model, the easier it will be for them to adapt to it in case of future pandemic-like situations.

To set covid-19 aside for a moment, how different was the initial business idea for Physitrack from what it has become over the years?

That’s what we think about now and then. In the beginning, it was about saving time, happier patients (because of the improved quality of instructions we give them), and improving their adherence. The first one is no longer a benefit we emphasize, but we do like to highlight the other two. Further, it’s been clinically proven that Physitrack helps improve patient adherence.

Telehealth has become an important part of our platform, as it enhances the hybrid approach that we offer.

An honest answer is that the fundamentals, such as pricing and features haven’t changed that much. We haven’t pivoted, if you will, into a different type of company.

Did any particular technology matter when you were choosing the tech stack?

I liked the elegance of Ruby after having worked in Perl and PHP on previous projects. Ruby on Rails was (and still is) a mature and popular framework, and therefore became a logical choice. For large applications, common knowledge dictates that if you’re not using a framework, you’re writing one.

To sum it up, it was the availability of Ruby on Rails developers and the popularity of the framework itself that made us decide on it.

In the age of data leaks, security is one of the number one concerns for both business owners and app users. Physitrack stores data as all telehealth systems do. How do you make sure that all the data stays within the system and is not threatened by unauthorized access?

I called Maciej, told him to keep it secure, and hung up the phone! (laughs) More seriously,

Prograils has its own ISO 27001 certification. So do Chaos Gears (the SysOps services provider for Physitrack) as does Physitrack.

The ISO 27001 standard looks at all security aspects in an organization in a holistic fashion. For example, you could have the most amazing encrypted computer, but if you never lock your screen when you go get your lunch, people still have access to it.

In terms of service security, we leverage off AWS (Amazon Web Services). AWS offers refined controls and a mature engineering community around it.

When I first met with Maciej (Litwiniuk, CEO at Prograils) in 2018, and he said that Prograils does not do SysOps, I set out to find a suitable party to design, implement and maintain our AWS infrastructure.

In the end, we chose Warsaw-based Chaos Gears to manage and help secure our AWS infrastructure, and, to date, the collaboration between Prograils, Chaos Gears, and Physitrack has been excellent.

We are halfway through 2021. What are the plans for Physitrack’s further development?

We are pretty busy! There is a major refactor which will speed up the application and improve database performance.

We are also moving all of Physitrack’s payment and subscription logic away to an external billing platform. This will let us focus more on features and improvements in the core domains of our application, rather than on subscription management.

Most recently, Prograils have been rebuilding Physitrack’s native mobile apps for practitioners. The Physitrack iOS app was rewritten from the ground up, with a brand new API. We also have a totally new Physitrack app coming for Android. An official recommendation by the Indonesian Physiotherapy Association will likely boost usage in this country, as Android is the most popular phone operating system in the emerging markets.

These are some of the things to look forward to, and they will bring new opportunities to physiotherapists, and their patients, worldwide.

Visit Physitrack’s page in our Portfolio.

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