Digitization of healthcare provider business processes and workflows is one of our healthcare team’s key investment themes. Our focus on this theme is a derivative of several industry dynamics affecting hospitals and physician practices, including reimbursement headwinds that are pressuring already slim operating profit margins, workforce shortages and high employee turnover, and a reliance on manual, labor-intensive, and / or paper-based methods to facilitate key business processes, among others. Put simply, across front, middle, and back office applications, we believe healthcare providers will increasingly adopt automation software to drive operational and financial efficiencies, increase workforce productivity, improve employee retention, reduce burnout of clinical personnel, and, perhaps most importantly, improve the patient experience.

In baseball terms, we believe the healthcare industry is in the “early innings” with regard to software adoption. While provider organizations have spent the last 10-15 years adopting electronic medical records (EMRs), they continue to lag other verticals in terms of software adoption for managing and / or automating various business processes. As one example, healthcare providers have only recently begun implementing customer relationship management (CRM) software platforms, while most other industries have had CRM systems for decades. To this juncture, automation software (often termed “robotic process automation” or “RPA”) adoption in healthcare has largely focused on back office applications – revenue cycle, specifically. However, we believe automation of front-office workflows through technology – healthcare’s “digital front door” – will have the most profound impact on the patient experience, while also driving significant operational and financial value for providers.

It is against this backdrop that we are delighted to lead Syllable’s $40M Series C financing in partnership with our friends at Oak HC/FT, Section 32, and Verily Life Sciences. Our investment in Syllable is intended to help Syllable expand its artificial intelligence and machine-learning (AI/ML) enabled software platform into adjacent applications and use cases, penetrate new healthcare customer segments (e.g., payor, pharmacy, etc.), rapidly scale headcount across all functions, and forward invest in future growth initiatives.

There has been a lot of “buzz” recently regarding the healthcare industry’s “digital front door,” which we define as simply the technology-enabled mediums via which patients engage with the healthcare system. This is largely a function of the growing consumerization of healthcare and corresponding emphasis on improving the patient experience, and numerous technologies have emerged to help facilitate digital interactions between patients and providers. Having said that, our research – and data from Syllable’s customers – indicates that the dominant modality for patient engagement with providers remains a telephone call; in our view, this is a derivative of the uniqueness of an individual patient’s circumstances and needs, in addition to the complexity of the healthcare system and its historically limited or non-existant digital channels. As a result, we believe the technology platforms best-positioned to automate front office workflows must offer solutions that address both voice and digital mediums.

Enter Syllable and its CEO, Kobus Jooste. Kobus founded Syllable in 2017 with an initial vision to build a software platform capable of removing high-friction barriers between healthcare providers and their patients. Prior to founding Syllable, Kobus spent several years in engineering leadership roles at Google, the most relevant of which was his leadership of the engineering team that developed and launched Google Assistant. Given Kobus’ background in conversational AI and natural language understanding (NLU), we believe that he is well-positioned to build a platform capable of automating both voice and digital patient-provider interactions. More specifically, Syllable’s technology platform leverages AI and NLU to automate inbound patient interactions with providers via phone, web, chatbot, and SMS text. As 95%+ of all patient interactions with providers presently take place via phone call, healthcare providers invest heavily in call center operations – anecdotally, some of Syllable’s customers field 15M+ patient phone calls per year, and invest hundreds of millions of dollars in their own call center personnel and operations. At the same time, providers are also investing significantly in digital applications to facilitate more efficient patient engagement.

Despite this level of investment, the healthcare industry continues to lag others in terms of consumer (i.e., patient) experience. As one datapoint, healthcare’s average net promoter score (NPS) is approximately 27; an NPS of 50 to 70 is generally considered “good.” As another, healthcare providers have call abandonment rates close to approximately 30% (per data from Syllable’s customers) – one of many reasons underpinning a poor patient experience. For providers, a poor patient experience negatively impacts their revenue from multiple vantages; for example, calls abandoned may represent lost revenue opportunities, and a poor experience with a provider reduces the probability of a repeat visit. Properly and efficiently engaging patients is incredibly challenging, as any digital mechanism for managing interactions needs to be highly approachable for patients, must incorporate healthcare-specific contextualization in terms of the intent of the interaction, requires immense scalability (e.g., large systems have 15M+ inbound phone calls annually), and, to reiterate, must facilitate engagement across both digital and voice channels.

That’s precisely the problem that Syllable is out to solve. Syllable’s technology platform leverages conversational AI and NLU technology in tandem with the company’s purpose-built digital applications to automate inbound patient interactions with healthcare provider organizations. Across the company’s current customer base and use cases, Syllable’s platform is capable of automating the majority of inbound patient inquiries, and those inquiries it cannot drive to a conclusion without human intervention are routed to the customer’s call center personnel for further triage. Common use cases include routing calls to the correct endpoint, appointment scheduling, and referral and medication management, among several others. What’s more – Syllable’s ML technology trains its AI on those interactions it cannot automate such that the company’s automation percentage improves with incremental volume and customer utilization. Syllable’s data suggests that its platform drives hard ROI for customers across multiple dimensions, including a significant reduction in call abandonment rates (to zero with Syllable’s platform) and wait times, a 2x+ or greater increase in first call resolution rates, and higher appointment scheduling conversion rates, among others – all of which result in an improved experience for patients.

Syllable’s compelling value proposition, coupled with its reputation for relentless innovation and top-tier customer service, contributed to engendering customer delight, and the company boasts an NPS of 80+. Its customers include numerous healthcare provider organizations, including Parkview Healthcare, Shannon Healthcare, New York Presbyterian, Weill Cornell Ambulatory Care Network, Houston Methodist, and Mass General-Brigham, among others – a particularly impressive roster given the company only began marketing its platform in October 2021. In 2021, Syllable interacted with 39.7M Americans in text and voice about primary care, specialty referrals, vaccinations, and general practice information. Based on Syllable’s sales momentum, the company will more than double its revenue in 2022, particularly as Syllable scales product and technology resources and continues to add to its go-to-market organization. 

CEO Kobus has assembled an impressive team of advisors and experts to advise Syllable on the healthcare industry’s needs and complexities, in addition to AI and ML technology. With this in mind, we are excited to have TCV Venture Partner Anita Pramoda support Syllable as the company takes-on new challenges in the healthcare industry.

“Syllables compresses the delay between needing and accessing care,” says Anita. “With Syllable, healthcare providers can now bring reliability, repeatability, and ubiquity to access – foundational tenets of good health. I’m honored to partner with Kobus and the entire Syllable team as they scale their platform and offer better care for all patients.”

Growth metrics and accolades aside, what perhaps impresses us most about the Syllable team is its unwavering commitment to approaching the healthcare industry with humility and respect. For a brief anecdote on this front, please refer to this segment with Joe and Syllable’s CMO, Adam Silverman, on a recent episode of the company’s podcast.

“Syllable is at a crucial point in its growth trajectory. As one of the most transformative platforms for health systems, our vision is clear. We want to help as many patients navigate hospital and primary care, while lowering the cost of access to care and the burden on front office staff and clinical staff,” says Kobus.

Syllable was also recognized as a most promising startup in healthcare for 2022 by CB Insights, picked as a leader in the private market from a pool of 7,000 companies – chosen based on R&D activity, proprietary Mosaic scores, market potential, business relationships, investor profile, competitive landscape, team strength, and technology novelty.

We are off to the races in our partnership with the Syllable team – including newly-appointed COO Catherline Krna, who joins Syllable from the Chief Administrative Office of Ambulatory Care and Service Lines at Stanford Health Care. We are incredibly excited to help build what we believe is a category-defining, generational software company that engenders patient delight while driving operational and financial efficiencies for healthcare providers.

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The views and opinions expressed are those of the author and do not necessarily reflect those of TCMI, Inc. or its affiliates (“TCV”). TCV has not verified the accuracy of any of the data or statements by the author and disclaims any responsibility therefor. This blog post is not an offer to sell or the solicitation of an offer to purchase an interest in any private fund managed or sponsored by TCV or any of the securities of any company discussed. The TCV portfolio companies identified above are not necessarily representative of all TCV investments, and no assumption should be made that the investments identified were or will be profitable. For a complete list of TCV investments, please visit www.tcv.com/all-companies/. For additional important disclaimers regarding this interview and blog post, please see “Informational Purposes Only” in the Terms of Use for TCV’s website, available at http://www.tcv.com/terms-of-use/.