Awell

So today we’re chatting about Awell and how it’s used at your company. Could you give a brief overview of the company and your role there?

We’re a tech-enabled digital healthcare services provider. My role is Head of Product.

What led you to look at Awell?

It actually started with some gaps we noticed in Healthie. We had chosen Healthie as our EHR, and I knew of another Healthie customer who was using Awell. They showed me how they set it up, and we thought it was pretty cool. We had identified some limitations in Healthie’s out-of-the-box setup that could be addressed using their API. We didn’t have a big engineering team to tackle this, so I was on the hunt for a solution that offered low-code capabilities for manipulating Healthie’s API that wasn’t too expensive.

Initially, I was a bit hesitant because it wasn’t as user-friendly as something like Zapier, and while Healthie does have some custom actions where you can just click on forms and it’s quick and easy, with Awell, to do what we really wanted, we had to write our own API queries and mutations. That intimidated me at first, but in the end, it was a workable choice for us.

What other requirements did you use to assess Awell and its competitors?

What I really wanted was something that could seamlessly integrate with Healthie and allow me to work with the API without having to set up our own server. I wanted to avoid that extra overhead. So, in essence, I was looking for an integration platform that would let me create my own queries and run them based on our needs. Awell couldn’t do that at first, but later on, they added more custom webhooks. Plus, it had to be cost-effective and HIPAA compliant. There were some nice-to-haves too: the sales team seemed pretty responsive and motivated to support us.

Did you look at other vendors?

Yeah, I did check out a few other options. I had a strong recommendation for Tray.io. But their pricing was quite high. I think they wanted around $44,000 as their sticker price, and they weren’t very open to offering discounts. I thought maybe Tray.io was more future-proofed, but I didn’t even bother evaluating it further because of the cost. It just didn’t seem worth it.

I also spoke to another company, Keragon. They were marketing themselves as a HIPAA-compliant Zapier. However, when I spoke to them, it turned out they were primarily a services company that would write integrations for you, with the promise of eventually turning them into products. I didn’t like that approach, and when I asked for references, they couldn’t provide any, which raised some red flags.

Then there was Morf Health, which seemed to have a less robust UI and was a bit cheaper. However, it felt like I’d still have to rely on their services for a lot of things, rather than being able to handle them myself, which wasn’t ideal for me.

And finally, there was Dock Health. I’m not entirely sure why, but someone I talked to had a negative experience with them and strongly recommended against them, so I steered clear of them as well.

How did you find the sales and implementation process with Awell?

It’s been pretty good. They had a really compelling vision, but I felt like they oversold it a bit. Especially before they had the Healthie integration, it wasn’t exactly what they had made it out to be. However, I managed to make it work. Once they got the Healthie integration, that was really helpful. Their onboarding and account management are top-notch. They have a Slack channel where they’re super responsive, and they’ve jumped on calls with me to troubleshoot issues. I’ve made some suggestions and pointed out pain points, and they’ve put them on their roadmap and made fixes based on my feedback. So overall, it’s been a really positive experience.

Can you talk about how the onboarding and setup process went?

Well, to be honest, they basically handed me a sandbox. I started poking around and reading the documentation, and occasionally asked questions when I needed to. Initially, they did have a more formal onboarding process where they created the first workflow for me. But pretty quickly, I decided to dive in and do things myself because it empowers me more, and it helps me better evaluate how everything works. I didn’t want to be reliant on them all the time.

The time zone difference was difficult. They were based in Europe, and I’m in the US. So, coordinating with them in Belgium was a logistical nightmare. I’d send messages in Slack, and they’d often reply the next morning. Then I’d have maybe an hour to respond before missing them for another 24 hours. But they managed to secure some funding and hired folks in the UK and California. This has made them much more available to US-based customers. So, things have improved in that regard.

How are you currently using Awell?

Right now, I’m using Awell to automate the sending of assessments; for example, I’ll schedule an assessment to go out one hour before various encounters, and to send reminders immediately after specific encounters or a couple of days later. One tricky issue I encountered in Healthie was that they don’t automatically lock patient-reported outcome forms after a patient completes them. This means patients could go back and change their scores anytime. I used Awell to automatically lock these forms, plugging that hole. I’ve also automated an assessment form that gets sent out weekly from the moment a patient joins our program until they either drop out or complete the program.

I use it for logging metrics too. Healthie is able to plot certain metrics graphically, but it couldn’t display the metrics from the standard PHQ-9 form, which is used for depression. It’s designed mainly for nutritionists, tracking things like food intake and water consumption. So we needed to create a custom metric to extract data from the PHQ-9 forms using the API and send it back to Healthie as a metric that can be graphed. It doesn’t work out of the box, but with the API, you can make it work.

Additionally, we’ve created automated tasks to streamline the care coordination process. For example, if a patient doesn’t complete an assessment before a therapy session, we trigger a task in Healthie to remind the therapist to complete the assessment with the patient at the beginning of the session.

We’re looking at automating tasks for both the patients and the providers. There are other potential uses too, but at the moment, our patient volume isn’t big enough for me to dive too deep into those. We might consider adding more as our patient volume increases, and there’s more demand for optimizing our processes. I could see us automating the sending of content to patients between sessions to keep them engaged, for example. However, this is something that a guide or therapist could handle manually as well. So, it’s all about optimizing our workflows and enhancing productivity.

What specific features in Awell are you using across your various automation use cases?

They have a graphical workflow engine that has if-then logic built in. You can also make custom API queries with GraphQL. So, that’s the main stuff I use. Additionally, we leverage all of their Healthie webhooks to kickstart the workflows. They also have a form-building functionality, which is pretty neat, but we already have that in Healthie, and I don’t really see a compelling reason to put in the effort to switch it over, even though I do think Awell’s functionality is better. If someone had a different EHR that lacked good form functionality or had none at all, I could definitely see them using Awell for that purpose. I know some folks who use Awell specifically for that. However, I don’t personally feel that, right now, it’s incrementally valuable enough to justify the switch. But I might consider it in the future.

How does Awell’s form-builder compare to Healthie’s?

I think it’s mainly about the patient-facing user interface. Awell’s is just so much more visually appealing and user-friendly. The text and font are easier to read, which makes a big difference. Healthie has single page forms, whereas Awell also offers multi-page forms, which tend to be better for mobile. With Healthie, if you set up a weekly PHQ form and someone hasn’t completed it, it just sends another one the following week, and then another one the week after that. So, you end up with three open PHQ requests, and the patient might complete all of them on the same day, which is not very useful for us, and it’s inconvenient and confusing for the patient too. I actually had to set up some logic in Awell to check if there’s an open form already, and if there is, it sends a reminder to complete it; if not, it sends a new one. I’m pretty sure that if I were using Awell to make the forms, I wouldn’t have encountered this problem in the first place. So, there are definite benefits to Awell in these areas I’ve mentioned.

One downside is that if you’re sending assessments to Healthie using Awell forms, you have to send them as chat messages. But we have multiple providers and a whole care team on our chat, and I don’t want to bombard them with form-related messages. I’d rather reserve the chat for actual conversations. That’s another reason why I hesitated to switch to Awell for forms.

What do you see as Awell’s strengths and weaknesses?

For strengths, I think it’s pretty usable and versatile. You can find a lot of different use cases for it, and they have great support; they make themselves really available to us. Plus, it’s quite cost-effective, especially considering all it can do.

There have been a couple weaknesses. First is the number of integrations it offers. If you really want to use it as an integration platform, you’ll need to start writing your own custom webhook handlers to connect it to other platforms since it doesn’t have as many webhooks as some competitors. That can be a bit of a hassle. It’s not yet really a true integration platform at this stage.

And there have been some bugs that I’ve run into, which stopped me in my tracks for a couple of weeks while they fixed them. So, they’re still ironing out some kinks. For instance, I had tested a new feature in staging, and then when I moved it into production, there was a bug related to how things got promoted from staging to production. It took them a while to figure out how to fix it. It wasn’t a critical issue for us, but it was frustrating to think that I’m paying for this product, and I can’t use it the way I want to right now. But I haven’t had any downtime or reliability issues, just those bugs that I’d mentioned.

I know you’re approaching this from a product standpoint, but you’ve taken on quite a few engineering tasks. How would you describe the overall developer experience? How is the documentation?

I’m not a developer, so take everything with a grain of salt! But I did create this custom webhook handler to kick things off before they built the out of the box integration with Healthie. I found the documentation pretty easy to use. It was relatively straightforward and easy to follow, even for a newbie like me. Also, their customer support is really good. Whenever I had questions about why something was behaving a certain way, they were super responsive. At one point, I was experiencing an error that turned out to be a rookie mistake on my part, but they were able to give me actionable feedback really quickly.

Do you have any tactical advice or any potential pitfalls you’d like to highlight for others looking to build on top of Awell?

I think the main thing was the lack of integrations, especially with Healthie. Initially, that was a bit of a challenge, but they’ve since improved it significantly. So, that initial hiccup isn’t really a concern anymore. Now, you just enter your API endpoint URL and API key, choose the webhooks you want to trigger, and they provide a URL for you to use on the Healthie side to receive the webhook. That’s pretty much it to kickstart the care pathway and transfer the data. After that, you just need to get comfortable with writing your own API queries. There are a few built-in functions, like sending assessments and chat messages, but I’d say about 80% of what I needed to do in Healthie with Awell required me to create my own API queries or mutations.

However, it’s still not as robust in terms of pre-built integrations as something like Tray.io. If you’re looking for a platform with extensive out-of-the-box integrations across various data sources, Tray.io might be a better choice. But for us, as a super early-stage startup, our use cases were quite limited, and the cost considerations led us to stick with Awell for now. We anticipate needing more integrations in the future, but we’ll address that when the time comes.

How would you characterize Awell’s integration offerings?

Their website does list all their available integrations. But here’s the thing, you need to be cautious because they have limited webhooks available for each of those integrations. They might claim to integrate with something, but it’s possible that you can only trigger it with very specific actions. If you want more flexibility, you might have to create your own custom webhook. For instance, when we first started with Healthie, you could trigger an action if an appointment was scheduled, but not if a form was submitted. So, you’ve got to look into what the integration actually covers. Don’t assume it can handle everything in every way. It’s probably clear to experienced folks, but maybe not so obvious to those who are less experienced.

How has their support team been for you?

They’ve been really good. I got myself into a bit of a mess at one point because of a bug, but there was someone who hopped on a call with me to help fix it quickly. Overall, I feel like they’re pretty responsive, it feels like they’re really collaborative, like a real team. So I’d give them high marks there. The only issue is that the time zone can sometimes be a bit wonky here in the US.

Looking back, do you feel like you made the right call by going with Awell?

I think so. Considering our budget and our current use case, yes. If we had raised more funds and had more to invest, maybe Tray.io would have been a more future-proof choice. But honestly, I haven’t delved deep into Tray.io; I’ve just heard good things from people who’ve used it. Right now, given the complexity of our use cases, I think Awell offers great value for the money. However, there’s a good chance that as we scale and deal with more complex systems that need integration, we might need to switch, or maybe Awell will have expanded its range of integrations by then.

If you were to give advice or recommend improvements for Awell, what would it be?

Well, I think the key thing is to keep adding more integrations. That’s where the real power lies, in my opinion. Also, currently they don’t offer two-factor authentication, which I find really strange for a HIPAA-compliant platform. It’s not technically required for HIPAA compliance, but I feel like it’s table stakes for security. It’s not a deal-breaker, but it does make me uncomfortable to just have a username and password.

Do you have any advice for buyers looking to choose this type of product right now?

Well, I’ve found that I make the best decisions when I’ve got the time to really dig in. I mean, it can be tough when you’re in a rush, but if you’ve got the luxury of time, I’d say go all in. Dive deep into the sandbox environment, set up your workflows, and see if it can actually do what it claims to do. That’s where you’ll find the real gaps, you know? That’s exactly what I did with Awell, and that’s why I’m pretty satisfied with it.