Five Questions with Thrive Health Co-Founder and Executive Board Chair David Helliwell

Thrive Health is a software company based in Vancouver, B.C., building tools that help health care providers and patients navigate the complexities of the health care system.

Thrive Health Co-Founder and Executive Board Chair David Helliwell is also a wealth of knowledge about how to navigate government procurement. He recently sat down with CCI President Benjamin Bergen to talk about HealthTech, and how innovative companies can sell their services to government more effectively.

This transcript has been edited for length and clarity.

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Benjamin Bergen: David, thanks for joining me. As we get started, can you give us the story of how Thrive Health was founded? What was the original idea that got the business started?

David Helliwell: Absolutely! So, the main idea behind Thrive Health is to help patients and their families through their health care journeys. Two of the three of us who started the company didn’t have a health care background; before Thrive, we’d been building software companies since the 90’s, but we had seen our own families and friends falling through the cracks of the Canadian health care system.

We wanted to use technology to help both families and the system while taking the burden off clinics and offering clinical decision support. We began just before Covid and started with aiding patients preparing for surgeries, and then expanded to post-surgical, chronic pain, and other chronic conditions.

By the time Covid hit, we had just enough pieces together for guiding people through health care journeys that we were able to launch a BC Covid app in about 10 days, and then a Canada-wide Covid app two or three weeks after that.

We went from being this brand-new startup to having the No.1 and No. 2 health apps in Canada. We had a thousand times the number of people on the platform within a few months, going from 10,000 users to 10 million users; that really helped us to become a player in the Canadian health tech space.

Now most of our work is with hospitals and health systems, but it’s the same mission, giving people the information and the guidance to empower their own health care journeys.

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BB: That’s really incredible. One takeaway is that technology can act as a level-setter in terms of people’s ability to access health care.

For us at CCI, 2024 is really the Year of Government Procurement. Procurement allows governments to provide better services for us as citizens, but we can also use it to create wealth and prosperity through building great companies. You mentioned how Thrive Health was a relatively small player until Covid brought the need for government to procure your services. Could you walk us through that process and what it means to a company while its building?

DH: Yeah, it’s always tricky to use a Covid procurement story as a model because things were so different for a period there. If you compare what happened with Thrive for our Covid apps to what you’re hearing about ArriveCan, you’ll find a totally different story.

It’s worth noting that ArriveCan was not the procurement of a product; it was just outsourcing a whole bunch of things that were built. That’s not good for innovation; it’s just hiring consultants to do stuff.

When it’s a big and heavy procurement, often there isn’t a sense of collaboration or sense of trust. Procurement can be very confrontational, with lawyers and checking boxes. That’s a hard way to put out a good product when you’re under a microscope for every little step. With procurement I’m a big fan of starting small and iterating. That means the mistakes are less costly and faster to fix, and it’s almost always going to give you a better product at a lower cost in a shorter time.

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BB: You talked about how your team at Thrive Health has been able to develop a bit of a relationship with the government through your work. At CCI we often look at countries like Estonia and Finland who have good government procurement vehicles. Their governments learn by procuring domestically, while building capacity internally to make decisions about whether products are good for them to purchase.

I’m curious for your thoughts on how much capacity Thrive Health has added into government, what does that relationship look like moving forward, and how do you improve the government procurement process?

DH: Sure, with the partners we’ve worked with in government, we all collectively upped our games over the last few years of working together. So much of it is trust, and that’s something that’s hard to legislate, but its more about providing an environment where there is a way to have some trust.

We once had a request for proposals from government that was hundreds of pages. One of the tasks was an Excel worksheet that had 10,000 cells to be filled in which needed quarterly pricing for 25 sites over four years for a bunch of different products. If you’re getting pulled into those little holes, and one side is the enforcer, then you’re never going to build the trust.

I’m not talking about buying a submarine or a fighter plane— those products work a certain way and require a clear design from the start or they just won't work. I’m talking about software that’s used by people and is going to evolve and integrate with other things. Having that shared sense of figuring out things together helps to reduce the barriers of getting things started.

And the reciprocal side of this, which should make those in government happy, is it also makes the process easier to get out of. This forces everybody to know there’s an alignment for making the work together, instead of one side holding all the cards while the other party resents it and tries to squeeze out every penny they can. It’s hard to argue with a strategy that puts more effort into delivering results than responding to an endless stream of over-specified requirements assembled by huge teams of consultants.

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BB: It's interesting to hear you explain that relationship and dynamic. What do you think would be required to fix more challenges within our health care system? It sounds like your company has had areal opportunity to try and help engage and create capacity within government. As you scale this, what elements are needed?

DH: There are a couple elements to it. I think a lot of it is having the senior people making space for the mid-level decision makers to do things in a different way. I’m a big fan of organizational behaviour theory; it really explains why people make the decision they do, because they just really don’t want to make a decision that leads to failure. You can’t blame the people for reacting the way they do when those are the signals that are sent to them. This is a systematic change that’s needs to occur not just in government but in other big organizations.

The other side of the equation, though, is something that really annoys me as someone who’s always been at different parts of this equation. For the past 15 or 18 years I’ve worked in startups, but I’ve also worked with 100,000 person companies, and was the director of policy for the Minister of Procurement in the federal government 20 years ago.

There is this sense that it’s higher risk to go with a local supplier. If you look at what the risks are, the local supplier is going to be way a lower risk than a big multinational that has 100 other projects like this, they just won’t be as invested in your project. If you get a smaller company that specializes in the area of procurement, they will have an existing product that is better suited to your needs. They will also give you better service and not allow themselves to get into the disasters that larger companies are able to afford.

BB: Absolutely, yes. So you’ve worked in government and procurement; you’ve worked in big companies. Where is good procurement happening? Is there anywhere that can be used as a guiding light moving forward?

DH: It’s worth recognizing that procurement, much like health care, is just hard. There are few people who would feel like it was working perfectly anywhere.

I think a lesson Canada can learn is that procurement people will often add on more so-called layers of safety than what is required by the law. They’ll be overcautious and not want to give a chance to a local company out of fear of a trade tribunal. But there are countries that do it well and organizations that do it well. We were just talking about Estonia who have been very deliberate, they are about the size of British Columbia so we should be able to mimic that at a provincial level.

In terms of companies, I’ve been impressed with Google. I’ve had some transactions where they don’t get lost in the weeds and make a fast decision. Sure, it helps to be a trillion-dollar company, but governments are big too and have lots of access to cash. The idea is moving quickly and not being bogged down.

Across all of them, a critical success factor is the need to empower mid-level decision-makers to share in the risks and rewards of making decisions that involve uncertainty. That means moving beyond the current state where the only motivation is to not be involved with a decision that leads to a bad outcome. People should also be accountable for bad things that happen when decisions are avoided or delayed, just as they should be rewarded for making decisions that work out well. A change like this will take time, but I’d argue that any organization that does procurement well has figured out a way to make this happen.

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The Council of Canadian Innovators is a national business council of more than 150 scale-up technology companies headquartered in Canada. Our members are job-creators, philanthropists and leading commercialization experts in the 21st century digital economy.

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