This post is part of Accel’s Secrets to Scaling series, where leaders from across our portfolio share their learnings and advice with the next generation of European and Israeli entrepreneurs building global winners
The 1,200-strong team at Kry has a very clear mission: to deliver great healthcare for everyone. Providing patients with the ability to see a doctor, nurse or psychologist via video or chat on smartphones or tablets, Kry/Livi is now operating in five countries across Europe - Sweden, Norway, Germany, France and the UK. In 2020, the company opened its own clinics in Sweden and this connected healthcare journey, which blends digital support with physical appointments, is now being scaled-up in Europe with further sites opening. Last week, the company announced it has delivered more than six million patient appointments, marking an all time high with a 200%+ increase in consultations since 2020.
I sat down with Johannes Schildt, Kry’s CEO and co-founder, to discuss how the team balances the complexity of the healthcare industry whilst launching in multiple countries, the ways in which he copes with pressure, the similarities between building a company and creating a film, and a lot more…
Your family has a background in drama and acting, but you’ve always known you wanted to experience the entrepreneurship journey. How did you discover yourself from an entrepreneur perspective?
It would have been natural for me to go into acting - my mother’s an author and screenwriter, and my father’s a theatre and movie director - but they never pushed me in that direction. In fact, they encouraged me to do anything else! I was always interested in technology and products, and had the fortune of joining a fast-growing company, Stardoll, when I was just 18. But even before that I knew I wanted to be an entrepreneur and build companies in some shape or form.
Building a company isn’t that dissimilar from what my parents do. Writing a script or producing a movie is turning a thought into reality. We’re doing the same – taking an idea and bringing it to life. And, just as with movie production, building a company requires a lot of people. As well as a good script, you need a strong team – you need a vision of what you’re trying to achieve, and to make sure everyone’s working toward the same goal. It’s super rewarding to create that reality.
We’re aware of how important role models are in the ecosystem to inspire others and get them onto the entrepreneurial track. Sweden’s been way ahead in this respect for years. You were at Stardoll when still at school. How important was it to have all these role models around?
I think it’s really important. When you have the luxury of joining a company like Stardoll, which was a Swedish rocketship back then, you can do a lot if you have the courage and grit. I’d never worked before, but I was young and ambitious - I was managing some of our largest projects. I was able to learn from a lot of talented people in the early days of Superdoll, some of whom work for us at Kry today. It’s inspiring to see the success of Swedish companies like Spotify, too. It shows that you can build something big and impactful. There’s a way bigger talent pool in Stockholm today than ten years ago, because there’s a lot of people who have previous experience of scaling things. For many of our senior executive team, this isn’t their first job – they’ve had the opportunity to do it before.
Yes, and I think Sweden – particularly Stockholm – is especially advanced on that front. Moving to Kry – it’s a very mission-driven company. What was it around healthcare and the mission that drove you to do things differently to anything you’d done before?
Probably my own frustration. I’ve had my own share of healthcare issues and have always been astonished at how badly things are structured from a patient’s perspective.
Our mission has been clear from day one: you can build something extremely impactful - there are no upper limits, it just needs to happen.
I’d find it hard now to work on something that wasn’t as important for society. There are plenty of big problems out there that still need to be solved and can be solved with innovation, technology, and hard work, so why spend your time and effort on something less important?
Your mission to address some pervasive problems in society has led to you solving some very complex issues. From the outside it looks fairly simple, but you’re dealing with healthcare regulators, governments, policymakers, law, doctors, and patients across five geographies where every system is different. How do you balance it all? What have you learned from working in a regulated business about what’s important?
A lot of people tend to shy away from complexity, but we embrace it. Solving some of the really big problems will be complex; there are a lot of regulations, for instance. Some tech companies take the view that these regulations don’t apply to them, but that’s not how the world works.
If you want to get into deep problems like healthcare, you can’t avoid complexity. The short answer is it takes a lot of work!
But how do you make sure you don’t get pulled too far in one direction?
You need to keep your eye on the prize - on the patient focus. Keep asking yourself why you started doing it in the first place – it’s all about helping people and solving problems for the patient. You can’t do that if you don’t go deep into the system, and if you don’t get healthcare providers on board and tackle the payment infrastructure, for example. There’s an awful lot of complexity involved, but there’s just no way around it. I think we’ve done a good job of turning that complexity to our advantage - it’s more fun to solve hard problems than the easy ones.
When it comes to dealing with regulation, policy, and public affairs in multiple geographies, what have you learned about how to do this effectively i.e. brand building, how you hire, and how you project the business?
The answer is not to shy away from it. You have to build a diverse team that can do a lot of different things. Different people have different approaches to building something in healthcare. People from the clinician side are boxed into how clinicians think, and only build for the system itself, whereas people who have come from product teams at tech giants, for example, may think they can solve the actual healthcare issues just by building the product.
You have to do all of it. You have to be in conversation with regulators and payers, build great technology, and run operations. You can’t do digital healthcare across Europe and not interact with the public payers. We’re a complex company by choice. We could choose to be a simple company and address one part of the problem very well, but that puts an upper limit on how big you can build. We’ve learned it’s best to embrace everything.
You’re also incredibly focused on patient outcomes. The company’s values and priorities were always clear to all stakeholders. Tell us a bit about those values.
It’s so important to have the patients’ best interests front of mind at all times. Some healthcare companies’ real agenda is to sell people’s healthcare information. They may say they’re patient-centric, but they’re usually building for the system itself rather than for the end user. We’re doing the opposite – our core value is putting the patient first.
How do you create change in established environments? Until recently, for example, public digital health and digital reimbursement was illegal in Germany. What role have you played in these types of conversations, helping regulators and payers to evolve, and how have you managed to attain that credibility to be in those conversations?
We’ve taken different approaches in different markets. During our previous funding round, there wasn’t a reimbursement infrastructure in any of the European markets, so we subsidised it ourselves. There was considerable consumer demand but, if it was a private service, only the wealthy few could pay for access to services, so we had to make sure it was part of the public system. This showed people what was possible and it fulfilled a need for patients.
Many of the things we learned from our first market, such as managing the balancing act between partners and competitors, can now be applied to others. At the start of the pandemic, for example, we were invited to talk directly to the UK Government to discuss how we could help.
Let’s talk about hiring. You’ve managed to attract some of the best talent from the likes of Spotify, as well as Juliet Bauer who drove NHS Digital in the UK. How do you do it?
Ultimately, a company is all about its people – including its investors – so you should have really high ambitions regarding who you’re bringing on board. We’ve recruited a lot of great talent, but it’s important we keep the bar high. Founders need to look for people who will ask why something shouldn’t be possible, rather than focusing on obstacles to growth.
It’s important, too, not to believe someone is so huge you can’t hire them. The worst thing that can happen is you have to try again. Aim high. Rather than trying to hire a team member, why not hire the person at the top? Don’t have a lack of ambition when it comes to who you hire.
Almost against conventional wisdom, you built a pan-European business in a complex market. What drove you to do this, from a commercial perspective? Why did you make these parallel bets when it would have been far easier to focus on just one or two markets?
It’s always been a given that we shouldn’t be just a Nordic or Swedish company – it would cap our ambition level and why would we let someone else do what we do when we’re already good at it? I think we did a great job of pushing ourselves to create the bandwidth we needed to operate in different geographies at the same time. There’s a fair amount of complexity given that each market has different levels of maturity and different payer infrastructures and different learnings along the way. But, while we’ve had to adapt certain things, the underlying platform means there’s a lot that scales across borders.
It’s a lot of hard work, but - again - we haven’t shied away from that complexity. There were a lot of other companies around five years ago that tried to scale but crashed and burned. Many of them probably didn’t go deep enough and understand the details. But this is an area where you have to go into the details and understand the different pain points in each system.
There’s also a mentality you find in a lot of tech companies: keep it simple. Don’t try and add to the complexity – embrace it and boil it down into something simple. Healthcare’s tricky - it isn’t really an industry where you can do that. Sweden alone is like 21 small nations in one. You need to operate slightly differently in each market - different go to market, different products, different marketing.
Where do you see the transformation of healthcare going, and over what time period? And how much of the change brought about by COVID do you think will stick?
While it was there before, the pandemic has accelerated the trend for telemedicine. It’s really validated what we do as it’s now obvious to everyone that digital plays a crucial part of our growing healthcare infrastructure. There’s also a general trend of people wanting more control over their health.
These trends are interlinked – there’s no way things will go back to how they were before. COVID unlocked new cohorts that, in the past, may have been reluctant to adopt new ways of accessing healthcare. But in the first phase of the pandemic, when there was little access to healthcare, people used our service for the first time. Now they’ve seen how easy and efficient it is, why would they go back to calling a doctor at 9am and travelling long distances to sit in a waiting room for something they can get help with directly? Likewise, when clinicians understand they can do a lot of their work remotely, they won’t go back either.
The world would have been very different if Kry and other similar services weren’t around…
Doing healthcare at the volumes we’re currently operating at saves lives every day. The lack of access to primary care you have in the European systems has a spill-over effect into secondary care. People are lining up at emergency rooms with issues that should have been addressed in primary care. That’s why, six years in, I still love what Kry’s doing. We’re saving lives.
What’s sustained you through this rollercoaster? You still show up with the belief, the motivation, the mission, and a smile…
Sometimes I surprise myself at how well I handle it and my stress threshold! Like a lot of things, it comes with practice. I’ve always had a high stress threshold but it’s tough work, there’s no way around it.
It can be lonely at times, but a lot of my friends also run companies - it helps to bounce things off other CEOs. Exercise is a huge stress reliever, too. I try to exercise at least four times a week. The cost can be high, but I wouldn’t change it – I’m doing what I want to do.
In terms of personal leadership style, how has yours evolved?
Maybe best to ask my direct reports! For me, it starts with trust and support. I put a lot of trust in people – I have very high ambitions and want to make sure the people around me share these.
You need to trust that they’ll have good intentions and make good decisions. Obviously, they’ll make mistakes occasionally, but you then need to coach and support them. If you don’t trust someone, however, you need to replace them.
I’d also add that Kry’s goal and direction haven’t changed. Everyone may have different things to do, but they know what they’re working towards. That’s important from a leadership perspective.
Yes, we see people joining for the right reasons – everyone understands the direction we’re moving. It’s been crystal clear to me from the start where the world is heading, and what we need to do to get there.
Healthcare’s broken – who’s going to fix it if we don’t?
We have a great mandate, we have great partners like Accel, and we have a strong team – we’ve attracted some of the best talent in the world. We can do this. We just have to work very hard to pull it all together. It’d be hard to do anything else – we’re saving lives!
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