Are You Right for Alto?

Dec 3, 2020


Alto Pharmacy

Why Mission-Driven Software Engineers Hold the Key to Alto’s Continued Success

Alto is the world’s most people-centric pharmacy. Our goal is not simply to distribute medications but to improve health outcomes and quality of life. What’s more, we want to make those improvements accessible to everybody.

To get to that point, we need to understand what is preventing people from accessing all the benefits medicine has to offer. We believe it’s especially important to address non-adherence, which is when people don’t take medications as prescribed. Non-adherence is a national problem that causes 125,000 avoidable deaths per year (more than three times the number of car accident deaths) and $300 billion in avoidable medical costs (more than half the money spent on pharmacy as a whole).

It also means learning how to scale our technology and processes to bring our products to a bigger swath of the population. To achieve both of these things, we need to first scale our engineering team.

Poised for Growth

Because of our unique business model, Alto is positioned to pursue three exciting growth vectors:

  • New Therapeutic Specialties: In addition to our general pharmacy capabilities, we have developed specialized expertise and infrastructure for managing complex treatments like fertility, dermatology, HIV, psychiatry, and other therapies that come with sticky coordination issues and unique considerations. We have made it easier than ever for people to navigate these treatment areas, but there is more we can do. Our team has identified 26 additional treatment areas that could benefit from specialized technology and processes. Mastering those areas is high on our to-do list.

  • New Geographic Markets: By expanding into the top 50 U.S. cities, we could potentially serve 55% of the country’s population. If we expand to the top 100 cities, our coverage would increase to 70%.

  • New Clinical Partnerships: Alto facilitates coordination between our team, healthcare providers, insurance companies, and the people taking the medications. In the process, we improve workflows and health outcomes. That offers a powerful benefit to clinics, medical groups, and hospital systems. Because of that reputation, we currently have a waiting list of healthcare providers who want to partner with us. That’s more demand than we can keep up with, which isn’t such a terrible problem.

When Opportunity and Demand Exceed Capacity

Alto is in a fortunate position. It is rare among companies to have multiple compounding growth vectors and a reserve of would-be partners angling for our product. We are not demand constrained, we are operationally constrained, and even then, we continue to double our business every six to nine months — just not as quickly as our potential promises.

Scaling up as a means of reaching our potential is an exciting challenge we’re already tackling. In late 2018, we closed our Series C, giving us the fuel we need to build out our engineering team and develop the technology and processes that will make our continued growth possible. That work will entail fleshing out each of our existing product areas, scaling them, and identifying and solving even more deep-rooted industry issues through better technology and better processes.

There’s No I in Team (or Alto)

Currently, Alto boasts a small but talented and agile engineering team staffed by individuals who honed their experience at some of the biggest names in tech like Facebook, Google, Uber, 23andMe, MIT, Stanford, and Berkeley. All of our engineers are relatively senior, so everyone has autonomy and ownership over their projects. It’s a collaborative, supportive, mission-driven environment, which is how we’ve been able to build so much in a relatively short period of time.

Up until now, we have been deliberate about keeping the team small, but we’ve reached an inflection point. In the next 18 months, we’re looking to increase the engineering team four-fold. With our new team in place, we will be in a great position to focus on our objectives: building and perfecting our operational efficiencies and product scalability.

Our Technical Challenges

We’re approaching the challenge of scalability from a few angles:

One is automation. We want to take the algorithms that are in our employees’ heads and put them into code, so they can focus more on caring for patients rather than logistics. We’ve done a bunch of automation work already, but there’s a lot left to do.

We’re also intent on designing tools to help our own team be more efficient with their time, which will mean better UX, better UI, more batching, and less context switching.

The third angle is self-service, and it’s the one we’re focused most intently on. Right now, there is significant human interaction between our team and consumers because we want to make sure consumers have the information they need to make optimal healthcare decisions. In our next phase of growth, we want to automate that process without losing any transparency or depriving a consumer of any agency, no matter their technological competence.

Essentially, we want to build the pharmacy version of TurboTax (without the part about lobbying to keep the system broken). With the right prompts and information, TurboTax walks users through the U.S. tax system, which is huge and complicated. In effect, the user becomes totally self-servicing. We want to do the same for the people who use Alto. That said, not everybody is proficient or comfortable with technology. In the spirit of accessibility and inclusivity, it will still be important that everyone who uses Alto also has the option to speak to a real, knowledgeable, and friendly person to get their questions answered and needs met. We have a responsibility as a healthcare provider to take care of all our patients, no matter how tech-savvy they might be, but for these patients we can still use technology to enable our team to get the patient the best possible option, quickly and easily.

Alto’s Next Frontier

Our engineering team is working toward products with even more expertise built in. In the process, we will also make our operations more efficient and more scalable, unblocking barriers to expansion in existing markets, new markets, and new verticals.

When we succeed at that alignment, we stand to change the nature of the industry. To get there, we will continue to grow our engineering team with right-fit, world-class talent that not only has the skillset to take Alto to the next level but also the values to keep us aligned and mission-driven in the process.

Learn more about Alto’s company values and mission-driven work culture.