How Alto’s CTO is applying his MIT-honed engineering skills to reinvent the pharmacy

by Drew Housman
March 13, 2019
alto engineering team
photo via alto

Many people with backgrounds in engineering from heavyweights like MIT and Stanford end up trading in their collegiate sense of idealism for a job at companies that build a product with mostly profit in mind. 
 
But Jamie Karraker wanted something more. His goal? To affect the lives of millions of people on a daily basis in a positive way. So, he co-founded online pharmacy Alto.
 
“We have built out a platform connecting doctors, insurance companies, our pharmacies, and the patient, and that solves many of the deep coordination issues between these parties ― issues that often lead to patients not getting the medications they need,” Karraker told Built In Colorado. 

We spoke with the chief technology officer to learn more about how Alto is using tech to power the pharmacy revolution — and where he’s taking the company next. 

 

Let’s talk big picture. What is Alto’s vision? 

We’re fixing the deep-rooted issues in the pharmacy industry by using better technology and processes that lead to better patient experiences. 

This includes surface-level improvements like a modern consumer app and free same-day medication delivery, but, more importantly, we have fixes for the problems under the hood that are at the root of many barriers for patients. 

Our physician platform, AltoMD, as well as our deep integrations with insurance and other pharmacy industry middlemen, address these issues and help us provide more transparency and better options to patients around price and clinical options.

 

It sounds like there are some great opportunities to use data for personalized care. How does that work at Alto?

As a pharmacy, we have a deep level of engagement with patients as well as other stakeholders in the healthcare ecosystem. We are interacting with our patients more often than their doctors are, and, vice versa, we are interacting with the doctor more often than their patients. 

We use our data to improve the patient experience and their health outcomes by making personalized recommendations and interventions. For example, we can provide transparency around pricing options that require waiting for insurance. We don’t actually know what the price will be until the insurance makes a decision — often many days later — but we can tell the patient what to expect the price to be and the probability of that price based on thousands of cases like theirs.

 

We are looking for impact-driven engineers, designers and product managers who want to see their work make a meaningful difference in people’s lives.”

 

From a tech perspective, what is the company’s biggest accomplishment?

We have built out a platform connecting doctors, insurance companies, our pharmacies and the patient, and that solves many of the deep coordination issues between these parties ― issues that often lead to patients not getting the medications they need. 

We now have a strong foundation of modern technical infrastructure that supports an efficient, streamlined, automated experience for patients, even when they have complex therapies with confusing and complicated insurance or clinical workflows. 

 

With so much going on, how do you structure your days?

I spend two to three hours per day on team management and product work, including one-on-ones with members of the product and engineering team, product critiques and product planning meetings. 

I spend another two to three hours on company processes and strategy, making sure we are building the right things, and making sure the product and engineering team are aligned with the other teams at the company. 

Also, we are growing our team very quickly ― we have plans to double the product and engineering team in the next six months ― so I am currently spending about three to four hours a day on recruiting. 

 

That’s exciting growth. What kind of tech stack will the new hires be working with? 

Our back end is Ruby on Rails and Go, and our front end is React and React Native. Rails is a great framework for building a lot of product very quickly, which is critical in a startup environment, while Go is very scalable and robust for more complex workflows. 

React is the clear winner of the JavaScript framework wars, and it provides a framework for building scalable, robust user interfaces quickly. Also, React Native enables us to build for multiple platforms without having to entirely replicate our codebase in multiple languages.  

 

Other than a strong technical background, what are you looking for in new members of the team? 

It’s critical that every new Altoid, no matter what role, shares our the core values of our company. Aside from that, we are looking for impact-driven engineers, designers and product managers who want to see their work make a meaningful difference in people’s lives. 

 

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