More than 3 billion people worldwide lacked reliable access to healthcare when Justin Fulcher founded RingMD in Singapore in 2014. That figure shaped every architectural decision he made.
“Around the time we founded RingMD, more than three billion people around the world still lacked reliable access to healthcare,” Fulcher said in a recent interview. “In many places there simply weren’t enough doctors, and geographic distance made care difficult to reach.”
What followed was a decade-long exercise in building technology for people at the edges of healthcare systems rather than its center, a distinction that drove nearly every design and regulatory choice the company made.
Designing for the First-Time User
The challenge Fulcher encountered early had less to do with engineering than with human behavior. Nearly half of RingMD’s users were accessing healthcare for the first time, not just new to telemedicine but to navigating healthcare systems at all.
That reality rewrote the product roadmap. “One of the biggest lessons was that when people are accessing a service for the first time, simplicity matters far more than sophistication,” he said. “The technology had to be intuitive, lightweight, and designed for mobile-first environments where connectivity might be inconsistent.”
The mobile-first constraint was also a market reality. Smartphone adoption was accelerating across Southeast Asia faster than fixed-line infrastructure could be built out. Millions of people who’d never had a landline were carrying internet-connected devices. “People who had never had a landline suddenly had a smartphone in their pocket,” Fulcher said. “If technology could connect people to banking, transportation, and information, why couldn’t it connect them to medical care?”
Answering that question required more than good software. Trust had to be built with users who had no prior experience with digital health services. “When someone is speaking to a doctor for the first time through a digital platform, the experience needs to feel reliable and human,” he said. Designing for that condition produced platforms that worked better everywhere. “If the system works well there, it often works even better in more developed environments.”
Navigating Regulatory Complexity at Scale
Scaling across 22 countries meant operating inside 22 different regulatory environments, each with its own licensing rules, privacy standards, and expectations about how care should be delivered. Those differences were treated as part of the design problem, not external friction to be minimized.
“The starting point was recognizing that most healthcare regulation exists for a reason, patient safety and trust,” Fulcher said. “Rather than trying to push against regulatory frameworks, our approach was to work within them and build strong relationships with local healthcare institutions and regulators.”
That approach earned RingMD a place inside Singapore’s Ministry of Health regulatory sandbox in 2018, one of the first telemedicine companies to be selected for the program. The sandbox allowed new care models to be tested in a structured, supervised environment ahead of broader licensing. “Instead of forcing companies to operate in a regulatory gray area, it created a structured environment where new models of care could be tested safely,” Fulcher said.
The Singapore decision was itself deliberate. Fulcher chose the city-state over Silicon Valley because its infrastructure was strong, its healthcare system was trusted, and its regulatory environment was open to collaboration. Starting there forced the team to think about healthcare access at scale from day one.
Healthcare Technology as a Systems Problem
The lesson Fulcher draws from the RingMD experience centers on systems more than software.
“At scale, you realize healthcare technology isn’t just a software problem,” he said. “It’s a systems problem involving regulation, institutions, and trust. Successfully expanding across countries required adapting to those systems while still maintaining a unified platform.”
That framing sets what RingMD built apart from platforms designed primarily for convenience in markets where healthcare access already exists. The company’s early users weren’t choosing between in-person and digital care. For many, digital was the only option available. Serving them required a platform that was durable, compliant, and reliable across vastly different infrastructure conditions.
“For many people on the platform,” Justin Fulcher said, “it was the first time they had ever been able to speak with a doctor.”
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