Introduction

Back in October of last year RJ and I had a chat about Consig. They’d been selected as one of nine startups in the inaugural Plug and Play Healthcare Accelerator in Orlando, backed by GuideWell, Orlando Health, and KPMG.

Our reason to chat this time is Shai Berger has joined Consig. Like RJ, I’ve known Shai since 2009, we met at eComm in San Francisco (surprisingly the event’s website sort of remains here, http://ecommconf.com/).

I see Shai’s work in the refinement of Consig’s purpose, patient outreach. I wish Shai and RJ the best of luck in building Consig. As a patient I know first-hand they’re solving important problems for patients, medical professionals, and insurance companies.

Welcome Shai

Shai makes the point that Consig is an impressive team including: Jason Sajovic and Andreas Volmer. It was the whole team that attracted Shai, as he’d been thinking about starting a venture in outbound communications.

Back in 2024 Verint bought Fonolo. In August 2025, private equity firm Thoma Bravo agreed to take Verint private in a $2 billion deal. Thoma Bravo merged Calabrio into Verint, and Shai took that as an opportunity to jump back into the start-up world.

RJ has known Andreas Volmer from his Voxeo days, when they acquired Voice Objects, which RJ credits with helping Voxeo learn how to sell into the enterprise, addressing security and compliance. Voxeo had been relatively developer / platform focused to that point.

What attracted RJ to Shai is how he built a win:win solution between customers and contact centers with Fonolo. That’s the call backs when the wait time is too long because the agents are busy.

Consig’s Focus

A win for health professional, patients, and insurance companies. Consig searched for common problem across the complex healthcare communications landscape. The Plug and Play Healthcare Accelerator in Orlando, backed by GuideWell, Orlando Health, and KPMG proved invaluable for gathering real-world experience.

There are 6B phone calls in healthcare, which includes not just back office communications between healthcare professionals / administrators, but the also patients and the patients’ families.

The common work flow across many use cases is patient outreach, whether its connecting to a nurse or a doctor or an administrator or an AI. The current challenge with this use case is the pollution of the PSTN, because of to CPaaS companies, as highlighted by the US state attorney generals. People are not answering their phone, using call screening. Hence business messaging or branded calling or even email; really anything that improves answer rates for specific customers, as we behave differently depending on context. Getting a customer on the phone is hard these days.

Once on the call, the customer must be authenticated. Today its name and date of birth, an easy combo, discovered on the internet, so not secure. Consig are moving the focus to device biometrics and passkeys to improve authentication.

The Consig Opportunity, Patient Outreach

I shared a recent frustration on a call to confirm I was attending an appointment, ‘with press 1 to confirm’, it was not receiving the 1 tone so kept asking. The telecom wrinkles are stifling communications. Now if we move to an app, that presents another set of problems, here RCS is supposed to help, but its slow adoption highlights other challenges. Hence a solution needs to bundle several work arounds to ensure communications is successfully achieved.

I brought up even fax is an important channel in health care. As a test needed to be sent to my neurologist, and both Shai and RJ shared their experience from the HMSS conference. RJ points out that fax remains important because of the rules and regulations regarding transmission of electronic health records. This is the opportunity for Consig to navigate those rules across all US states, on behalf of healthcare professionals.

I then shared my experience on using SMS to confirm attending an appointment by replying 1. I received the response, “Looks like we are not able to perform this acton. Looks like appointments are missed.” WTF! There are so many ways to resolve that intelligently. Hence the Consig opportunity.

The role of AI

Healthcare communications are not centralized. The solutions from the contact center are not directly applicable, though much of the experience is. Its disperse communications. That 6B phone calls are across many unconnected platforms.

RJ highlighted chronic care as relevant case study, where reaching out to patients can avoid hospital visits, which everyone prefers. Today nurses are going through a list of numbers trying to connect with patients with all the usual failure mechanisms. Nurses’ time is wasted, and patients are left frustrated with failed communication that are important to them, amongst all the robocalls and damned time-wasting robo-voice-messages from “the approvals department.” And remember these patients are ill!

Consig can provide the black box to connect the 5 available patients to the available 5 available nurses, an action with a compliance risk across telecoms, AI, and healthcare domains. One of the insurers Consig works with have team of 100 nurses dedicate to procedure follow-up. Yet they are only able to reach 25% of he patients because of all the communication failures. The problem is real, significant and the ‘one throat to choke’ most definitely applies given the emergent state by state compliance risks.

There is a balance between scripted (deterministic) and free form conversations, as some will because of medical requirements need specific questions and answers, the patient will be guided. While others, for example scheduling can be more freeform, an LLM approach can be taken.

Consig are at about one million calls per year in high value patient outreach. I am a patient living with the failures in communications, Consig’s solution can not come soon enough. I wish them the best of luck!