Waterford-based RelateCare is one of those that suddenly found itself on an accelerated growth trajectory, as its healthcare customers and partners leaned on it to keep the cogs turning during the crisis.

The company has ingrained itself as a key service provider for some of the biggest US hospital groups such as the Cleveland Clinic, Stanford Children’s Health and Michigan Medicine. It also works with the HSE in Ireland.

It bills itself as a virtual clinical support provider – an extension of a hospital’s or clinic’s healthcare team – helping to manage patient appointments, aftercare and other services.

The US is its biggest market and its biggest growth opportunity. The Irish firm has just announced plans to create 255 new jobs over the next three years, based out of a facility near Little Rock in Arkansas – Clinton country. It already employs about 1,100 people in Ireland – 500 of them in the south-east – and about 1,500 in total.

RelateCare’s chief executive, Conor O’Byrne (40), is up early at his hotel room in Cleveland, Ohio, to chat over Zoom before hopping on a flight to New Jersey and then home to Waterford for a while before he hits the road again.

With the US being the company’s main market, he needs the face-to-face contact with customers that was denied during the pandemic to cement relationships.

“We saw huge growth between 2020 and 2021,” says O’Byrne. “We grew our workforce by over 500 employees in the last three years. We’ve doubled our revenues from where they were just before the pandemic.

“It was a very tough time for everybody,” he points out. “In healthcare, there was a huge impact in terms of the number of patients who were coming into these organisations. There was a huge challenge around staffing and being able to support what was occurring.”

Existing customers during the crisis turned to firms including RelateCare to help underpin their services.

“We stood up programmes of support very rapidly during the pandemic,” according to O’Byrne. “We were able to recruit across our multiple locations, including in Ireland. By having a model where we could provide services, but not necessarily need to provide them in the traditional, physical setting, it allowed us to grow the organisation and the support we’re providing for our clients.”

He says the company “felt obliged” to step up.

RelateCare began life in 2013 as a partnership between Waterford-based contact centre provider Rigney Dolphin and the Cleveland Clinic. In 2019, private equity firm MML Capital took a majority stake in RelateCare in a move that saw Mr O’Byrne and president and founder, Dr Frank Dolphin, also retain stakes. Enterprise Ireland is also a stakeholder. The deal with MML gave RelateCare the financial injection it needed to grow its US presence.

In 2021, RelateCare posted revenue of €34.1m, up from just under €20m the year before. Accounts for the company behind it – Akusus Holdings – show that it generated earnings before exceptional items, interest, tax, depreciation and amortisation of €1.65m in 2021, up from €1.4m in 2020. Finance costs of €2.4m in the year pushed it to a bottom line pre-tax loss of €2.8m.

O’Byrne says the relationship with MML prompted a “significant change” in the day-to-day running of the business, where Dr Dolphin and his wife had been heavily involved.

“MML has been an accelerator for the business,” O’Byrne explains. “Not only in terms of the capital investment and what we’ve been able to do, but also their ideas and focus around growth has helped transform the business over the last three years.”

For O’Byrne, his relationship with Rigney Dolphin stretches back more than two decades.

“I joined officially when I was in college,” he says. “I had just finished the Leaving Certificate and was doing business studies at the Waterford Institute of Technology [now South East Technological University].

“My sister was working in the organisation in finance and she said, if you want to earn some money, come and work for us,” he recalls.

He started off as an agent working on behalf of Vodafone customer service in 2001.

“I did my time on the phones dealing with all sorts of queries and problems, applied for a team leader role,” he says. From there, went on to be a call centre manager and operations director before pivoting within the group, “moving sideways” into business development and sales.

“In 2009, the seed of RelateCare was an introduction to Cleveland Clinic,” says O’Byrne. “I put my hand up and said I’d go to the US and work with the Cleveland Clinic. I spent a lot of time there working as a consultant on a big access transformation project that they were embarking on.”

It was, he says, a “very successful initiative”, and one that deepened the relationship with Rigney Dolphin and provided the genesis of RelateCare.

O’Byrne describes himself as a “proud Waterford man” and that having RelateCare’s headquarters in the city “does get me up in the morning”.

“I think it’s important,” he adds. “We have started to expand, though. We put an office in Tralee last year [that will eventually have 280 employees], and we’re looking at other locations.”

With the US being a “huge market” for the company, it’s where much of its focus will remain in coming years, although other English-speaking countries are also in the frame, eventually, to spur further growth.

“These organisations that we’re working with, you combine a couple of these together and it’s the equivalent from an employee workforce standpoint of working with the HSE,” he explains. “So I think the US will remain our primary market and location.”

RelateCare is also looking at providing additional services to its clients, giving them more outsourcing options and the ability to further streamline their relationship with patients.

“We’d be pretty advanced in terms of what we’re doing from a US perspective,” says O’Byrne. “We have 24/7 nursing infrastructure that’s supporting lots of different organisations.

“The next evolution of this will be to migrate more into remote patient monitoring,” he adds. “We’re looking at a number of different opportunities there. In post-surgical, we’re looking at avenues to discharge the patient and get the patient out of hospital, but still have the right monitoring and support for that patient from the home. We’re also looking at opportunities for chronic disease management programmes.”

The decision to select Arkansas for expansion was more happenstance than anything else.

A Dubliner working for RelateCare in the state, along with his wife who is a nurse, made connections in Sherwood near Little Rock and the firm started hiring staff there. About 100 people already work in the area for the Irish firm, while the company has a further 100 dotted across other states.

“It’s not the most obvious place to go to in terms of setting up a business,” O’Byrne concedes. “But there’s lot of different incentives and initiatives in place. We don’t really look at it from a monetary view in terms of incentives. It’s a question of, can we put a platform and infrastructure in place that’s going to succeed.”

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