New Technology For Old Age: Singapore Caregiving Platform Homage Hustles To Keep Up With Demand For Care As Asia Ages

As Asian populations grow older, Homage CEO Gillian Tee is growing the digital platform’s pool of caregivers, nurses and doctors to meet rising demand.

Gillian Tee was 10 when the elderly nanny who helped raise her passed away from cancer. That experience, and a close bond with her grandmother, made Tee aware of the daily help needed by many seniors, and the struggle families face in finding qualified care. Over two decades later she cofounded Singapore-based Homage, which today claims to have the biggest pool of caregivers in the city-state that families can hire by an app.

“I think most people in healthcare startups start in the industry because they had some personal experiences,” says the 40-year-old CEO by video. The computer science graduate (University of Melbourne) got her first taste of running a business after getting an M.B.A. from Columbia University. In 2012, she cofounded New York-based ticket booking platform Rocketrip. A few years later she moved back to Singapore to be closer to family, where she saw an opportunity to marry digital technology with home-based care services. “I really believed in the concept of doing well by doing good,” she says of her decision to start Homage with cofounders Lily Phang and Tong Duong, who have since left the company.

Since launching in 2016, Homage has grown to 15,000 part- and full-time caregivers, expanded to Malaysia and Australia, and raised more than $45 million in funding from investors including Sheares Healthcare Group, owned by Singapore state fund Temasek, and Southeast Asia-focused Golden Gate Ventures.

The company’s move into Malaysia in 2018 helped boost revenue by 170% to S$1.8 million ($1.3 million) in 2020, while losses narrowed to S$4.8 million from S$5.8 million, according to the latest available figures. Tee says sales more than tripled last year and international revenues grew eightfold in the past 18 months, following the company’s expansion into Australia in 2021.

Homage, which made the 100 to Watch list this year, has also diversified beyond caregiving to include services such as telemedicine, medicine delivery and the sale of medical products. Tee is now focused on tackling the challenge of keeping up with demand for care as Asia ages. In Singapore, government figures show the number of people aged 65 or over made up almost 17% of its resident population in 2022.

Demand for skilled caregivers is increasing steadily not just in Singapore, but across the Asia-Pacific, home to some of the world’s oldest and fastest aging populations. In the next decade, the region will account for 60% of the world’s over-65 population and will also have 250 million diabetics, according to Vikram Kapur, partner and head of Asia-Pacific healthcare at consultancy Bain & Co. in Singapore. “Healthcare in this part of the world is really at a tipping point,” Kapur says.

In Singapore and Malaysia—where the aged are mainly cared for by family members, live-in domestic help, or attendants in nursing homes or those contracted from brick-and-mortar agencies—Homage’s digital platform provides a niche decentralized service in an increasingly tech-savvy region. A report this year by Bain found more people in Southeast Asia began using digital healthcare tools because of limited access to in-person appointments during the pandemic. As with online food delivery and fintech, many continue to use digital healthcare because of its convenience, the report added. “Consumer expectations are changing a lot,” says Kapur. “For food delivery and other services, you get almost immediate access. But there’s frustration with healthcare.”

Homage is trying to solve that problem by enabling families to hire part- and full-time caregivers for periods ranging from one hour to flexible prepaid packages of up to 200 hours that it offers at published rates. Its app has over 15,000 downloads on the Google Play store and the company claims to have offered more than 1 million hours of service to customers. Compared with Singapore’s Doctor Anywhere—a popular telemedicine app with over a million downloads in Southeast Asia that promises video consultation with a doctor in under five minutes—Homage says it can arrange such virtual appointments within 30 minutes, plus house calls within a day. It sends caregivers within two days.

“During the pandemic, we found that many stroke patients required telemedicine services,” says Tee. “So, we have [telemedicine], which is an ancillary because it adds to the well-being of patients.” Homage’s move into selling medical and healthcare products such as blood pressure monitors is meant to also serve a need. “We will always focus [on] the care recipient,” she says. “For example, what does a stroke patient need? We will always look at what can be a better solution for the patient.”

“I really believed in the concept of doing well by doing good.”

Tee’s also been busy raising capital. There was an undisclosed “double-digit” series B round in January 2020, led by EV Growth, a joint venture between Southeast Asia-focused East Ventures, YJ Capital (a subsidiary of SoftBank-backed Z Holdings, now part of its corporate venture capital arm Z Venture Capital) and SMDV, backed by the billionaire Widjaja family’s Sinar Mas conglomerate in Indonesia. That followed a $4.15 million series A funding in 2018, led by Golden Gate Ventures and HealthXCapital.

In September last year, the company completed a $30 million series C round, led by Temasek’s Sheares Healthcare, which invests in and provides healthcare services in Asia. Homage says the funds will be used to scale up its platform and double down on its overseas operations in Malaysia and Australia, which are its key growth drivers. However, Homage may be hitting speed bumps. In late October, a spokesperson for Homage said the company “is making a few key strategic changes in response to the macro environment,” later adding those changes are in relation to its Australian expansion plans. When asked to clarify, the spokesperson did not respond.

To keep Homage on a growth trajectory, Tee must overcome fresh challenges of an uncertain economic environment and recruiting healthcare professionals fast enough from a dwindling talent pool. “We’re not doubling nursing schools every year,” she says. “So [supply] is linear, but the demand is growing exponentially because of the aging population.”

The shortage of caregivers for the aged is particularly acute in Australia, Homage’s newest market. “The pandemic has escalated burnout and reduced retention rates,” says Sharon Hakkennes, vice president analyst at Gartner’s healthcare practice. “Clinicians are leaving the profession.” Australia’s aged care sector could face a shortage of at least 110,000 workers in the next decade, according to a 2021 report by the Committee for Economic Development of Australia, a nonprofit organization.

Hakkennes says digital technologies such as Homage’s platform can help alleviate the shortage by allowing healthcare professionals to access and treat patients more efficiently. “[Digital technology] is going to enable scale,” she says. “And when we’re struggling with the clinical workforce, that’s going to be important.” Besides enabling aged care facilities to tap into a “vetted pool of certified care professionals,” Homage claims on its Australian website that its platform enables users from diverse backgrounds to access caregivers who can speak 93 languages, including sign language.

Meanwhile, Tee is doing all she can to incentivize healthcare professionals to join her company’s platform. In March 2020, Homage partnered with Singapore-based insurance technology company Gigacover to provide healthcare benefits to all its healthcare professionals and their dependents. A month later, Homage launched a fund to provide them with financial support during the peak of the pandemic. “Our care professionals are our main clients—they are our care recipients, if you want to put it that way,” says Tee. “We should take care of them. Why? So that they can take care of other people.”

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