Bruno Van Tuykom has the résumé of someone trained to admire systems. Electrical engineering first. Eight years at Boston Consulting Group next. Then a startup whose apparent simplicity - consult online, speak with a provider, receive what is prescribed - conceals a thicket of insurance rules, licensed networks, logistics, regulation, and trust. The tidy screen is the least interesting part. His work begins where the screen ends.
That distinction explains Twentyeight Health, the company Van Tuykom launched with Amy Fan in 2018. Plenty of digital services were already selling convenience to people who could pay for it. The founders chose a more stubborn brief: make convenience available to people frequently left outside it, including customers covered by Medicaid, people without insurance, and communities far from traditional services. It was a business decision with an ethical center and an operational invoice attached.
The result is not the familiar founder tale in which a clever app arrives and bureaucracy politely evaporates. Bureaucracy never received the memo. Twentyeight Health had to negotiate with it, integrate it, and make it less visible to the person seeking care. That is less cinematic than disruption. It is also what useful infrastructure tends to look like.
An engineer walks into healthcare
Van Tuykom studied electrical engineering at the Université libre de Bruxelles, with an emphasis on energy. An early paper bearing his name concerned state estimation for electrical distribution systems. Later, as a young BCG associate, he helped write a report on Belgium's internet economy. The subjects changed, but the habit remained: map the network, identify the bottleneck, and watch what happens when one component fails.
At BCG, he rose to principal over eight years. Four of those years included work supporting the Gates Foundation on expanding access to care, with projects touching family planning, HIV, and malaria. He saw how distance, infrastructure, and stigma could make theoretically available care practically unreachable. Telemedicine suggested a bridge. The significant word was never merely tele. It was reach.
“Through my experience at Gates, I realized the potential that telemedicine could have in improving access to care, particularly when it comes to women's health.”Bruno Van Tuykom
The American system offered a different geography and a similarly troublesome outcome. A provider might exist yet be out of network. A prescription might be covered yet difficult to obtain. A digital clinic might be easy to enter yet unavailable to someone using Medicaid. Access was not one door. It was a corridor of doors, each fitted with a different lock.
The invisible product
Complementary, on purpose
Van Tuykom met Amy Fan through a friend and colleague from BCG. Fan brought consumer instincts sharpened at Bain and in beauty, where close attention to the customer was standard operating procedure. Van Tuykom brought the access lens, healthcare relationships, and a consultant's appetite for complicated systems. They did not have identical strengths, which was rather the point.
He has described complementary skills as especially valuable in a founding partner. The pair also did an unfashionably sensible thing before the company became busy: they discussed personal values, the culture they wanted, and which decisions needed both founders in the room. They agreed on kindness, questioning the status quo, and a growth mindset. They also established where each could act independently. Affection is lovely; decision rights survive calendars.
That operating agreement mattered as Twentyeight Health grew. In the first three months of 2021, the company doubled its state footprint. Each new state brought decisions about providers, operations, customer support, compliance, marketing, and money. Shared values helped the founders disagree productively; explicit ownership helped them disagree without turning every Tuesday into a constitutional convention.
The moat lives in the plumbing
Asked about a common founder mistake, Van Tuykom did not blame timid ambition or small markets. He pointed to weak differentiation. Founders can persuade themselves that a market is large enough for everyone, he argued, while neglecting the hard-to-copy reason customers would choose them. Twentyeight Health's answer sits beneath the interface: payer contracts, licensed providers, multilingual access, affordable self-pay routes, and the logistical chain that connects a consultation to delivery or pharmacy pickup.
“Not enough focus on what truly differentiates them from other players.”Van Tuykom on a common founder mistake
There is a useful startup lesson here. The overlooked customer is often overlooked because serving that customer is expensive, regulated, or operationally annoying. This makes neglect easy to explain and difficult to defend. It also means the constraint can become a moat for the company willing to absorb it. Twentyeight Health was not simply attaching a mission to digital care. It was allowing the mission to choose the difficult product work.
The numbers eventually caught up with the premise. Twentyeight Health reported more than 60,000 users in early 2023 and surpassed 100,000 in October 2024. By January 2025, it operated across 43 states, covering a reported 93 percent of American women. Half of its users earned less than $20,000 a year. The company said three in five were considered underserved and nearly three in five identified as people of color. Those figures describe reach, but they also audit the original intention.
They also reveal why Van Tuykom's preferred kind of differentiation is difficult to summarize in a screenshot. A customer sees one journey. The company has to manage many simultaneous ones: a person with commercial insurance, another covered by a state Medicaid plan, and another paying out of pocket. Each route has its own economics and administrative seams. Building for all three means refusing the convenient fiction that every online customer arrives with the same wallet, coverage, schedule, or pharmacy options.
This is where the consumer sensibility Fan brought and the access discipline Van Tuykom brought become mutually useful. Empathy without operations can produce a charming prototype that excludes people at checkout. Operations without empathy can reproduce the very maze a digital service promised to remove. Their combination asks two questions at once: does the experience feel dignified, and can the machinery reliably complete it? A startup has to answer both every day. The second answer is rarely pretty, which is precisely why the first can feel simple.
Growing through the untidy middle
Growth arrived with obligations. In April 2023, as SimpleHealth wound down, Twentyeight Health took custody of patient records and supported the transition of eligible customers. It also acquired part of The Pill Club's patient assets. This was growth by inheritance, with continuity work attached. Van Tuykom called the SimpleHealth transaction the company's first acquisition and publicly thanked Fan, the technical and implementation leads, the wider team, and outside counsel by name.
That instinct to distribute credit offers a glimpse of his public style. His posts tend to be crowded with colleagues and partners. When something happens, he lists the people who made it happen. The tone can be exuberant, but the nouns are concrete: implementation, technology, counsel, operations. Even celebration arrives with a dependency map.
The January 2025 Series A put $10 million behind the next stage and brought the company's reported funding to $25 million. The round, led by Seae Ventures, arrived alongside payer partnerships with Aetna, AmeriHealth, and Molina. Van Tuykom framed the money and the contracts in the same sentence: capital mattered because it could expand reach. The aspiration was nationwide service regardless of geography, income, race, age, or coverage status.
From data to a door that opens
In 2026, Twentyeight Health began connecting its infrastructure to platforms people already use. Its work with Oura linked member insights with licensed providers. A June partnership with Clue offered US users a route from cycle tracking to counseling and, when appropriate, online prescriptions and delivery or pharmacy pickup. The partnerships suggest a broader ambition than becoming one more destination website. Twentyeight Health can be the clinical layer behind other consumer experiences.
Van Tuykom described the Clue partnership as a movement from understanding to provider-led care. The phrase captures his career's recurring move. Information is useful. Infrastructure converts it into action. A chart can reveal a pattern; a functioning system must help someone do something about it.
“It's about making cycle-informed care simpler, more informed, and more accessible.”Bruno Van Tuykom, 2026
There is no tidy ending because infrastructure is allergic to endings. Provider networks need maintenance. Insurance relationships change. Expansion adds edge cases. Partnerships create handoffs that must work on an ordinary afternoon, not only in a press release. Van Tuykom's engineering education may be the most honest preparation available: systems are never finished; they are observed, adjusted, and kept alive.
The portable lesson is not that every founder should enter healthcare. It is that a company's hard constraint can carry strategic information. The burden everyone else avoids may identify the customer worth serving, the capability worth building, and the moat worth defending. Twentyeight Health chose the unlovely machinery between intention and access. Van Tuykom's career has been a long argument that machinery should behave.