Built for telehealth companies that need deliverability, audit trails, and control — without relying on a single provider.
The FDA issued 70+ warning letters to telehealth companies in the last enforcement wave. State attorneys general are investigating patient communication practices. Data breaches carry per-record penalties that scale with volume.
Most telehealth companies didn't fail because of product. They failed because their communication layer wasn't defensible.
If a regulator asks “what exactly did you send this patient, when, and can you prove it?” — your email infrastructure needs to answer that question in minutes, not weeks.
Single provider dependency — if they flag your account, patient emails stop.
No audit trail — you can see "sent" but not "delivered" or "opened" or "what was in it."
No control over messaging risk — any engineer can send anything from any domain.
No fallback — if your provider goes down during a patient notification window, you wait.
Marketing and transactional email sharing the same domain reputation.
That's not infrastructure. That's liability.
A layer between your application and email providers. Multi-provider routing, full audit logs, policy enforcement, and synchronous delivery confirmation.
SES Ireland primary, Brevo France backup. If one provider blocks you, flags you, or goes down — your patient communication continues.
Every message logged: what was sent, when, to whom, which provider delivered it, and whether it arrived. Searchable. Exportable. Defensible.
Confidence scoring catches problems before send. Bad addresses, suppressed recipients, and domain health issues flagged before they become incidents.
Define what can be sent through each domain and stream. Outreach and transactional email are isolated at the API level. Violations blocked, not warned.
Delivery guarantees: best_effort, at_least_once, exactly_once. Durable retry queues with dead-letter recovery. Nothing gets silently lost.
send_sync returns delivery status before your application continues. Your system knows the email arrived — not just that you sent it.
Primary provider in Ireland. Backup in France. Both EU member states. Your patient data stays in the EU — on both the primary and failover paths.
Growth without control gets you flagged.
Control without growth slows you down.
Truncus gives you both.
Patient appointment reminders
Delivery confirmed in 1 second. If the primary provider fails, the backup sends automatically. The patient gets their reminder.
Prescription notifications
Audit trail proves exactly what was communicated, when, and which provider delivered it. Searchable by patient, date, or message content.
Billing and payment emails
Operations API with at_least_once guarantee. Failed sends retry automatically. Dead-letter recovery catches edge cases.
Post-visit surveys and follow-ups
Pre-send validation prevents bounces. Domain reputation monitoring catches deliverability issues before they affect patient communication.
Marketing and outreach
Stream isolation keeps promotional email on separate domains. Marketing complaints never affect transactional deliverability.
All plans include send_sync, audit logs, multi-provider failover, and stream isolation.
Free
$0
3,000 emails/month
For testing and development
Pro
$19/mo
50,000 emails/month
For shipping to patients
Scale
$99/mo
300,000 emails/month
For healthcare at scale
Audit trails. Multi-provider failover. Policy enforcement. EU-hosted. Free to start.
Talk to us