Tamir Gottfried, the Chief Commercial and Strategy Officer at TytoCare came on THCB to show us how their remote device works to deliver the last few inches of telehealth. Most telehealth is just a video call but with Tyto’s device, the patient can asynchronously (and/or synchronously) take their vital signs including videos and pictures of the skin, ears, mouth, heartbeat et al, and share it with their doctor. It actually amazes me that they haven’t been more popular but in the last few years Tyto has made significant inroads with health plans and providers delivering their devices, as well as adding chronic care management module, with a forthcoming smart clinic (AI) companion. Tamir explained who, how what and why to me, and gave a not too gruesome demo–Matthew Holt
Teledoc Medication Abortions Under Attack
By MIKE MAGEE
For those prepared to take a deep breath and relax in the aftermath of the MAGA induced assault on the First Amendment that whipsawed Disney leadership last week as they abandoned and then rescued Jimmy Kimmel, be advised reproductive health access is at the top of the list when it comes to MAGA campaigns to “restrict liberties.”
Consider the ongoing campaign to federally restrict telemedicine enabled medication abortion.
A few facts:
- Medication abortion is a process that involves taking two medications (mifepristone and misoprostol) at specific intervals over one to three days. It is approved for use up to the first 70 days of a pregnancy and costs on average about $500.
- As defined by Yale Medicine, “Mifepristone is a medication that blocks progesterone activity in a female’s body. Progesterone is a critical hormone for supporting an early pregnancy. The second medication, misoprostol, causes contractions and expels the pregnancy tissue. It typically takes 12 to 24 hours to pass the tissue.”
- The overall number of abortions have risen since the Dobbs decision overturned Roe v. Wade. There were 1.1 million US abortions in 2023, that is 88,000 per month compared to 80,000 the year before.
- Medication abortions account for 2/3 of all abortions in the US. At least 1 in 4 of these last year involved telemedicine provision by mail order including to citizens from states with highly restrictive abortion laws.
- Success rate in terminating pregnancy is 99.6%. Major complications occur in .4% of cases and mortality is nearly non-existent.
- Anti-abortion advocates are currently focused on obstructing legal access to abortion pills.
Immediately following the Dobbs decision, 12 states banned abortion and 4 states imposed a 6-week gestational limit on access to abortion. Nine of these states now explicitly ban telehealth enabled medication abortion. Countering these measures, eight states where abortion remains legal have passed “shield laws” that protect health professionals from prosecution by other states for engaging in telehealth support of patients seeking self-care within states where abortion is illegal. By latest count, 1 in 7 telehealth assisted medication abortions involved practitioners from shield states.
President Trump’s campaign pledge to reinstate the dormant 1873 Comstock Act to cripple telehealth efforts in support of medication abortion has gone nowhere. In a similar vein, flawed science studies engineered by anti-abortion advocates attempting to challenge FDA clearances for safety and self management of the drugs involved have been exposed as unscientific, deceptive and biased. Multiple state suits, for and against imposing additional FDA hurdles to access in the absence of demonstrable medical benefit or risk mitigation are piling up in the courts. And Louisiana recently took a different tact, reclassifying misoprostol a “controlled substance” and inviting provider countersuits.
As Cornell legal experts remind us, the freedom of expression and the right to freedom of speech may be exercised “in direct (words) or a symbolic (actions) way.” When first written, and adopted as the first of the original 10 entries in the Bill of Rights in 1791, the First Amendment said: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
Nowadays, the provision applies to the entire federal government and is reinforced by the Due Process Claus of the 14th Amendment which protects citizens from state government interference as well.
For better or worse, the actions leading up to the Dobbs decision were led, funded, organized and executed primarily by religious groups, primarily Roman Catholics and Evangelical Christians, joining ranks on the issue five decades ago. Those very religions legitimacy and independence has long been protected by the First Amendment.
A simple listing of the opening salvo of our Bill of Rights reveals a complex tangle of protections that define not only our primary rights as citizens, but also our power and legitimacy as a healthy representative democracy.
What’s included? According to legal experts, our 1st Amendment “protects the right to freedom of religion and freedom of expression from government interference. It prohibits any laws that establish a national religion, impede the free exercise of religion, abridge the freedom of speech, infringe upon the freedom of the press, interfere with the right to peaceably assemble, or prohibit people from petitioning for a governmental redress of grievances.”
Religious leaders remain deeply divided. Opposing reproductive choice while protecting the religious freedom assured by the very same 1st Amendment is a difficult needle to thread. Consider the comment of Baltimore Archbishop William Lori, Chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, on June 24, 2022, the day of the Dobbs decision: “I recognize there are people on both sides of the question in the Catholic Church. What we are finding though is that when people become more aware of what the church is doing to assist women in difficult pregnancies … hearts and minds begin to change.”
Well, not exactly. A March, 2025 Pew Survey of Catholics nationwide revealed that 6 in 10 Catholics believe that abortion should be legal in all or most cases.
It is ironic that, in attempting to usurp women’s rights to their own reproductive freedoms, that some religious leaders continue to attack the country’s foundational 1st Amendment that has assured the continued existence of their sponsoring organizations.
Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex.
Telehealth safe harbor: a call to action for health plans
By AMI PAREKH
A little-noticed telehealth safe harbor provision tucked inside the One Big Beautiful Bill was a significant milestone in virtual care. Though it specifically addresses pre-deductible telehealth services in high-deductible health plans, the legislation has far wider implications for both care delivery and insurance design, especially in the commercial insurance market. In fact the permanent extension of a pandemic-era policy is a clear signal to health insurers that a new era of virtual care is under way.
The provision, which permanently extended an expired pandemic-era policy, is a win for employers and workers. After five years of uncertainty, employers are now empowered to provide telehealth services to their entire workforce at little or no cost, which has been shown to reduce access barriers and close gaps in care. For self-funded employers in particular, this flexibility in cost-sharing — combined with an increasingly sophisticated ecosystem of virtual care providers — will further accelerate innovation in benefits strategy and workforce well-being.
Less obviously, this employer-led innovation is also changing the virtual care landscape for a key partner: health plans. Though 20% of employers contract directly with specialized telehealth vendors, 78% rely on their health plan partners — and their vendors — to provide telehealth services for employees. As employers revisit their long-term virtual care strategy with new assurance in the wake of the safe harbor provision, health plans have an important seat at the table.
That seat is heating up, however. In a year when employer healthcare costs are projected to increase by more than 9%, employers are scrutinizing their partnerships and plan design to ensure that virtual care solutions are delivering meaningful value to their employees and their bottom line.
In a new annual survey from the Business Group on Health (BGH), more than three-quarters of employers said they are actively eliminating underutilized programs and underperforming vendors, or are considering doing so. Employers are also stepping up expectations in RFPs, evaluating potential healthcare partners on a growing list of factors and capabilities including performance guarantees, product and network design, reporting and analytics, and member experience.
In this light, the safe harbor provision is a call to action for health plans to evaluate their own virtual care strategy and partnerships through an employer’s lens. Three areas are especially important:
1. Quality
In the BGH survey, employers cited navigation to higher-quality providers and better quality transparency as top priorities — and virtual care is no exception. In last year’s survey, half of all employers expressed concerns about the quality of virtual care.
Continue reading…Stuart Blitz, Hone Health
Stuart Blitz is COO and founder of Hone Health. He comes from a long career in health tech, notably at diabetes device pioneer Agamatrix. Stuart’s been working on his aggressive social media career, but in the background he co-founded Hone Health in the male health online telehealth/pharmacy space in March 2020 (great timing!). It’s now raised real money ($33m last month), has expanded to the other half of the population (women, too!), and is finding a space for itself in the cash-pay space where HIMS, Roman et al are well known. We had a great conversation about how that space is playing out and what Stuart thinks will work there, and what it means for health care overall–Matthew Holt
A Call for Responsible Antibiotic Use in the Era of Telehealth
By PHIYEN NGUYEN
Telehealth has revolutionized health care as we know it, but it may also be contributing to the overuse of antibiotics and antimicrobial resistance.
Antibiotics and the Risks
Antibiotics treat infections caused by bacteria, like strep throat and whooping cough. They do this by either killing or slowing the growth of bacteria. Antibiotics save millions of lives around the world each year, but they can also be overprescribed and overused.
Excessive antibiotic use can lead to antimicrobial resistance (AMR). AMR happens when germs from the initial infection continue to survive, even after a patient completes a course of antibiotics. In other words, the germs are now resilient against that treatment. Resistance to even one type of antibiotic can lead to serious complications and prolonged recovery, requiring additional courses of stronger medicines.
The Centers for Disease Control and Prevention reported that AMR leads to over 2.8 million infections and 35,000 deaths each year in the United States. By 2050, AMR is predicted to cause about 10 million deaths annually, resulting in a global public health crisis.
Increase in Telehealth and Antibiotic Prescriptions
Surprisingly, the growth of telehealth care may be contributing to antibiotic overprescribing and overuse.
Telehealth exploded during the COVID-19 pandemic and, today, 87 percent of physicians use it regularly. Telehealth allows patients to receive health care virtually, through telephone, video, or other forms of technology. It offers increased flexibility, decreased travel time, and less risk of spreading disease for both patients and providers.
Popular platforms like GoodRx and Doctor on Demand market convenient and easy access to health care. Others offer specialized services, like WISP that focuses on women’s health. Despite its benefits, telehealth is not perfect.
It limits physical examinations (by definition) and rapport building, which changes the patient-provider relationship. It’s also unclear whether providers can truly make accurate diagnoses in a virtual setting in some cases.
Studies also show higher antibiotic prescribing rates in virtual consultations compared to in-person visits.
For instance, physicians were more likely to prescribe antibiotics for urinary tract infections during telehealth appointments (99%) compared to an office visit (49%). In another study, 55 percent of telehealth visits for respiratory tract infections resulted in antibiotic prescriptions, many of these cases were later found to not require them.
Continue reading…Roy Schoenberg, CEO, AmWell
AmWell is a now veteran telehealth platform. It used its IPO money to re-architect its entire platform and add companies like Conversa AI chat service and mental health service Silvercloud, as well as integrating deeply with EMRs & more. That change hit its earnings….so can they recover? Roy Schoenberg, CEO, tells you why this is good for AmWell and what happens next.–-Matthew Holt
HLTH 2022: Wheel Adds More Telehealth Tech Infrastructure with Acquisition of GoodRx’s Care Software
by JESSICA DAMASSA, WTF HEALTH
Health tech infrastructure startups remain HOT and, given the industry-wide rise of the “omnichannel care” strategy, none might be hotter than telehealth infra biz, Wheel. CEO Michelle Davey talks about providing white label virtual care services that will now not only include telehealth and EMR technology, clinical care, and end-to-end lab technology, but also the back-office tech that has powered GoodRx all these years. We dive into the acquisition of GoodRx’s care engagement software, how it will enable Wheel to expand its behind-the-scenes reach into the healthcare market, and whether or not Michelle sees all this clamoring about omnichannel care as ultimately eroding Wheel’s biz…or as the force that will propel its growth long into the future.
‘Breaking Down Interstate Barriers to Telehealth Delivery’ Tops ATA’s Priorities for 2023
by JESSICA DAMASSA, WTF HEALTH
Just one week before the ATA EDGE Policy Conference (12/7-12/9 Washington DC) we get a SNEAK PEEK at what’s topping the agenda – and the American Telemedicine Association (ATA)’s list of priorities for 2023 – to ensure that digital health and virtual care providers avoid the ‘telehealth cliff’ that could send us back to pre-pandemic scaling issues of both practice and reimbursement.
Kyle Zebley, SVP of Public Policy at the ATA and Executive Director of ATA Action (the ATA’s affiliate advocacy organization) gives us the skinny on where policies currently stand at the federal and state level and, more importantly, what’s in jeopardy of changing soon. The list is long – everything from interstate practice to originating site stipulations, in-person visit requirements (especially for tele-mental health visits), and a number of favorable reimbursement policies that made telehealth a covered benefit at federally qualified health centers, rural health clinics, and under some high-deductible health plans. And, these are just to name a few…
Right now, the pandemic’s public health emergency is still in effect until mid-January, and, though it is expected to be renewed, the renewal will only get us into the second quarter of 2023. Kyle gives us the in-depth details on what ATA is advocating for and how they’re doing it. Of particular interest is the work being done to preserve clinicians’ ability to deliver cross-state care. The details here are fascinating. Kyle explains the nuances of tactics like licensure compacts and common sense exceptions that are being explored to permanently extend cross-state telehealth care, as well as the role the federal government can play in helping these policies along by incentivizing states to adopt these them through a “carrot-and-stick approach.”
The time to get involved is now, Health Tech! Get your start by watching this in-depth chat with Kyle to get caught up on where things stand, then check out ATA’s site for information on what you can do to support these on-going efforts to keep virtual care a growing vehicle for healthcare delivery.
* Special thanks to Wheel, sponsor of this special monthly WTF Health series on the policies that are changing telehealth and virtual care. Wheel is the health tech company powering the virtual care industry, provides companies with everything they need to launch and scale virtual care services — including the regulatory infrastructure to deliver high quality and compliant care. Learn more at www.wheel.com.
“You’ve Gotta Shoot Some Sacred Cows:” MSU Health Care’s CIO On Health Systems & Tech Transformation
By JESSICA DAMASSA
“If I continue to hear how difficult it is for hospitals to make money, I would like for them to see what it’s like to operate a real business. They are overstaffed…they are overpaying…they are not responsible for quality or outcomes…there are no guarantees on their services…they can block competition from entering their markets…they can buy up market share – that’s not a real business.”
Well, lesson learned. If you ask Roger Jansen, Michigan State University Health Care’s Chief Innovation & Digital Health Officer, how he think things are going in US health systems when it comes to digital transformation and the integration of technology and value-based business models in hospitals, be prepared for a blunt conversation about how US healthcare model is failing and how the lack of incentive for change is keeping us all stuck in the same-old, same-old.
From digital health and telehealth to EMR and value-based care business models, we cover a lot of health innovation ground in this chat and get a reality check on whether or not things are really evolving inside health systems – and which stakeholders Roger believes hold the key to driving that change. (Hint: He identifies them as those who are already “footing the bill for the lavish lifestyles that healthcare administrators live that are probably well out-of-balance with the value that they actually bring to their corporations.”)
Roger on digital health? There’s better adoption and receptivity when it’s combined with “a service component that doesn’t add additional burden to the clinical component.” On virtual care and telehealth?
Down 70% since the pandemic’s lockdown days and more of a “behavior change problem” at this point than anything else.
When we get to EMRs around the 19-minute mark, things get extra spicy and we take a turn into “all this gibberish about volume versus value” and how value-based care models aren’t gaining meaningful traction either. It’s a big, bold reality check on the state-of-play of health tech, virtual care, and healthcare payment model innovation in health systems… watch now and let us know what you think!
Keycare raises $24m & Dr Lyle thinks he’s found a virtual care niche!
Lyle Berkowitz has been very well known as a techy doc for years. He’s ran an innovation center at Northwestern, written books, been featured at tons of conferences (including Health 2.0), had a stint at MDLive and was founder and Exec Chair at HealthFinch which was bought by Health Catalyst. But instead of lying on the beach drinking MaiTais, Lyle has decided that there’s room for yet another virtual care play, and today his new company Keycare is announcing a $24m round and a deal with Spectrum Health (Michigan). What is it? It’s a virtual medical group that’s going to be supporting traditional health systems with care after-hours, out of state and much more. Is there room in the telehealth market for yet another niche play? You may guess that I asked and Lyle explained why!–Matthew Holt
