I’ve worked in enough start ups to know that creating
something from nothing can be hard. It is especially tough when you must create
a market and explain to people that what you’re doing isn’t nearly as heretical
as it may sound. When my friends and I started Subimo in 2000, people wondered
why they’d use our product to learn about hospital performance when (in their
words) all they really needed was to have their doctor to tell them which
hospital they should use. What people eventually realized was that there is
variation in outcomes by hospitals and even by service lines within hospitals.
That’s why the recent spate of articles about the newly
emerging direct-to-consumer companies in health care – the ones that are
condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies
that have leveraged all we know about direct-to-consumer marketing and have identified
an unmet market need. In some respects, they’re not dissimilar from companies
like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a
convenient way for people to get what they need (in this case, good vision). Or
companies that offer behavioral health services directly to consumers.
What do these companies have in common? Aside from a strong marketing
foundation, they have identified a market need that can be met with a new
approach that leverages technology. They are convenient, offer a high level of
customer service and may even be easier to work with than traditional players.
According to Toby Cosgrove, 2019 is “THE YEAR of telehealth.” The former CEO of Cleveland Clinic, who is currently an executive advisor to Google Cloud’s healthcare and life sciences team, proclaimed it as such to CNBC, saying that this year is “THE YEAR” telehealth becomes ubiquitous.
That’s a pretty bold statement – particularly as utilization rates for virtual visits continue to fall short of expectations – so we double-checked this prognostication with Teladoc’s CEO, Jason Gorevic.
Does he think 2019 is going to be telehealth’s
Well, although he’d rather call the space ‘virtual
care’ instead of ‘telehealth’ (maybe this will be the difference maker?), he
confesses he’s pretty much on board with Cosgrove’s assertion that more
consumers than ever will visit virtual exam rooms this year.
How does 2019 become “THE YEAR” of virtual care?
Is this going to be an industry-wide boon, or is Teladoc just banking on its
partnership with CVS and their new family member, Aetna?
Tune in to hear Jason get real about what’s impacting utilization rates, how things are going to change this year, AND whether or not he’s worried about competing with Apple, Google, and Amazon for screen time. (Hint: He’s not.)
On Episode 67 of Health in 2 Point 00, Jess is appalled at the CDC’s salmonella warning for hedgehogs. But in other news, Jess asks me about uBiome, which has raised over $100 million, laying off over 50 people; Planned Parenthood’s new chatbot that helps answer teenagers’ questions about sexual health; and Lively’s recent $16 million raise for their telehealth hearing assessment platform. Don’t forget to stop by our booth at HIMSS in 2 weeks! —Matthew Holt
WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of the health industry and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health.
I guess he warned us that Teladoc was feeling ‘A-quisitive’ — the question now is are they done? A few weeks ago I spoke with Jason Gorevic, Teladoc’s CEO at the new HLTH Conference about consolidation in the telehealth space and what’s next for the virtual care giant.
Although he was mum on the company’s $352M mega-buy of Advance Medical, there was a shopping list of other solutions that seem to have caught Teladoc’s eye — everything from tech that turns Alexa into a telemed access point to NLP plug-ins and any number of shiny devices that make remote monitoring easier, less expensive, and more effective.
Perhaps an indicator of where they’ll look next as they continue to sweep up market share? Listen in on some of the details about their CVS partnership (VIRTUAL Minute Clinic, anyone?) and the VERY interesting talks he’s having with the country’s largest payers on redefining benefit designs to push virtual care first.
In this edition of Health in 2 point 00, Jessica DaMassa asks me about enterprise sales (Qventus, Medicity, Health Catalyst), DTC vs Enterprises as a market, the VA allowing nationwide telehealth,, and the TEAP & TEFCA frameworks (that last answer may have overran the 2 minutes a tad!) — Matthew Holt
Last week Avizia, where I’ve been the Chief Medical Officer since 2014, was acquired by American Well (AmWell). From my perspective, the merger made perfect sense. Avizia has been focused on chronically and acutely ill patients—those more directly attached to a hospital system. AmWell, on the other hand, has been the dominant solution for community-based care; it’s an online consultation service for folks who might otherwise have gone to an urgent care for problems like fever, headache, or a sore throat. Combining these entities provides a solution that spans the spectrum of care, which aligns with the needs of many healthcare systems. Issues related to patient access and satisfaction (think: less acute, community-based care) are top-of-mind for many administrators. However, with 80% of the dollars going to 20 % of the population, managing the continuum for the chronically ill (which is more in line with the mission of Avizia) is imperative to provide better care at a lower cost.
The merger also marks a predictable milestone in the common transition pattern for big ideas (internet, aeronautics, GPS, etc.)—from the military, to academia, to scalable business.
Telemedicine started as a military-run effort. NASA, concerned that astronaut healthcare issues would cause mission failures, was the first organization to devote significant funding to telemedicine research. Early ATA meetings were opened with military-sponsored presentations featuring the Telemedicine & Advanced Technology Research Center, a branch of the Army.
Next came academia. Millions of dollars in grant money were offered, but academics were no longer focused on the health of astronauts. Instead, the goal was providing care at a distance—to the citizens of Rural America. Many early leaders of the ATA came from the universities that built and deployed this technology.
The US Federal Communication Commission’s reversal of Obama-era net neutrality regulations sets the stage for broadband internet service providers (ISPs) to slow or block certain content from reaching their customer’s screens. This is likely to have a significant and potentially negative impact on a healthcare system poised to go fully virtual in the coming years.
Healthcare consumers already depend heavily on internet search results for advice when making healthcare purchases. Coupling preferred content with existing search engine optimization strategies will undoubtably steer consumer behavior. What will be the result? The American healthcare market is unique, both in its expense (higher than any other nation), and its shocking lack of value. Some of this is due to misinformed consumers swayed by direct-to-consumer marketing. Arguably, repealing net neutrality may amplify the problem.
Even more troubling is the prospect of an ISP partnering with a health delivery system. Telehealth – the use of electronic communication technology for healthcare delivery – will become standard of care in the coming years. National telehealth have already managed to get a foothold in today’s highly competitive healthcare market, supplying a disruptive and potentially cost-containing force in the healthcare market. With the elimination of net neutrality, larger, more well-established healthcare delivery systems, seeking to defend or expand their marketshare, can now partner with ISPs to preserve internet “fast lanes” for realtime video doctor’s visits. Smaller, possibly disruptive companies, unable to make these same financial commitment to ISPs, may be marginalized or lost.
One in a series of interviews that should have been posted months ago, but Matthew Holt is just getting to now.
Alan Pitt is an old friend of the family at Health 2.0. He’s a Professor of Neuroradiology at Barrow Neurological Institute, and now the Chief Medical Officer of Avizia. He has been working with patient-provider collaboration tools for several years now, and previously co-founded Excelsius Robotics (now acquired by Globus Medical).
Avizia spun off from Cisco in 2013. Now it provides a collaboration technology services to hospitals. Recently, Avizia secured $11m in Series A funding to expand their telehealth platform. Back in February at HIMSS, Matthew Holt interviewed Alan to see what the patient-provider platform looks like.
Priya Kumar is an Intern at Health 2.0, and a student at George Washington University
Over the past two years, policy makers across the nation have been actively adopting policies in support of the rapid adoption of telehealth. From states affirming that health insurance plans should appropriately cover care provided through innovative technologies, to Congress contemplating multiple proposals for telehealth expansion within Medicare – telehealth is fast becoming a permanent part of our healthcare ecosystem.
This movement has been most clearly demonstrated by state medical boards. It has been their job to answer the questions: can physicians use technology to extend the reach of their care? Can telehealth be used to create a treatment relationship, and if so, are their limitations to this relationship?
Overwhelmingly, the resounding answer to these questions has been a consistent one – yes, you can use robust telehealth technologies to provide care and the main limitation is simple – uphold the same standard of care. The Federation of State Medical Boards has upheld this concept.
But if you’ve been following this movement, you know there’s a rather large blip on the national map: Texasa state with more than 27 million residents and a clear need for increased access to care – was recently ranked “worst in telehealth” by the National Center for Policy Analysis. The good news: despite restrictive rules and a lawsuit that’s hindering progress, telehealth is working in Texas and changes, they are a coming.
Approximately 12 million Americans utilize some type of home health care every year. From home health aides visiting the infirmed in their homes, to physical therapy services to aide in recovery, to medical equipment being used to treat the chronically ill, home health has been a critical component of care management for decades.
One of the Medicare payment requirements for these services is for the prescribing practitioner to have a “face to face” encounter with the patient within a reasonable timeframe. This has widely been viewed as a burden on patients, many of whom face mobility issues and other barriers to meeting this obligation. It has also been a barrier for our overburdened physician supply.
Just recently, CMS published a new rule extending this requirement to states – stating that home healthcare matching Medicaid funds will be linked to this same requirement. But, there’s another component of the rule which mirrors Medicare and will have a tremendously positive impact on the home health care community – the face-to-face requirement can be met through telehealth.