Remote patient monitoring has emerged as the next significant challenge for virtual healthcare and that challenge is creating significant opportunities for many companies largely outside of the traditional healthcare technology marketplace. In particular, it is potentially setting up an opportunity for Big Tech companies like Apple, Google, and Amazon, to revolutionize telemedicine and healthcare similar to what those companies have accomplished in mobile phones, Internet search, and retail.
Next Generation Remote Health Monitoring
Next generation remote healthcare monitoring will likely look much different than anything done before. What is emerging today is the potential for the broad adoption of remote health monitoring devices and systems that leverage consumer wearables, smart home communication systems, and big data to produce holistic views specifically for healthcare providers. The pandemic has thrust telemedicine solutions forward by years if not a decade or more in the short span of three to six months. This is creating an opportunity for remote patient monitoring to provide even better visibility into patients beyond what can be accomplished with basic video conferencing.
But while telemedicine is now becoming more firmly established, remote monitoring seems to still have a long way to go. This is evident in a new report by KLAS Research (a healthcare industry research firm) published on August 27th, where they interviewed 19 executives from 18 healthcare organizations regarding their challenges and solutions during the outbreak of the pandemic. Not surprisingly, telemedicine was the top challenge with 32% of the executives. Overall, though, 84% of the executives indicated that the telemedicine issues were already solved and the remining 16% indicated that the solutions were in progress. However, remote patient monitoring ranked as the second most significant challenge with 26% of the respondents. But furthermore, only 22% of the executives indicated the remote monitoring challenges were solved, with 33% saying it was in progress, and 45% indicating it was completely unsolved. So, a clear opportunity exists.
There are few better positioned to speculate on what’s next for telehealth than Roy Schoenberg, co-CEO & President, of Amwell. After 15 years, more than $710M in total funding, and probably the best analogies out there for describing telehealth’s potential as a disruptive technology, Roy weighs in on just how unprecedented COVID19 has been for the uptake and evolution of virtual care.
“Historically, people thought, could telehealth be as good as a physical visit? The reality of COVID,” says Roy, “has literally opened the door to the question, can telehealth be better?”
From the near-term “new wave” of telehealth that has already begun to “eclipse the urgent care telehealth” to how Amwell’s clientele of clinicians, healthcare delivery systems, and payers are shifting to accept the idea of the technology as “the start of healthcare,” Roy talks of a future of telehealth that is “entrenched inside the system.” And how Amwell is meant to act as “facilitator.”
“When we start thinking about telehealth as a switchboard — not as a product, but as an infrastructure for the redistribution of healthcare — we’re talking about a completely different experience for us as Americans on what healthcare is available to us and how we can consume it.”
“To me, and I’ll fast forward to the end here, we want to get to the point that telehealth changes our expectation when we grow old as to where we can grow old. We want to be in a place where we can stay at home…where we don’t have to be in the ‘belly of the beast’ to get healthcare.”
How far away is this future that Roy describes, midway through telehealth’s biggest year yet? Is the appetite there among incumbents? And what of those Amwell IPO rumors? How might that kind of funding help rush things along? Tune in to this episode of ‘WTF Health – What’s the Future, Health?’ with Jessica DaMassa to find out.
Today on Health in 2 Point 00, Jess and I talk about Oscar raising $225 million, Evidation Health raising $45 million doing digital clinical trials, Lululemon buying fitness startup Mirror for $500 million, Calibrate raising a $5.1 million seed round bringing telehealth to weight loss and metabolic health, at-home urine analysis startup Healthy.io buying Inui Health for $9 million, and Airvet raising $14 million for veterinary telemedicine. —Matthew Holt
As healthcare systems around the world grapple with the coronavirus, ‘virtual-first healthcare’ is fast becoming the global response of private and public healthcare systems alike. In Australia, the federal government recently committed to investing $500M to built out its country’s ‘virtual-first’ healthcare infrastructure, so we caught up with Louise Schaper, CEO of the Australasian Institute of Digital Health (AIDH), to find out what that means for telehealth, remote monitoring, and digital health companies looking to capitalize on the market opportunity in Australia.
With a population of 25 million people (roughly the number of people in Florida) and a set of newly-minted reimbursement codes that makes telehealth available to all of them via the government-funded public healthcare system, the appetite for investing in new health tech solutions has grown ravenous.
Says Louise, “Anyone who has solutions that are already market-tested and approved, I’d actually expand your networks globally now. There’s not a section of the globe that hasn’t been impacted by [covid19] and we’re all needing to work out how to deliver healthcare differently.”
As in other parts of the world, the government codes reimbursing telehealth and other virtual-first services are temporary (Australia’s are set to expire September 30, 2020), but organizations like the AIDH, the Australian Medical Association, and others are advocating for their permanence and are optimistic.
The prevailing sentiment is that, like in the US, the benefits of virtual care to healthcare consumers and clinicians are going to be difficult for the government to ignore. Add to that the potential of linking virtual care to the Aussie government’s AUD$2 billion dollar build of its MyHealthRecord system — a centralized, cloud-based EMR that holds the healthcare data of 90% of all Australians — and the prospect grows even more appealing.
Join us as we talk through the basics of the Australian healthcare system and get an insider’s look at the demand for digital health, remote monitoring, and telehealth Down Under.
After my posts on telemedicine were published recently, (this one on Manly Wellness before the pandemic and this one after it erupted, on A Country Doctor Writes, then reblogged on The Health Care Blog, KevinMD and many others), I have been asked about my views on telemedicine’s role in the future of primary care.
Things have changed quickly, and a bit chaotically, and there is a lot of experimentation happening right now in practices I work or speak with.
Before thinking about telemedicine in Primary Care, we need to agree on some sort of definition of primary care, because there are so many functions and services we lump together under that term.
Many people think of primary care mostly as treating minor, episodic illnesses like colds, rashes, minor sprains and the like. This is an area that has attracted a lot of interest because it is easy money for the providers, since the visits tend to be quick and straightforward and such televisits are also attractive for the insurance companies if they can keep insured patients out of the emergency room. With the technical limitations of video quality and objective data such as heart rate and rhythm, I think this is an absolute growth area for telemedicine. However, with all the other forms but mostly here, fragmentation of care could become a complicated problem. To put it bluntly, if we still expect a medical professional or a health care organization to keep an eye on reports from various sources, such as hospital specialists, walk-in clinics or independent telemedicine providers, they are going to want to get paid for it.
“I never anticipated — and no one did — the level of uptake and the level of scale.”
It says a lot that Joe DeVivo, CEO of Intouch Health, who’s worked with hospitals and health systems on standing up B2B-focused telehealth programs for years (and whose company was acquired by Teladoc Health for $600-million dollars in January) is surprised about the uptake of virtual care during the COVID-19 pandemic.
“Historically, I look at virtual care as a bell curve,” says Joe. “On one side of that small tail of the bell curve are the virtual care companies. Teladoc dominates that space for D2C. There’s millions of consultations a year, and we’re seeing a subset of that. On the opposite side of the bell curve is high-acuity, and what InTouch has been doing for critical care.”
“This crisis, and the changes in reimbursement, have opened up the middle of that bell curve. The core, everyday transaction of healthcare is now being impacted by virtual care. And the big question that everyone has is, “is this going to stick? Is this a crisis management tool and we’re going to go back to the ways of the past, or is that genie out of the bottle?”
We put Joe on-the-spot with his own question, find out what he thinks it will take to enable the permanent shift to virtual care at-scale, and dig in on how demand for telehealth within hospitals has changed as a result of the pandemic, where its not only being used to expand access to specialists, but has also been adapted into a PPE-hack to help frontline hospital workers distance themselves from infected patients.
And what of working with Teladoc? While waiting for the paperwork to finalize (all on-schedule for the end of Q2 as originally announced), the two have organized a co-selling agreement to be able to “hit the market fast” and bring their “hospital-to-home” end-to-end virtual care offering to those who need it now.
The tipping point for telehealth just happened. Many ways of doing business will change forever after the experience of the COVID-19 pandemic, and health care, too, will never be the same.
Between the release from some HIPAA requirements announced by President Trump this month, shifts in payor policies, and mandated insurance coverage of telehealth visits, innovation and adoption are taking off like wildfire. As patients and outpatient-based physicians hunker down at home, they are rapidly experimenting, and improving the way care is being delivered remotely.
Our institution, which had no prior program, faced with an imminent shut down of elective activity, developed an enterprise-wide telehealth program in days, rendering hundreds of visits as soon as we launched it. This activity is being replicated all around the country.
In the early days of the U.S. COVID-19 outbreak, BlueCross BlueShield of North Carolina (Blue Cross NC) stepped up as one of the first health insurance plans to announce reimbursing telehealth visits “at parity” with face-to-face office visits for all providers and specialists. Chief Medical Officer Rahul Rajkumar talks us through the strategy behind that decision to “flip the switch” for telemedicine — which was made in just one meeting (!) – and what metrics and outcomes the Blue plan will be looking at post-pandemic to decide if the switch remains on.
Changing reimbursement policies to cover ALL COVID-19 testing and treatment
6:45 min: The role of virtual care during COVID-19 and reimbursement at parity
11:11 min: How will telehealth be evaluated post-epidemic?
13:58 min: Telehealth innovation, B2B use, remote monitoring (looking to providers to lead the way)
17:25 min: What’s going to happen with healthcare costs in 2021?
For more on how health tech companies in digital health, telehealth, remote monitoring, health data, and more are responding to the COVID-19 crisis, check out the other interviews in this special series at www.wtf.health/covid19.
Today on Health in 2 Point 00, we have a no-nonsense April 1st episode—with deals this time! On Episode 115, Jess asks me about Olive raising $51 million for its AI-enabled revenue cycle management solution, Bright.md raising an $8 million Series C for its asynchronous telemedicine platform, and AristaMD raising $18 million for a different sort of telemedicine, eConsults, which allow primary care physicians to consult with specialists virtually. —Matthew Holt
Jamey Edwards, CEO of one of the larger in-hospital B2B telehealth startups in the US, Cloudbreak Health, is already seeing changes in the way hospitals are using his company’s telemedicine services in the wake of COVID-19.
From a noted rise in the rate of infectious disease consults, to “quarantine rooms” where telemedicine equipment is cleverly deployed to practice “clinical distancing” to minimize risk to front-line healthcare workers (and also preserve PPE), Jamey talks about what he’s seeing among hospital clinicians and what they seem to need most right now from telehealth providers amid the COVID-19 outbreak.
With changes to licensing regulations, HIPAA policies, and reimbursement changing the very infrastructure around telehealth, will we finally see virtual care become a true part of the healthcare system at-scale?
“One of the hardest things to do in our healthcare system is match cost to acuity,” says Jamey. “I’m not going to say we’ve overvalued the in-person encounter, but we certainly have been very hesitant to step away from it.”
“The fact of the matter is that that’s a bias. And so it’s up to us to look at these biases and say, ‘Well, no. What is the right way to do this?’”