Some of the biggest legal stories of the year include patients attempting to mount a class action lawsuit against Mayo Clinic after an employee improperly viewed more than 1,600 health records and the Supreme Court hearing opening arguments in a case challenging the constitutionality of the ACA’s individual mandate.
CVS Health Corporation names Neela Montgomery Executive Vice President and President of CVS Pharmacy/Retail, effective November 30, 2020. Montgomery will oversee the company’s 10,000 pharmacies across the United States. Montgomery, currently a Board Partner at venture capital firm Greycroft, most recently served as chief executive officer of furniture retailer Crate & Barrel and has nearly 20 years of global retail experience.
The Cleveland Clinic and Amwell joint venture appoint Egbert van Acht as Executive Vice Chairman to the Board of Directors and Frank McGillin as CEO. Formed one year ago as a first-of-its-kind company to provide broad access to comprehensive, high-acuity care via telehealth, the company has made great progress scaling digital care through its MyConsult® offering. With an initial focus on clinical second opinions, the organization also offers health information and diagnosis on more than 2,000 different types of conditions including cancer, cardiac, and neuroscience issues.
Healthcare industry veteran Dana Gelb Safran, Sc.D. has joined Well Health Inc. as Senior Vice President, Value-Based Care, and Population Health. In her new role, Dr. Safran will expand WELL’s uses to improve healthcare quality, outcomes, and affordability through partnerships with payers and Accountable Care Organization (ACO) providers.
Talkdesk®, Inc., the cloud contact center for innovative enterprises appoints Cory Haynes to lead Talkdesk’s strategy for the financial service industry and Greg Miller to lead the strategy for healthcare and life sciences. Haynes and Miller are key members of the Talkdesk industries team led by Andrew Flynn, senior vice president of industries strategy for Talkdesk.
Imprivata appoints Mark McArdle to Senior Vice President of Products and Design. Mr. McArdle has more than two decades of experience in software development, Software-as-a-Service (Saas), in Cybersecurity, and advanced products for the enterprise, SMB, and consumer markets.
Eden Health names Jack Stoddard as executive chairman of its board of directors. Formerly serving in COO roles for Accolade and Haven, Stoddard brings two decades of healthcare innovation and operating experience to the board position, providing leadership, wisdom, and counsel during a time of monumental growth and adoption for the company.
Augmedix names Saurav Chatterjee Chief Technology Officer. Prior to joining Augmedix, he most recently served as Vice President of Engineering at Lumiata, Inc., where he led the engineering team that built a leading AI platform, focusing specifically on transforming, cleaning, enriching, featurizing, and visualizing healthcare data, and on building, deploying and operationalizing machine learning and deep-learning models at scale.
Tridiuum, the nation’s premier provider of digital behavioral health solutions names Philip Vecchiolli has joined the company as Chief Growth and Strategy Officer. Vecchiolli, who brings over 30 years of experience to the new role, has a successful track record of leading business development for large and mid-size healthcare companies.
Connect America appoints Janet Dillione as its new chief executive officer (CEO). Prior to joining Connect America, Dillione worked in the healthcare information services industry as CEO of Bernoulli Enterprise, Inc., GM of Nuance Healthcare, and CEO of Siemens Healthcare IT.
Health Catalyst, Inc. announces that current Chief Financial Officer Patrick Nelli has been named President, effective January 1, 2021. Following Nelli’s promotion to the President role, Health Catalyst has named Bryan Hunt, current Senior Vice President of Financial Planning & Analysis, Chief Financial Officer, also effective January 1, 2021.
Two additional promotions, also effective January 1, 2021, include Jason Alger, Senior Vice President of Finance, to Chief Accounting Officer, and Adam Brown, Senior Vice President of Investor Relations, to Senior Vice President of Investor Relations and Financial Planning & Analysis.
Apervita hires health IT veteran Rick Howard as Chief Product Officer. In his role, Rick will oversee product vision, innovation, design, and delivery of Apervita’s digital platform, which enables digital quality measurement, clinical intelligence, as well as value-based contract monitoring and performance measurement.
Conversion Labs, Inc. appoints Roberto Simon to its board of directors and as the chair of its audit committee. Following his appointment, the board now has eight members, with six serving as independent directors. Mr. Simon currently serves as CFO of WEX (NYSE: WEX), a $6+ billion fintech services provider.
PRA Health Sciences, Inc. appoints senior FDA official Isaac Rodriguez-Chavez, Ph.D., MHS, MS, as Senior Vice President, Scientific and Clinical Affairs. He will lead the company’s Global Center of Excellence for Decentralized Clinical Trial (DCT) Strategy. Dr. Rodriguez-Chavez’s responsibilities will involve the continued growth and development of PRA’s industry-leading decentralized clinical trial strategy, regulatory framework creation, and clinical trial modernization.
Proprio appoints three global thought leaders to its Medical Advisory Board. Dr. Sigurd Berven, Orthopedic Surgeon and Professor at the University of California, San Francisco, Dr. Charles Fisher, Professor and Head of the Combined Neurosurgical & Orthopedic Spine Program at Vancouver General Hospital and the University of British Columbia, and Dr. Ziya Gokaslan, Professor and Chair of the Department of Neurosurgery at Brown University and Neurosurgeon-in-Chief at Rhode Island Hospital and The Miriam Hospital will apply their globally respected surgical and research expertise to the development of the Proprio navigation platform.
Kaiser Permanente names Andrew Bindman, MD Executive Vice President and Chief Medical Officer. In this role, Dr. Bindman will collaborate with clinical and operational leaders throughout the enterprise to help lead the organization’s efforts to continue improving the high-quality care provided to members and patients throughout Kaiser Permanente. Dr. Bindman will report directly to Kaiser Permanente chairman and CEO Greg A. Adams.
Greenway names Dr. Michael Blackman Chief Medical Officer at Greenway. Dr. Blackman will further support the company’s ambulatory care customers, ensuring providers are equipped with the solutions and services they need to improve patient outcomes and succeed in value-based care.
Suki expands its leadership team with six key hires to support the company’s rapid commercial growth. Tracy Rentz, formerly Vice President of Implementation at Evolent Health, joins Suki as the Vice President of Customer Success and Operations to lead all customer operations, with a particular focus around deploying new Suki customers. Brian Duffy brings over 20 years of sales experience to Suki, joining the team as Director of Sales-East, after having most recently served as Regional Director at Qventus, Inc. Brent Jarkowski will also join Suki’s sales team this November as the Director of Sales-West, bringing over 15 years of experience in strategic relationship management. Brent joins Suki after serving as Senior Client Development Director at Kyyrus. Together, Brian and Brent will head the company’s efforts in building new partnerships across the country. And Josh Margulies, who previously served as the Director of Integrated Brand Marketing for the Jacksonville Jaguars, will serve as Suki’s new Senior Director of Field Marketing.
– Amwell just announced some new offerings Amwell Now, Touchpoint
Tablet software, and C500 to help increase doctor-to-patient virtual
connections as patient and doctor preferences change in light of the pandemic.
– The new solutions (a quick-to-deploy video visit offering, new tablet software, and a telemedicine cart) are designed to be easy-to-use but fully integrated in the provider’s systems and secure.
leader, today announced new connectivity, device and cart offerings, all
tailored to meet the evolving needs of care teams and patients. Spurred by the
impact of the COVID-19 pandemic, Amwell is introducing Amwell Now,
Tablet software, and the C500
telemedicine cart to help health systems and other healthcare organizations
easily leverage telehealth as a safe, quality care option.
and Amwell’s latest Carepoint tablets and carts are designed to make it easier
for providers to quickly onboard patients and use virtual care. These tools can
be integrated within and scaled across organizations’ current systems and
devices, making it simple to embed and launch telehealth across various
specialties and serve an entire care organization. New offerings include:
enables a simple connectivity experience for patients and providers,
streamlining entry to the Amwell platform, which is purposefully designed for
healthcare interactions. Amwell Now addresses physicians’ needs for easy, fast
video visits, all on Amwell’s HIPAA compliant, clinically tailored platform. It
delivers simple reporting functionality and the ability for organizations to
put forward their own brand versus that of Amwell. Providers can deploy Amwell
Now with only a few clicks, invite patients by text or email, launch an instant
video connection, and experience an adaptable video visit workflow that is easy
for both themselves and their patients.
Touchpoint Tablet Software
Amwell’s Touchpoint Tablet software offers a new and simple
way to connect remote providers to on-site patients and providers. With it,
health systems can use (existing or new) iPads to facilitate bedside video
connectivity and collaboration in a secure, reliable, HIPAA-compliant way. The
Touchpoint Tablet software is integrated with Amwell Fleet Monitoring, enabling
health systems to track their tablets as part of their Carepoint fleet.
C500: Lightweight Telemedicine Cart
is Amwell’s latest-generation, lightweight telemedicine cart that empowers providers
to conduct efficient, high-quality remote exams across a variety of
specialties. Featuring an embedded 4K camera that responds immediately to user
commands and smart sensors that make the cart environment-aware, the C500
provides a seamless care experience that is fully integrated with the Amwell
Why It Matters
“Amid COVID-19, healthcare organizations’ needs for and expectations surrounding telehealth have fundamentally changed,” said Ido Schoenberg, Chairman and Co-CEO, Amwell. “Increasingly, virtual care is being used as core to all types of care delivery, whether it’s to safeguard care teams, limit unnecessary exposure for patients, or to prioritize the home as a go-to care setting. Our latest offerings are responsive to industry calls for simplicity, integration, and quality, and in service to the evolving landscape of healthcare and our lives overall.”
Teladoc Health has sued competitor American Well for patent infringement. The company is seeking unspecified damages and a ruling that would prevent AmWell from using the telemedicine cart technology that Teladoc claims to hold the patents for.
The thing to do in health tech this week? Trademark infringement. Today on Health in 2 Point 00, we try to make sense of all the lawsuits right now with Teladoc suing Amwell, Allscripts suing CarePortMD, and whose side are we on for Zocdoc suing Zocdoc? On Episode 160, Jess asks me to make sense of Augmedix’s faux IPO in a reverse merger and publicly traded company Newtopia arising $75 million. Twentyeight Health raises $5.1 million in a Series C and TestCard raises $5.8 million for at-home mobile urine testing.—Matthew Holt
a national telehealth leader, released the results of its annual Physician and Consumer Survey. The results show physicians
and consumers expect to use telehealth more often following COVID-19 than they
did before the pandemic. Telehealth usage is up considerably in 2020, with 22%
of consumers and 80% of physicians having a virtual visit this year, up from 8% and 22%, respectively, in 2019. This adoption is largely driven
by a shift to scheduled visits across all specialties, whereas prior to
COVID-19 the majority of visits were for on-demand urgent care.
Amwell commissioned Dynata to conduct an online study among
more than 2,000 adults, and commissioned M3 Global Consulting to conduct an
online survey of 600 physicians—300 primary care physicians and 300
specialists—to measure consumer and physician perceptions and usage of
telehealth. Both surveys were fielded in June 2020.
Read the findings from Amwell’s
2020 Physician and Consumer Survey for a deeper look into what happened
during the pandemic—including how consumer and physician experiences,
behaviors, and expectations shifted—and to better understand the quickly
evolving role virtual care will play in healthcare. In addition to new survey
data, the eBook covers:
How COVID-19 has accelerated hybrid care models that combine
in-person and virtual care
– The importance of usability in provider and consumer
adoption of telehealth technology
– How consumer access to virtual care and the know-how to
leverage it remain highly uneven
– How, when, and how much consumers and providers plan to
use virtual care in the future
– Strategic questions organizations should consider to
influence the future direction of virtual care
For more information on this report, click the download now button below:
Today on Health in 2 Point 00, Jess and I gossip about the wild rumor that UnitedHealthcare is acquiring Amwell. On Episode 157, we discuss Lark raising $55 million in a Series C along with a deal with Anthem to be their preferred DPP provider, Medicare Advantage plan Clover going public with a valuation of $3.7 billion, NOCD raising $12 million in a Series A providing specialized CBT and virtual OCD treatment, Cerebral raising $35 million in a Series A for its comprehensive digital mental health offerings, and Express Scripts adding to their digital health formulary with offerings targeting things like women’s health, tobacco cessation, muscle and joint pain, and more. —Matthew Holt
– Amwell ranks highest among direct to consumer brands
and Cigna ranks highest among health plans for telehealth patient satisfaction,
according to the J.D. Power 2020 U.S. Telehealth Satisfaction Study
– Though telehealth has been pitched as a solution to
improve access to healthcare for everyone, more than half (52%) of telehealth
users say they encountered at least one barrier that made it difficult to use
The J.D. Power U.S. Telehealth Satisfaction Study, now in
its second year, measures consumer satisfaction with their telehealth service
experience based on four factors (in order of importance): customer service
(42%); consultation (28%); enrollment (19%); and billing and payment (11%). The
study is based on responses of 4,302 health consumers who used a telehealth
service within the past 12 months. It was fielded in June-July 2020.
“The COVID-19 pandemic has been a moment of truth for telehealth, and, by most accounts, the technology is rising to the challenge and delivering a high degree of satisfaction among those who use it,” said James Beem, managing director of global healthcare intelligence at J.D. Power. “However, even though the public awareness with Telehealth is higher due to the influence of COVID-19, the barriers for the consumer to engage with the technology has been a consistent theme in our research.”
Key findings of the 2020 study include:
– Amwell ranks highest in telehealth satisfaction among direct-to-consumer brands, with a score of 885. Doctor on Demand (879) ranks second.
– Cigna ranks highest among payers of health plan-provided telehealth services with a score of 874. Kaiser Foundation Health Plan (867) ranks second and UnitedHealthcare (865) ranks third.
– Great patient experience: The overall customer satisfaction score for telehealth services is 860 (on a 1,000-point scale), which is among the highest of all healthcare, insurance and financial services industry studies conducted by J.D. Power.
– Barriers to access persist: Though telehealth has been pitched as a solution to improve access to healthcare for everyone, more than half (52%) of telehealth users say they encountered at least one barrier that made it difficult to use telehealth. The most common hurdles are limited services (24%); confusing technology requirements (17%); and lack of awareness of cost (15%). Additionally, 35% of telehealth users indicate they experienced a problem during a visit. Tech audio issues (26%) are the most common problem.
– At-risk patients have lower levels of satisfaction: Overall satisfaction is 117 points lower among patients with the lowest self-reported health status than among patients who consider themselves to be in excellent health. Similarly, healthier patients are significantly more likely to understand the information provided during the visit, receive clear explanations, feel their visits are highly personalized and obtain a high-quality diagnosis.
– Safety becomes a top driver of utilization: Among patients who used a telehealth offering this year, 46% say their top reason for choosing telehealth was safety. That compares with just 13% in 2019.
Amwell expanded its partnership with Tyto Care, a startup that makes connected exam kits for telehealth visits. The companies will design new integrations of their technologies, and Amwell will become a reseller of Tyto Care’s devices.
Care and Amwell® announced an expanded partnership, allowing
the companies to develop new integrations to enhance virtual care offerings for
– By pairing Tyto Care’s TytoHome device and platform
with Amwell’s platform, the two companies will together provide patients
and providers with augmented virtual care experiences and
broadly enrich the capabilities and satisfaction with healthcare organizations’
virtual care applications.
provider Amwell, today
announced it is expanding its partnership with Tyto Care, the
healthcare industry’s first all-in-one modular device and examination platform
for AI-powered, on-demand, remote medical exams. Together the companies will
introduce exclusive integrations and newly designed workflows and tools to
enhance the ability for providers using the Amwell platform to examine and
diagnose patients virtually. Additionally, Amwell will become a reseller of Tyto Care’s
Tyto Care Background
Tyto Care seamlessly connects people to clinicians to provide
the best virtual home examination and diagnosis solutions. Its solutions are
designed to enable a comprehensive medical exam from any location and include a
hand-held, all-in-one tool for examining the heart, lungs, skin, ears, throat,
abdomen, and body temperature; a complete telehealth platform for sharing exam
data, conducting live video exams, and scheduling visits; a cloud-based data
repository with analytics; and built-in guidance technology and machine
learning algorithms to ensure accuracy and ease of use for patients and
insights for healthcare providers.
Conduct Exams and Diagnoses
By pairing the TytoHome handheld examination
device – which enables on-demand examinations of the heart, lungs, abdomen,
skin, throat, ears, heart rate, and body temperature – with Amwell’s telehealth
platform, providers can guide patients through
virtual health examinations and together gain real-time insight into a
patient’s health data and status directly in the visit. For patients and
providers, this will augment the virtual care experience and more broadly
enrich the capabilities and overall satisfaction associated with healthcare
organizations’ virtual care applications. This enriched workflow will be available to
thousands of Amwell hospitals, health systems, health plans
and employer clients who collectively serve millions of patients.
“As COVID-19 wages on and more patients and providers adopt telehealth, it’s critical that we accelerate the depth of care that can be provided in the home – to keep patients and providers safe,” said Roy Schoenberg, President and Co-CEO, Amwell. “Our latest integration with Tyto Care will allow providers to clinically come closer than ever before to patients during telehealth encounters, allowing them to see, interact, examine and deliver care in ways that growingly resemble in-person care.”
Offering More Holistic Care for Patients
“Our longstanding partnership with Amwell exemplifies our shared goal of providing deeply integrated telehealth solutions that put health in the hands of consumers, creating a more impactful and seamless healthcare experience for both patients and providers,” said Dedi Gilad, CEO and Co-Founder, Tyto Care. “The integration with TytoHome will enable Amwell to offer more holistic care for patients, especially for urgent and primary care needs, as well as help to enable better adherence to treatment plans. We look forward to continuing our work together as we realize the full potential of clinic-quality, at-home care in this new era of telehealth.”
Can we call this digital health anymore? What do we call it? On Episode 146 of Health in 2 Point 00, Jessica DaMassa asks me about Amwell filing for their S1, Lyra Health getting $110M to develop their mental health platform, PatientPop raising $50M to improve SEO for doctors and patients (they also brought Johnathan Bush on their board!), Brightline closing $20M for their behavioral health platform for kids, and Science 37 getting $40M for their site-less clinical trials — Matthew Holt
It’s all go in the US telehealth sector, with Alphabet’s Google investing $100 million in Amwell on the same day the Boston-based firm unveiled plans for an initial public offering (IPO).
Google has also agreed a partnership with Amwell that makes the telehealth company its preferred partner, while Amwell in turn has agreed to switch some of its online service to Google Cloud from current provider Amazon Web Services.
The IPO aims to raise around $100 million, according to Renaissance Capital, but no pricing has been publicly disclosed yet.
Amwell is one of the larger players in the US market, providing telemedicine to more than 2,000 hospitals and 55 health plan partners with more than 36,000 employers, and recording $202 million in revenue in the 12 months ended June 30.
The coronavirus pandemic has resulted in a dramatic increase in the use of telehealth in the US and elsewhere, and in turn seems to have prompted companies to look at strategic deals to enhance their presence, and avoid falling behind the competition.
Earlier this month, Teladoc and Livongo announced an $18.5 billion merger that will create a digital health giant with pro forma sales of $1.3 billion from telehealth systems and health monitoring tools if it gets regulatory approval.
That is the largest deal ever signed in the telehealth sector, and according to analysts signals growing confidence in the continued growth of the market once the pandemic subsides. Frost & Sullivan has predicted sevenfold growth in telehealth by 2025, an annual growth rate of more than 38%.
According to data from the US Department of Health and Human Services, Medicare primary care visits delivered remotely grew from less than 1% in February of 2020 to more than 40% in April when the pandemic was starting to peak.
“The pandemic has resulted in historic telehealth utilisation, making it a priority and, in many cases, a preference for patients, providers, and health plans,” said Amwell in a statement.
“The partnership aims to make the healthcare experience much simpler and more continuously accessible to underserved populations” like seniors and patients with chronic illnesses, it added.
The partners say they plan to work together in areas such as automated waiting rooms and checkout, language translation services, and digital triage to reduce the burden on clinicians and streamline the reimbursement process.
Google Cloud’s global director of health care strategy Aashima Gupta said in a blog post that the aim is to create a future “in which your visit begins with a customised greeting and relevant information in a digital waiting room.”
A conversational chatbot would ask about symptoms and the reason for the consultation, sharing this information with a physician prior to a remote consultation. All the interactions would take place in the patient’s preferred setting with artificial intelligence (AI) providing live, translated captioning of the conversation.
Routine tasks such as filling out reimbursement forms would be automated during the visit, freeing up more time for the consultation, and the same technology could also be applied to ongoing monitoring of patients at home.
“We’ll work together to bring these solutions to market, helping expand access to virtual care among our mutual customers and the global healthcare industry,” said Gupta.
Today on Health in 2 Point 00, Jess asks me about the big news that Google Cloud has entered into a partnership with Amwell and invested $100 million into the company—looks like their IPO is really a thing! OneDrop gets $98.7 million in a partnership with Bayer, following at $40 million partnership last November, in a funding and development agreement. Outset Medical files their S1 and is going to go public, looking for $100 million for their portable dialysis system, and finally Podimetrics raises another $8 million for their foot ulcer detection platform for diabetics.—Matthew Holt
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.
Full Transcript of the Interview:
Hey, it’s Jessica DaMassa with “WTF Health – What’s the Future, Health?” We are getting insight scoop on everything happening in health tech from some of the biggest names in the industry. And so what conversation about telehealth would be complete without this guy right here? We have Roy Schoenberg. He is the president and co-CEO of Amwell. Roy, it is so exciting to talk to you. How are you?
Thank you. It’s great to be with you, Jessica.
Oh my gosh, I can’t imagine how busy you must be.
We don’t complain. We can’t complain. Telehealth seems to be the name of the game right now. So we’re riding the wave, I think with many others, but it is a big time for telehealth.
Oh my gosh. Okay. So I want to hear all about exactly what kind of a big time this is. And Amwell… obviously, your company, you’re one of the leaders in this category and there is lots of news going on about not only the industry, but also about Amwell. We’ve heard some IPO rumors that we may or may not address later. You guys closed a massive funding round, $194 million in May. So tell me a little bit, I guess about, let’s start with what’s going on. So what have you been putting that funding to use for so far?
Well, I’m sure that everybody at this point is a little bit aware of the role of telehealth in COVID. It started off maybe even four or five months ago as the thing you use for convenience maybe to, in the middle of the night, if your child is crying or you have a rash or a flu to get a simple antibiotic. And it has literally almost overnight became the first line of defense for everything in healthcare. Not only that most Americans, especially during March and April, and now actually more so in some parts of the country, were asked to stay at home and socially isolate. And not only that they were concerned about COVID, but anything else that they had going on in terms of healthcare, all of the places that you would normally go to get healthcare were locked up, physician offices and urgent care centers and retail clinics. And nobody wants to be in a waiting room of a hospital right now. All of these disappeared.
At the same time, a lot of the clinicians of all the different disciplines were also home. Many of them were told, “You can’t come in if you’re a primary care physician or whatever it is, you’re going to be isolating, sheltering in place as well.” So they were stuck in their homes. And the reality is that at that point in time, telehealth became from a novelty or from something that people thought, “Oh that’s a good way for healthcare to modernize,” became almost overnight the only way by which clinicians could do their job and practice their art and do what they were responsible for doing with their patients. So literally within the course of a couple of weeks, we have seen an incredible, we call it unprecedented, the title where fill in the blanks in terms of what kind of giant word you want to put in there.
But we’ve seen an incredible, incredible hiking in telehealth. It started off with a wave of urgent care telehealth, which everybody’s familiar with. That was, and it is still about 10 times what it was at the beginning of this, some time in March. But I think more importantly, we’ve seen an entire avalanche of a new kind of use of telehealth where clinicians who actually have a relationship with patients with chronic patients and cancer patients and so on, physicians who are in a hospital are now using telehealth in order to support, maintain, and follow up on those patients. And that wave of telehealth has somewhere along the way eclipsed the urgent care telehealth, which was the name of the game just until February or March. And that has grown in some cases 30 times, 40 times the volume that it was a couple of months ago. And what people say is that this, I think the term is that that genie is not going back in the bottle or that toothpaste is not coming back into the tube. And that really is forcing everybody to completely rethink how the healthcare system should operate in a world post COVID. So it’s definitely been a fun time in telehealth.
All right. I want to unpack some of this stuff, because you said a lot there. I want to address this toothpaste that has come out of the tube. I don’t think I’ve heard that one yet in reference to telehealth. That’s pretty cute. And so I want to go back though to what you’re talking about in terms of how unprecedented this is. And I would like to get your input on this. Amwell is a company that’s been around since the beginning. You guys have birthed the sector more or less with a few others. 15 years, is this really as unprecedented a time in telehealth as we think it is?
Yeah. So you really can break it down to a lot of the historical barriers of telehealth, which I think everybody has heard about over and over again, so they’re not that interesting to repeat. Reimbursement, licensure, all of that kind of fun stuff. I think we’ve seen over the last couple of years a growing acceptance of telehealth by consumers, funnily enough, who are for lack of a better word, are open to embracing technology that makes their life better. So there was less of a concern there and that worked really well. The part that really, really changed is actually on the clinician side of things.
Tell me more about that.
That’s kind of a little bit of an unusual observation, but I would say that historically, and that’s true for us and for Teladoc and for other companies as well, most of the telehealth that’s out there in terms of volume that’s doing urgent care is utilizing clinician services of clinicians who are participating in telehealth programs. But the vast majority of healthcare doesn’t happen with the clinician that are on our network or Teladoc network or whatever it is. Most healthcare happens by clinicians who are in their offices in the hospitals and everything else. And for the most part, adoption by them has been growing steadily, but nothing to write home about. Nothing that is a headline in the newspaper. That changed.
And the reason for that was that almost overnight, a lot of the health care institutions, we don’t think about it when we think about COVID, but a lot of the health care institutions out there, the way they survive is by essentially doing patient encounters, which translates to a lot of fun stuff like claims, submissions, and adjudication and everything else, but that’s how they get paid. And that’s how they pay for the buildings and everything else.
And that disappeared overnight. So suddenly the financial reality of the healthcare industry that is tightly driven to the volume of patient encounters was under an existential threat. And the translation of that was, it is no longer to be the discretion of everybody to decide if they want to try it out or taste it and maybe opine on it and maybe try it on a Sunday afternoon when they have time. We have to, as an industry, transition to telehealth to survive. And that drive to telehealth has a completely different kind of firepower than the curiosity about telehealth. And the result of that is that the number of clinicians around the country that have been not only exposed to telehealth, but have been literally asked to transition everything they do into telehealth in order to continue to work in the institutions that they belong to, that has forced a completely different adoption curve of telehealth to clinicians.
And the one thing that we all know, like it or not, healthcare is driven by the clinicians. We as patients, we actually do as we’re told. We’re probably the one person that it doesn’t matter how strong our character is, when we sit in the doctor office and the doctor tells us, “This is what you need to do,” we say, “Yes. Okay. That’s what I’m going to do.” So the reality is that a lot of healthcare is really driven by the physician’s decision of what’s the right thing to do next. And the fact that physicians now, in huge numbers, are telling their patients to use telehealth, that is a very different reality than before COVID. And to me, that is kind of the secret ingredient of why that toothpaste is not coming back.
Okay. How do you make sure that that stays the case? How do you prevent these clinicians from going back? Right now they’re more or less, as you said, they’re forced to deliver care this way because inpatient visits are not necessarily an option, especially in some places that are hotspots. So how do you make sure that their experience with telehealth right now is so sticky that they want to stick around and continue to provide telehealth or deliver certain kinds of care via telehealth services, as opposed to returning back to the same old office visit and what they’re comfortable with? How do you do that?
I think, maybe to be a little bit humble about it, I actually don’t think you can make clinicians do anything. Or maybe that’s an exaggeration, but for the most part-
Spoken like a true clinician, right?
Well, years ago when I was doing clinical care, but the reality is that what they do is driven from true good motivation of, I want to do something that is the right thing for the patient and something that allows me to sustain my ability to care for the patient long term, which is to maintain a practice and have a life and everything else. And it is the balance of those that at the end of the day drives what they do. I think the reality is… it’s not about, payment is important. Of course you have to pay clinician for the work they do like any other person that works.
But I think that the experience the clinician had over COVID is that their ability to interact with a patient is so gratifying and liberating to the patients that they care about, that it is going to be almost unreasonable for them to withdraw those services and say to patients, “Hey, even though you are 82 and you’re frail, and you have all of these different things that make it really hard for you to keep the cadence of followup that we need to do to take care of you, and even though we actually did it really, really well over the last three months in telehealth, take the bus.”
At some point, that doesn’t make any sense anymore. And when all the pieces of the puzzle that are necessary, like making sure that it is encrypted and secure and making sure that it is paid for and making sure that it is tied into the EHRs and it’s tied into the scheduling system and how my staff as a clinician can support me in handling patient. When you’re taking all of these barriers out of the equation, which many of them have been taken out of the equation, you’re left with a, I don’t call it a humanitarian or human question of, how can I say no to this when this is such a powerful way to make the life of my patients better?
And that will resonate differently with different people. But I think at the end of the day, this isn’t about Amwell persuading people. It just makes sense. And that’s very powerful.
No, it is very powerful. And I’m curious too, as you talk about some of the things that have traditionally provided barriers against uptake have been kind of lifted in all of this. And I think it’s interesting to hear you talk about what you feel like individual clinicians are learning about telehealth as a result of having some of those old constraints lifted. What are some of the other things that you have been learning about the appetite for telehealth, maybe on the consumer side, or I know that private practice product that you guys just launched is giving you kind of these insights into the physician part of things. But you’ve got a lot of health plan clients. I mean, some big health plan clients, and you guys have big healthcare provider clients as well. So what have you been hearing on that side? What new things have been revealed now that the restrictions have been lifted on that side of the world as well?
So where do I start? How much time do we have? I think we are, as I said, we’re in a very unique position. I think very unlike many of the other telehealth operators out there. The difference with us is that we’re kind of equally footed. We have one very strong foot on the consumer, employer, payer side of things, and we serve big chunk of the country there. And we have an equally strong footing on the clinician side of things, on the provider and practice, and very importantly hospital and delivery network and health system part of things. And the systems are actually built to bridge the two. Now, this isn’t the pitch for one architecture or another, but the fact that we are essentially being a conduit between the patient side of things or the consumer side of things and the delivery side of things opens up the door to real opportunities that we never thought about.
So for example, I can tell you that we are turning a corner in thinking. Historically people thought about, could telehealth be as good as a physical visit? For more than a decade, that was the name of the game. Can it be safe and good enough and whatever it is? The reality of COVID has literally opened the door to the question, can telehealth be better? And the reason for that is not to say that a remote physician is better than a physician that’s in front of you.
But rather to say if we think of the way that we envelope a patient that has a serious medical condition and we throw telehealth into it so it allows us to, for example, check up on them for a couple of minutes, three times a week without actually incurring office visits and the whole hoopla that goes around that. Does that allow us to actually be much more attentive to the changes in their condition? Maybe changing their medication more frequently, to understand if there are side effects. If they have cancer, can support them by other ways… by way of nutrition and behavioral support and everything else. Can we actually rethink the way we surround patients with healthcare in the presence of telehealth that will allow us to change the cookbook of medicine, medical practice?
And I know that this sounds almost pithy, it’s almost kind of high level, but the fact that this conversation is literally now carried in both the health system side of our customers, as well as on the payer side, the health plan, side of our customers, who are saying, “Let’s actually kind of not throw telehealth as an added thing into everything that we offer. Let’s actually think from the ground up and say, maybe telehealth is the start of healthcare. Maybe that is the gate by which people enter when they have an issue.” And I can tell you that that translates into some really astounding conversations, both on the delivery side of healthcare as well as well as on the care side.
If you want to gossip about those astounding conversations, feel free to let us know what you’re thinking there. One question I have for you is, I guess from your perspective, what’s the next iteration of this then? You talked about this as like, okay, if this is the way in to developing a better opportunity for care delivery for patients, we’ve been hearing all sorts of things. Just earlier this week, Glen Tullman published on it, an article about this “consumer directed virtual care” as he’s calling it, talking about how telehealth is important, remote monitoring has a place, but there’s also this kind of other set of services that get added on there where we’re looking at data and things are ambiently collected so that patients can kind of take initial steps to prevent things from going wrong before we get there. What do you think is going to get added on to telehealth in order to make this new care delivery model really come to life? What’s the next thing in terms of what you’re looking at right now?
So I think, maybe to use an analogy here, and I’m sure that people are sick of Amazon analogies, they’re used everywhere. But, Amazon started by selling books and it was actually a very brilliant choice by Jeff Bezos at the time, because he really kind of introduced the notion of online retail in many ways, and books are a great product to flush the pipes with. They don’t go bad. You know what you’re getting. You ship them, you can track them, you can pack them, they’re square. You can actually pack them very neatly. And he figured out the notion of FedEx and credit card billing and PSI, all of the different kinds of compliance elements and returns. So it was a really, really good way to flush the pipes of online retail.
And then he extended it into the store that sells more things. And then further went into the third stage, which is now Amazon sells stuff that actually are not in Amazon warehouses. You have a lot of things that you buy from end producers of merchandise that goes through Amazon to you, but Amazon is not the one fulfilling it.
Funnily enough, I actually think that telehealth is going to go exactly through those stages. History tends to repeat itself. Urgent care was the books. It’s the way to get everybody comfortable. It’s not very sophisticated medicine. It’s not life threatening to anybody. It’s convenience. It’s simple. No big deal if it didn’t work very well. Of course, it needs to work very well. But it’s a really, really simple kind of product to get people to feel comfortable. Then, the next step was a lot of the delivery side of healthcare – big health systems are starting to use telehealth with their own patients that’s a little bit more like the Amazon store that has a lot of Amazon products in its facilities and sends it to patients. So that’s where we see a lot of health system.
But the third step is the one that is the most exciting, which is, if we’re able to connect the pipes and make this feel like a network – which, by the way, the technology is built like — we’re able to have a completely different understanding on how healthcare services can travel. Which opens up the door for things that historically we never thought about, like load balancing of healthcare around the country. Think about places in the country that are flushed with healthcare, with good healthcare, and areas around the country that are not necessarily flushed with them. Think about areas that are devastated by hurricanes and fires and viruses. Think about the notion that there are cancer patients in certain parts of the country that don’t have the knowledge of how to treat cancer that exists in large metropolitan areas.
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 kind of fast forward to the end here, what that translates into (and I think that’s the part that I’m personally very, very passionate about) 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, and all of the different disciplines surround us, rather than force us to go and seek, and, worse, try to patchwork the different disciplines that we need to see. I think that opportunity is right in front of us. And in that sense, telehealth is going to work like retail and it’s inevitable. It’s not me or you or Amwell or anybody else. I think that train is out of the station.
All right. I am going to turn your analogy on you, my friend.
And I’m going to ask you if all right, if you’re going to make an Amazon analogy here, to telehealth, right. So if you’re the Bezos here.
I didn’t say that. [laughter]
I am just saying if you’re…[laughter] Clearly, there’s only a handful of companies that I think at this point, right now, have the capital, the size, the scale, and the reach to be considered the Amazon of telehealth.
I think the reach is important.
Yeah. Right. Okay. Fair enough. Okay. But I’ve got you here with me right now. And so I’m curious, especially, and not to go… I know you can’t comment on the IPO rumors one way or the other, but the fact that they are there, I think indicates something about the market for this and where things are going potentially next. So as far as you’re concerned, you’re at the helm of this Amazon-like empire here that could completely redefine the way that we grow old in the future. What are you looking at next for the business? You have a lot of funding right now. You’re growing. Things are going well. We know you’ve launched some new products, like I mentioned earlier, that physician private practice one, which I think is very cool. It’s like a Shopify almost for telehealth in terms of private clinician practices. But where do you have your sights set then in terms of what’s next for Amwell?
So I think you actually kind of hit a lot of different of the important kind of things on the head there. First of all, and I can’t comment about IPO rumors or whatever it is, I’m aware of the fact that they’re out there. And it’s great to be in a position where people can talk about those kinds of options, because telehealth is real.
Yeah, exactly. Yeah.
The adoption curves and the volumes and everything else and, literally, from the Rose Gardens through HHS and Medicare and everything else, telehealth is the name of the game. Which of course makes companies who do telehealth be in the center of things, which of course opens up a lot of opportunity. And you mentioned our funding and so on. The one thing that I would say, however, is that this is also the point where you can make mistakes. You have an avalanche of adoption and we fully feel the responsibility to make sure that we are actually not the bottleneck, that we are the facilitator. We’re the ones that allow natural evolution of adoption of that technology to happen. And if we do a good job, then we actually don’t matter that much. We’re in the background. We are allowing clinicians and patients to interact naturally. We facilitate that under the hood, but it’s not about teaching people how to use Amwell.
To do that, that’s actually very, very hard to do. That’s kind of the transition, and I know I use too many analogies, but that’s a transition of when Google was a search engine to “Google” becoming a verb, right?
You don’t think about it, you Google stuff. And I think that is something that we see on the horizon, where telehealth becomes part of the natural way in which patients and clinicians interact. To do that, however, you have to care about the details. You have to really, really understand clinician workflow. You need to understand their reality. You need to understand the rules of engagement that are very complicated in healthcare. And to do that right, to become transparent, there is tremendous amount of investment that needs to go into there. And that’s a lot of the stuff that we’re doing. You mentioned some of the new products that were introduced.
At the end of the day, there is a common theme between all of these, which is try to assimilate into the reality of traditional healthcare. Not create a product, an app for urgent care, which is a godsend when you need it, but is sitting aside of the regular healthcare delivery. But rather be entrenched inside the system. That’s a very, very significant lift. We would not be able to do it unless we were, as I mentioned, equally nested on the payer/consumer/patient side of things, as well as on the provider delivery side of things. But that is an incredible opportunity that we have in front of us. And we’re very serious about that.
How do we not mess this up? Because you started that by saying we don’t want to, with all the eyes on this and this opportunity in front of us. And just even listening to you talk about everything up until this point in terms of how thinking around telehealth has changed and the conversation has shifted. So how do we not mess this up? And I say “us,” not just the telehealth companies, but even more broadly, the other health tech companies that are maybe in things that are adjacent? Digital health, digital therapeutics, remote monitoring. How do we not mess this up right now?
I think we have to listen. Which is really important when you deal with healthcare. And I think it’s really important to always take a step back and ask yourself if what you’re doing is actually going to move the needle on where it matters. You can move a lot of needles, but for example, I’ll be the first one to tell you that I think that the application of telehealth for urgent care is really, really important. But the vast majority of healthcare paying and expenditure and volume is not in the flu, it’s in diabetes and heart failure and what Glen is doing and some of those things, and maybe that helps Glen in some way. But I think that the reality is we need to look at where healthcare happens, tough as it may be, and find a way for technology to weave into that and give it wings. And if we’re able to do that, then we’ve moved the needle on people’s right to expect better health care experience going forward than what was before. And we are seeing that happening in front of our eyes.
All right. Last thing for you, toothpaste back in tube, what do you think? No? Yes?
Are you sure? No, it’s not going back.
It is not.
This is it. This is here to stay.
This is here to stay. Yes.
All right. Well, you have to come back and talk to us if there is any news in September that we had heard, you have to come back and talk to us, even if you acquire something cool. I would like to hear about it.
It’d be a pleasure.
Thank you so much for letting me pick your brain.
Happy to come back whenever you want.
Fantastic. And I have to say, I really like that little Amwell throw pillow behind you.
That is super nice. For a big pillow fight later, right? Right. Thank you so much for stopping by and letting us pick your brain. It’s so exciting to hear about your vision for the future of the sector of the industry. I really can’t thank you enough. Thank you again for joining us. I’m Jessica DaMassa here with Roy Schoenberg, the co-CEO and president of Amwell. Thanks to everybody for watching. We’ll talk to you guys soon. Check out more of these videos up on wtf.health, or find me on YouTube. Just search WTF Health. Thanks so much for joining us.
The COVID-19 pandemic has caused an unprecedented shift in the way consumers view and access a variety of goods and services—and healthcare is no exception. Recent studies show that many patients, including vulnerable populations like those living with cancer, are delaying recommended care and procedures—and will continue to do so for at least several months amid fears over the safety of in-person visits. In response, reports of providers adapting to offer care virtually are all the more commonplace, with almost half of physicians now treating patients through telemedicine platforms, up from just 18 percent in 2018.
These trends have solidified virtual care as a mainstay, and as a result, the virtual visit has become a commodity—a service that can be provided by many capable vendors. However, the logistics that power the adoption of virtual care are often overlooked. As healthcare administrators turn to telemedicine to resume “non-urgent” healthcare services, we must ensure that best-in-class technology solutions are utilized to improve the virtual care experience—for providers, clinical staff, and, importantly, patients.
Health systems and their networks face significant operational issues when delivering care in a remote setting, due to the range of potential interactions and diversity of devices—adding to the already recognized administrative burden that comes with routine patient care. With each patient visit comes over a dozen manual tasks, including patient intake and registration, in-visit clinical note writing, as well as back-office billing and claims processing. The virtual visit adds even more steps, such as helping patients access the appropriate technology for a two-way video interface or sending custom links to a “virtual waiting room” at the right time.
Facilitating a seamless virtual care experience before, during, and after a patient’s visit should be top-of-mind—particularly as patient expectations have heightened and healthcare has progressed towards a technology-enabled future. Fortunately, the automation of operational workflows can help healthcare administrators smooth the friction around conducting virtual visits at scale.
Intelligent automation extends our capacity in healthcare by enabling us to do more with the same workforce and technology infrastructure. In fact, digital medical assistants can use artificial intelligence to automate repetitive, cognitively tiring, and error-prone tasks. This technology can support the influx of virtual visits by offloading administrative processes, such as co-payment collection, clinical documentation, and pre-population of common clinical orders.
For patients not as familiar with digital interactions and the variety of telemedicine modalities, which can include platforms like Amwell, Doctor on Demand, and Teladoc or video conference solutions like RingCentral and Zoom, participating in virtual visits can be a daunting change. Additional technological challenges associated with virtual care can result in heightened frustration, increased no-show rates, or decreased activation, so maintaining patient engagement throughout the patient journey is even more important in a virtual environment. Digital medical assistants can automate appointment reminders, offer detailed setup guidance for patients, and provide “just-in-time” virtual visit links to ensure patients and providers can make the most of their time together.
The COVID-19 pandemic has also introduced new variables and risks that patients, providers, and healthcare institutions at-large must consider when seeking and delivering care. Until recently, it was a relatively straightforward process to determine where a patient should receive routine care. Now given the risk of disease spread, providers find themselves considering which patients to see when to see them and whether to see them virtually or in-person.
This creates additional complexity in determining when to schedule patients and in which medium to conduct the visit. Platforms that leverage intelligent automation can help clinical teams to pre-screen all scheduled patients, collect a thorough medical history, intelligently segment patients into risk cohorts and triage each cohort to an individualized destination, be it a return to in-person care or a virtual environment.
In the “virtual exam room,” things also look a little different. From the provider’s perspective, one of the oft-cited drawbacks of virtual visits is the limited ability to measure vital signs, perform a physical exam or order point-of-care diagnostics. At-home diagnostics, wearable devices and remote patient monitoring tools allow providers to collect continuous clinical data that can be gathered asynchronously and quickly, resulting in a more comprehensive picture of a patient’s health. Further, platforms that use intelligent automation algorithms to organize data collected across the care continuum can parse these data streams to identify at-risk patients and then automate outreach and care management to follow clinical care pathways.
The COVID-19 pandemic has given us a unique opportunity to reimagine healthcare using a modern suite of technology for patients, providers and staff that does away with outdated and inefficient processes. But we also have a responsibility to replace them with solutions that improve digital experiences by supporting patients before visits, automating repetitive workflows, and parsing large amounts of data to support clinical decision-making.
Combining intelligent automation with virtual visits creates a powerful tool to efficiently manage patient populations and offer an experience that feels intuitive while enabling healthcare systems to do more with less. By accelerating the digital transformation of healthcare today, we can position ourselves for a future of increased capacity, decreased overhead, and improved quality.
Muthu Alagappan, MD, is an attending physician at Massachusetts General Hospital, a trained engineer, and medical director at Notable Health, a healthcare experience automation company.