Today we can get almost any service or product at the click of a button with on-demand digital marketplaces. Forget to buy toilet paper? Go Puff has you covered. Too drunk to drive home? Thank you, Uber. Too sick to make it to health services (don’t want to go to health services because they will tell you that you have mono when you don’t)? Now, services like TelaDoc, American Well, and Doctor On Demand provide live video chatting, replacing an in-person visit. These apps allow doctors to diagnose, consult, educate, and treat from a remote location. Telemedicine has formally been around since the 90s, but only in the past 5 years has it received more attention, investment, and usage.
Reasons for this growth include the fact that the government is backing the fact that large payers are now reimbursing virtual visits. Next, the technology becoming sophisticated enough to securely and efficiently connect doctor to patient is allowing this service to be widely spread. Additionally, on-demand visits are roughly 40% less money than an in-person physician appointment. Lastly, the cultural adoption of on-demand technology is the main driver in the expansion of this service. People of all demographics and ages are demanding increased convenience and connectivity.
There are 4 distinct domains of telemedicine.
1. Live video. This is basically facetiming with a doctor.
2. Store and forward, which is a transmission of a recorded health record from one location to another through a secure network.
For example, a photo of your may be sent from one location to another where there is a specialist. This is really important for people who live in rural communities.
3. Remote patient monitoring again sends information from one location to another but is a more continuous communication. For example, a patient who recently had a heart attack can send daily information about blood pressure and other health conditions to a doctor to monitor overtime.
4. Mobile health is something we are all
probably most aware of. Using an app, we can track fitness, calories, sleep, etc. to monitor our health over time. Additionally, apps are increasingly being used for patient portals and to make appointments.
The on-demand health market is growing fast. Investment in on-demand health was just $200 million in 2014 and it is now expected to reach $1 Billion in 2017. TelaDoc and American Well are among the top most funded on demand companies. In fact, excluding the transportation industry, healthcare is the fastest growing on-demand sector. This investment reflects the value placed on accessibility and ease of use by the modern consumer. The investment breakdown is shown below:
Primary care: Through services such as Doctor on Demand, you can video chat in real time with board-certified doctors. These doctors can prescribe prescriptions to the pharmacy of your convenience.
Specialty Care: Companies like Spruce Health connect you with a dermatologist. This is especially important for rural patients who may not have access to specialty care.
Behavioral/ Therapy: Services such as Talkspace provide a space for virtual therapies online through sites such as Talkspace.
Consumables: The IV Doc provides users IV therapy for quick fixes to hangovers, the flue, or a long flight.
Fitness and Wellness: Services such as Handstand send a personal trainer to a location of your choice on-demand.
Veterinary: Now even your dog can get on-demand at home care with VetPronto and other services.
Cost and Convenience
As the healthcare industry continues to be complicated and expensive for many people, telemedicine adoption is rapidly increasing because it is not only easy but ends up being lower cost.
The cost of this session will vary based on if you have insurance or not. If you do, it is typically the same as an average copay. Without insurance, general medicine sessions on Dr On Demand, for example, are typically around $40, compared to the $130-$150 price of a typical in-person visit. Many of the top insurance providers are adopting on-demand healthcare, however. UHC, the largest insurance company, recently partnered with Dr. On Demand, AmWell, and NowClinic. By the end of 2016, 20 million of its insured patients became able to meet with a doctor through these services. Teladoc is another on-demand healthcare provider. Teladoc is working hard to help people, employers and insurers understand why their service is so valuable. It has successfully partnered with over 20 health plans, including Oscar and Aetna Inc.
On-demand healthcare provides the convenience factor that so many are looking for. In fact, 74% of people prefer easy access to healthcare most importantly. Increased rural access is providing healthcare and specialty doctors to people who would need to otherwise travel hours to get the proper care.
Cost and efficiency is a huge driver. Paying $40 instead of $130 for office visits is crucial for people without healthcare. This is especially important as the healthcare landscape is making it more challenging for people to get the care they need. A study done in Vermont showed that there was a $63,000 saving per patient created through use of home-based telehealth in 2013. In decreasing transportation, missed days of work, and cost of care, this service can give people a greater livelihood.
Accessibility is of huge importance to the modern consumer. On-demand healthcare creates an environment where it is easier to monitor chronic conditions in a more efficient way can really make a difference in someone’s life. Additionally, through easy of accessibility, second opinions become easier.
In all, studies have shown that telemedicine promotes continuity of care, decreases cost, and improve patient self-management and overall clinical outcomes.
Willingness to accept this technology varies due to potential downsides of telemedicine. For example, the fact that there is no physical examination can lead to an inadequate assessment. Doctors must rely on your own descriptive abilities rather that his or her expert touch. This is particularly challenging when consulting with children.
The depersonalized experience leaves some patients wary. The doctor-patient relationship definitely requires a level of trust which may not be adequately created through a virtual relationship. Additionally, the fact that you may not get the same doctor every time may pose frustrations for patients.
On-demand health has received legal attention as well. In Texas, you are required to meet with your doctor in person before the doctor can prescribe drugs. In other states, it is illegal to prescribe abortions if you do not meet with a doctor in person. As these services become more popular, legislation and regulation will change.
Telemedicine is really just getting the attention it deserves from agencies such as Accenture. The on-demand industry as a whole is certainly one to keep an eye on. With the current political landscape surrounding healthcare, these services provide an option for people who may not be able to afford healthcare. In all, I think these services are worth a try and may even help tackle some of the issues surrounding shortages in healthcare professionals.