UnitedHealth Group, the biggest insurer in the US, has recently announced that it is shutting down its Optum Virtual Care telehealth business, just three years after its inception. Optum Virtual Care offered nationwide virtual access to physicians and nurse practitioners. It is a substantial setback for #HealthTech. Why did it fail? is this the end of #telemedicine? The short answer is "no". The care delivery model must be redefined to demonstrate the value of telemedicine and HealthTech. 1️⃣ 𝐓𝐡𝐞 𝐜𝐮𝐫𝐫𝐞𝐧𝐭 𝐭𝐞𝐥𝐞𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞 𝐦𝐨𝐝𝐞𝐥 𝐢𝐬 𝐚𝐧 𝐢𝐧𝐞𝐟𝐟𝐢𝐜𝐢𝐞𝐧𝐭 𝐮𝐬𝐞 𝐨𝐟 𝐫𝐞𝐬𝐨𝐮𝐫𝐜𝐞𝐬 As Morgan Cheatham from Bessemer Venture Partners puts it: "In telemedicine, many of the inputs (e.g., clinician time) and therefore cost structures of in-person care persist, which is why we often see fee-for-service telemedicine companies struggle to achieve economies of scale (i.e., growing revenues non-linearly while growing costs linearly)." 2️⃣ 𝐓𝐡𝐞 𝐬𝐨𝐥𝐮𝐭𝐢𝐨𝐧: 𝐮𝐧𝐛𝐮𝐧𝐝𝐥𝐢𝐧𝐠 𝐦𝐞𝐝𝐢𝐜𝐚𝐥 𝐚𝐩𝐩𝐨𝐢𝐧𝐭𝐦𝐞𝐧𝐭𝐬 Specific digital solutions address unique challenges at each stage of the medical appointment. These digital solutions leverage the following improvement levers (non exhaustive list): ▪️ Self-service ▪️ Automation ▪️ Asynchronous care ▪️ Upskilling of resources through AI ▪️ At-home care 3️⃣ 𝐄𝐧𝐚𝐛𝐥𝐞𝐫 𝟏: 𝐂𝐚𝐩𝐢𝐭𝐚𝐭𝐢𝐨𝐧 𝐦𝐨𝐝𝐞𝐥 - 𝐥𝐞𝐭𝐭𝐢𝐧𝐠 𝐭𝐡𝐞 𝐇𝐂𝐏 𝐝𝐞𝐜𝐢𝐝𝐞 A capitation model in #primarycare involves paying healthcare providers a set amount for each patient they care for over a specified period, regardless of how many services the patient uses. In this model, the GP chooses the "portfolio of tools" they wish to use for each case, without being trapped in the current "face-to-face volume game". 4️⃣ 𝐄𝐧𝐚𝐛𝐥𝐞𝐫 𝟐: 𝐂𝐥𝐨𝐮𝐝-𝐛𝐚𝐬𝐞𝐝 𝐞𝐜𝐨𝐬𝐲𝐬𝐭𝐞𝐦 As of today, many GP practices are constrained by their outdated practice software. The solution is to migrate the entire technology stack to the cloud (can be done over the weekend), making the EHR practice software just one part of a larger system. This allows the GP to easily add or remove specific solutions as needed throughout the care journey. 5️⃣ 𝐑𝐞𝐬𝐮𝐥𝐭𝐬: 𝐕𝐚𝐥𝐮𝐞 𝐟𝐨𝐫 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬, 𝐩𝐚𝐲𝐨𝐫𝐬 𝐚𝐧𝐝 𝐩𝐫𝐨𝐯𝐢𝐝𝐞𝐫𝐬 Providers have more time to focus on the core aspects of their job and are empowered to select the most appropriate care model for each patient. Patients feel more empowered, perceiving that they are better understood and cared for throughout their entire care journey. Payors can incentivize GPs to maintain patients at home, thereby avoiding expensive hospital visits (focusing on preventive care rather than reactive measures). -------- HLTH Europe is only one month away! And primary care will obviously be part of the agenda. Make sure you join! #healthcare
Umar Faruqui
7mo
Great analysis Thomas Hagemeijer. Telehealth must be an integral part of the hybrid care jounrey, integrated with the in-person component. I’d add realising value will require aligning incentives across payers, providers and patients. Providers need to invest in technology and tools, and need payer support for it. They must understand economics of the value-based arrangement as well. Importantly, providers and payers need to reach a common understanding around program scope, outcomes, and how to operationalize the tracking of those outcomes - something not always easy to do.
Great right up. It speaks to a lot of what we are currently working on for patients with diabetes.
Cant agree more. How do we track the med history and diagnosis all in one place? What Medication offered and what pharmacy when a patient ends up treated by multiple doctors. Have encountered this real time and each Physician would have their preferred applications and every time a patient checks in for a diff physician, Patient need to download and activate a new app for tracking the history.
You are of course completely right Thomas Hagemeijer. What we have seen in the last couple of years is that you should try to focus on getting the “automation and self-service” components right since this is 100% free standing from FTEs in a delivery model and will give you a direct positive impact on the gross margin. Then you can continue with the FTE dependent components
In-line with principles of value based healthcare (value = outcomes that matter for pts/full cost of care)
Muy buenas reflexiones
Witold Górzyński
7mo
Could not agree more. Kudos.
Founder; Managing Director at Spectator Healthcare & Security Technology
7moYou are completely right, Thomas! Our experience in countries in 4 continents, from Europe to Middle East/Central Asia, Latin America and Africa shows the same! Telehealth technology should NOT be used as a stand-alone solution to mainly make appointments and increase the income of doctors based on fees per consultation. It should be an integrated, interoperable and patient-centered solution, covering the whole Patient Journey, from Prevention to remote Primary Care and Chronic (RPM)/Elderly Care services, all in one digital gateway, and based on a sustainable business model, with fixed fees per patient per month/quarter/year, independent of the use. An integrated gatekeeper for physical care, as well for customers/patients in urban, as in more remote/rural areas.