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The Future of Telehealth

From fitness trackers to virtual patient clinic visits, telehealth services run the gamut. Telehealth offers exciting new opportunities for advancing the future of healthcare. Not only can telehealth improve healthcare access to millions, telehealth also has the potential to significantly lower costs in the process. Likewise, telehealth will likely advance our overall quality of health substantially as well.

What is telehealth? Even healthcare providers struggle with this definition at times. Health insurers vary in how they define (and pay) for telehealth services. While most agree that diagnosing a patient over a Skype videoconference is an example of telehealth, other situations are less clear. But some of the dust is beginning to settle. Thanks to some innovative telehealth companies, the future of telehealth services is becoming progressively clearer.

Telehealth vs. Telemedicine

physician checking a patient's vital signs virtually
Virtual patient diagnostics

Some of the confusion regarding telehealth involves another common term, telemedicine. Think of telehealth as the larger umbrella. Telehealth is basically the use of any digital technology that allows you to remotely connect to health-related products and services. From this perspective, telehealth is a very broad term. Educational websites and YouTube videos that show you how to eat healthy or check your blood pressure count as telehealth. Likewise, telehealth services include online prescription ordering, interactive health blogs, and hundreds of other interactions.

Telemedicine, on the other hand, is a category of telehealth services. This telehealth service requires patient diagnosis, treatment, and management using remote telecommunications. For many healthcare providers, telehealth and telemedicine are used interchangeably. But in reality, telehealth offers much greater potential for our future. Imagine if every piece of health information could be accessed anywhere, anytime using a comprehensive telehealth platform. Your exercise data, recent blood pressures, and latest pharmacy refills could be part of your telehealth record. Likewise, telehealth services could link expert advice, research evidence, and education to match your precise needs. This is where the future of telehealth offers incredible excitement.

Driving Telehealth into the Future—Patient Needs

So, what’s the big deal with telehealth? What’s the big push for change? Plenty. For people in rural areas, telehealth lets them speak with medical experts with whom they otherwise might not have access. The same applies for some elderly with limited mobility in regard to telehealth. And for those with mental illness, telehealth lets people interact with a mental health professional with less hassle and social stigma. Telehealth services inherently offers better healthcare services to these populations.

Telehealth also meets other specific patient needs. In a few years, more than 20% of the population will be older than 65 years. And more than 85% of those older than 65 years will have at least one chronic health condition. Telehealth offers the ability to monitor these patients and their conditions remotely with much less cost and inconvenience. Telehealth also reduces the number of complications related to these conditions through more consistent care. For these types of patients in particular, telehealth offers better service, better care, and better outcomes.

Driving Telehealth into the Future—Dollars and Sense

elderly woman using blood pressure monitor while teleconferencing with her doctor
The convenience of telehealth: video services between patient and provider

Patient needs are important, but money also speaks loudly. Recent changes in how providers are being paid are also driving telehealth services. Rather than payments being based on the quantity of healthcare services, quality of care will determine this in the future. Telehealth offers a low-cost solution ideal for such these situations. Providers will be able to render higher quality care with telehealth services across a variety of care settings. Because this will improve patient outcomes, telehealth will provide better payment opportunities for providers.

With telehealth services, providers can ensure patients are taking medications, getting check-ups, and getting better without an office visit. Nurses and therapists can identify problems earlier with telehealth. And patients can more easily address issues remotely through telehealth without long wait times to see a doctor. Better quality of care with telehealth services means fewer complications and visits to the hospital or ER. And this lowers costs for everyone that will continue to drive the use of telehealth moving forward.

Barriers to Telehealth Still Exist

While the future looks bright for telehealth, barriers still persist today that limit its use. One of the most significant barriers for telehealth services is health insurance coverage. While some insurers allow payments for telehealth services, others do not. And even among those that do offer coverage, some telehealth services can be billed while others cannot. Telehealth services that cross state lines also pose problems. Some states will not license a telehealth physician if he or she primarily practices in another state. As a result, that provider may be unable to participate in some interstate telehealth services.

Other telehealth barriers relate to the privacy of health information. The primary reason health information on many personal and mobile devices cannot be shared via telehealth involve data security risks. With telemedicine requiring privacy protections under HIPPA, a great deal of telehealth data cannot be accessed and used. In addition, some people struggle in using new digital technologies. This is often true of older adults, which may also be a barrier in using telehealth services.

Some of Today’s Bold Telehealth Companies

Believe it or not, telehealth services have been around for a while. But the number of telehealth companies today are growing exponentially. With advances in data security, data integration, and the cost of technology, many firms see great tremendous future potential. The following describes a few of the market leaders in telehealth today.

American Well

This telehealth services firm is not new to the healthcare landscape, but it continues to make a big impression. In the last two years, American Well has doubled the number of healthcare systems using its telehealth platform. Among their 70 clients, American Well provides video and phone-based telehealth services. American Well allows data integration from some personal devices (like Apple and Samsung) with EHR information and pharmacy histories. And also, clients can actually market the telehealth services they offer under their own brands.

Avizia

The main competitive advantage for Avizia in the telehealth market stems from its extensive care coordination abilities. Their telehealth services can be used on several types of devices. This allows multiple providers and points-of-care to connect simultaneously. In addition, Avizia offers a cloud-based platform, which can greatly reduce cost barriers for clients. And with extensive encryption, fraud monitoring, and data integration capabilities, Avizia’s telehealth services are both secure and comprehensive.

Carena

This telehealth company began with the concept of making virtual house calls using its telehealth services. Today, Carena offers a virtual telehealth clinic to patients and providers for any health problem. With over 120 hospital partners, Carena can provide a number of telehealth services. These services include all types of medical staffing, marketing, and even healthcare providers. Using its telehealth platform, patients provide consent and pay for services, and hospitals use a variety of services on-demand. In essence, Carena offers one-stop shopping for telehealth.

SnapMD

SnapMD also offers a virtual clinic through its telehealth services. Using high-definition video, screen-sharing, and file-sharing, SnapMD can link multiple sources at once. In addition, telehealth services include scheduling and e-prescribing, and analytics and staff management software services are available. As a result, SnapMD provides comprehensive virtual telehealth clinics for patients, providers, and administrators. And with advanced data integration abilities, different sources of healthcare information can easily talk to one another. It’s just like being in a regular health clinic, but instead, everything is virtual and remote.

Teladoc

Teladoc has been in the telehealth business for 15 years. The company began offering telehealth services to large self-insured employers. Today, its telehealth clients include major health plans, hospitals, and large health systems. Teladoc allows its client to pick and choose how they would like to use telehealth services. One may take advantage of Teladoc’s virtual providers. Another may incorporate their own local physicians into the telehealth services. And still others use a combination of both telehealth services at different times. Teladoc provides high-speed connectivity with real-time information exchange. Its tenure and quality of telehealth services are major reasons they continue to be a market leader in telehealth.

Telehealth’s Future is Inevitable

Healthcare costs have now reached 18% of our nation’s GDP. The average money spent on healthcare per person in the US is double what it is in other countries. Despite this, the US ranks low in many health categories. Bold solutions to lower cost and improve quality of healthcare is desperately needed. For many in the healthcare sector, they believe telehealth offers one of the most powerful solutions to date.

Today, we socialize via Twitter and Facebook. We communicate through Skype and FaceTime videoconferencing. Telehealth is therefore a logical next step for healthcare. With more than three-quarters of the American people using smart phones, advancing healthcare services to a mobile, digital platform makes sense. Though some barriers remain, the cost and quality benefits of telehealth services will continue to incentivize solutions to these problems. Those companies insightful enough to realize this will have a great opportunity to be the telehealth leaders of tomorrow.

 

Sources:

Telehealth use in behavioral health cases shows promise in cost control, with utilization on the rise

Telehealth needs clearer definition amid regulatory inconsistencies, expert says

Comparing 11 top telehealth platforms: Company execs tout quality, safety, EHR integrations

Telehealth: Technology meets health care

 

Dog-Walking Services Giants Rover and Wag Receive Over $600 Million to Sit Dogs

Dog walking services and dog sitting app providers Rover and Wag recently closed funding rounds where they were able to raise a combined total of $600 million. For Rover, this is intended to be used to develop apps and other services for pets. For Wag, more than $300 million of the funds came from SoftBank.

The future for these companies, and the dog sitting app and dog boarding services industry as a whole is bullish.

Rover Financing Round Dog Sitting App

Dog Walking Services and dog sitting app
Dog Walking Services Comparison

Rover raised $155 million during its financing round. The funding round accounts were advised by T. Rowe Price Associates. Its previous financing round raised $156 million from investors including A-Grade Investments, Foundry Group, Madrona Venture Group, Menlo Ventures, OMERD Ventures, Petco, and StepStone Group. It also has a $30 million credit facility at Silicon Valley Bank. Rover had a valuation of $970 million before the round.

In 2017, Rover merged with DogVacay in an all-stock deal. Both companies had the same business model and instead of competing for space, they sought to merge for better economies. The resulting company looks to be in a better position to take on dog walking app industry leader Wag.

SoftBank Investment in Wag

Wag had earlier been in talks to raise only $100 million in capital until they got down to talk with SoftBank. The $300 million financing from the Japanese investment giant is based on a valuation of only $600 million.

In true Masayoshi Son investment philosophy, Softbank  now has a 45% stake in Wag. The investment firm’s position has always been to keep the majority stake, if possible, in any company they invest in.

Softbank, however, lets the company run itself and does not interfere with the management structure. As part of the investment, Softbank will have two board seats on Wag. Softbank investor Jeff Housenbold will have one of the board seats and will also become the chairman of the board.

Before the SoftBank investment, Wag was searching for a CEO. Hilary Schneider replaced co-founder Josh Viner as CEO. This was a separate development which was in the works and had no connection to SoftBank. Co-founders Josh Viner and his brother Jon will stay on in the company in senior positions.

The Model of Dog Walking Services and Dog Walking Apps

The dog sitting app and dog boarding services is a recent development. The model for dog boarding services is based on AirBnB. Pet owners go on the app and search for an appropriate place where their pets can stay while they are away. Much like AirBnB, Rover takes a 15% cut of the revenue from the sitters. In return, Rover handles the marketing, billing, online calendars, and insurance. The online calendars ensure that the sitters do not have more pets than they can manage. In terms of recruitment, they say that they take only 20% of the applicants for pet-sitters as they look for qualified sitters. The application process and sitter reviews help ensure that the sitters are dependable. The company has more than 200,000 sitters across the country, although a lot of these originally signed up with DogVacay. The company expects a 200% annual growth for the immediate future.

A Lot of Attention

The dog sitting app industry as it applies to Rover and Wag is still in its infancy. Dog walking services and caring has previously been the domain of freelance individuals who charge on a per day basis. Dog sitting charges in the New York City area averages $30 per day. Some sitters can charge up to $60 due to their experience or training. With these dog sitting app and dog boarding services actively seeking customers and sitters online, this opens up a huge business potential not just in New York City but all over the entire United States.

According to the American Pet Products Association (APPA), about 69% of all US households own a pet. This is roughly 85 million families who have at least one cat or dog. In 1988, during the first time the survey was conducted, only 56% of US households had a pet. Wag estimates that the pet market industry in the US could be worth as much as $70 billion. From an industry viewpoint, it is easy to see that the dog boarding services and dog sitting app segment can easily segue to cover the rest of the pet market industry with a captured market.

 

References:

https://techcrunch.com/2018/05/24/dog-sitting-startup-rover-just-raised-155m/

https://techcrunch.com/2018/01/30/on-demand-dog-walking-app-wag-raises-300-million-from-softbank-vision-fund/

https://news.crunchbase.com/news/wag-need-300m-softbank-walk-dogs/

https://www.recode.net/2017/12/15/16780158/softbank-wag-funding-deal

https://www.recode.net/2018/1/19/16911748/softbank-wag-300-million-ownership

https://www.recode.net/2018/1/30/16948506/wag-softbank-joshua-viner-ceo-hilary-schneider

https://nypost.com/2015/03/21/meet-the-people-making-3300-a-month-pet-sitting-for-strangers/

https://venturebeat.com/2017/07/13/rover-raises-65-million-to-grow-its-dog-sitting-platform-globally/

https://www.geekwire.com/2016/rover-raises-40m-dog-sitting-platform-eyes-ipo-aims-profitability/

https://techcrunch.com/2018/05/24/dog-sitting-startup-rover-just-raised-155m/

https://www.recode.net/2018/1/30/16948506/wag-softbank-joshua-viner-ceo-hilary-schneider

The Future of Telehealth

Is the Future of Healthcare in the Hands of Google?

Google is a search and online advertising giant. More than 70 percent of worldwide online search requests are handled by Google, placing it at the center of most online users’ experience. What most people don’t realize is that it is also a diversified technology, research, and development company. One of the core technology and research areas of focus is in healthcare technology. Google uses its expertise in artificial intelligence (AI) and deep machine learning to improve and develop healthcare technology. In this manner, it finds answers to healthcare issues where no question has been asked. Healthcare research is benefitting from the various Google AI experiments.

Healthcare Projects of Google

Picture of Artificial Intelligence in Healthcare, using Google Deepmind
Picture of Artificial Intelligence in Healthcare, using Google Deepmind

Google’s research into artificial intelligence in healthcare has given surprising results. A case in point is Google DeepMind, which is now developing healthcare solutions using the things it learned playing an ancient board game. Google subsidiary developed a Go-playing AI called AlphaGo, which was taught the rules of Go and encouraged to play with itself. This reiterative process taught the AI to discover winning strategies and develop ones on his own. It then won against the world’s best Go player. Since then, the company launched the Google DeepMind Health project in conjunction with the Moorfields Eye Hospital NHS Foundation Trust to improve eye treatments. The initial stage includes gathering of data through the mining of medical records.

In the same vein, Google is betting that its artificial intelligence strategy will allow it to get ahead in healthcare. Calico, a subsidiary of  Alphabet, is working on aging and age-related diseases.

Its life sciences subsidiary, Verily, is developing tools to collect and organize health data, then creating interventions and platforms that put insights derived from that health data to use for more holistic care management. In addition, Google is working on treatments for diabetes, heart disease, multiple sclerosis, and Parkinson’s disease. Further down the road, it plans to also work on COPD and cancer.

Promising Partnerships with Health Tech Companies

Verily has also teamed up with Optos, working on diabetic retinopathy detection. Optos, a Nikon subsidiary, is a recognized leader in devices for eyecare professionals. Google is also in partnership with other health technology companies like Johnson & Johnson. The joint venture is called Verb Surgical that aims to build a surgery platform that integrates robotics, visualization, data analytics and others.

Google uses an approach that involves data generation, artificial intelligence for disease detection methods, and disease and lifestyle management. The above approach makes it uniquely suited to enter the health insurance industry. And, by doing so, they can utilize it through different companies that are working on healthcare technology,

Interoperability in the Healthcare Industry

Another promising field is interoperability. It has delved into Fast Healthcare Interoperability Resources (FHIR), a data standard that helps to facilitate healthcare information exchange. In 2016, the company bought Apigee, a company working on FHIR-based application programming interfaces (API) to advance interoperability. APIs are programs or modules that allow information requests, queries, and their responses to pass safely between one system to another. DeepMind developers are working on FHIR-based projects. These include an app that can detect kidney injuries and sends alerts to healthcare providers. Currently, FHIR is only a standard, however, Google’s use of this interface gives other developers reason to work on it as well.

Google is supporting interoperability and FHIR with the use of Google Cloud as a platform and its G Suite of apps for use in the healthcare industry. As part of its approach, Google is developing data sets, allowing others to integrate these in their researches. The Project Baseline Study by Verily is one example of such a dataset. It composes data from more than 10,000 participants who monitor their fitness activities.

Google is onto healthcare in a wide range of research, partnerships, and projects. Sundar Pinchai, Google CEO, looks at their work as a collaboration with existing laws and rules. He says, “If AI can shape healthcare, it has to work through the regulations of healthcare.” Pinchai is optimistic of their work. Further he says, “In fact, I see that as one of the biggest areas where the benefits will play out for the next 10—20 years.”

Resources:

https://medcitynews.com/2018/04/google-healthcare/a>

https://www.cbinsights.com/research/report/google-strategy-healthcare/

https://www.theverge.com/2017/10/18/16495548/deepmind-ai-go-alphago-zero-self-taught