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Healthcare’s Digital Nightmare – The Struggles of Virtual Primary Care

It’s been a steep learning curve for healthcare during the pandemic. First, providers had to deal with a new virus and learn how to best manage hospitals exceeding capacity. Pharmaceutical companies and researchers then leveraged resources to develop some incredibly amazing vaccines. And meanwhile, virtual primary care emerged as telemedicine services became the norm for millions of Americans and providers. (Read more about the evolution of telemedicine that 2020 kicked into high gear in this Bold story.) Through it all, healthcare organizations came to realize that the future of healthcare clearly lied in the digital realm. As a result, hundreds of new digital apps, platforms, decision-making tools, and more now exist.

While this sounds exciting and intriguing, the reality of the current virtual primary care system is far from appealing. Patients and providers alike are bombarded with all sorts of digital services, not knowing which one to use. In many cases, confusion abounds, and rather than creating a high-value, efficient, healthcare system, the opposite occurs. This is hardly the way to improve patient outcomes or better engage patients in their own healthcare. Plus, it opens the door for many other problems, including privacy violations and security threats. Unless solutions are introduced, the future of healthcare and virtual primary care are definitely at risk.

“Everybody who is not investing in a digital front door right now—or [not] investing in the tools that will be covering experience from the patient side and the clinician side—are potentially creating a lot of friction for the future.” –  Yakunin Solad, M.D., Medical Director of Digital Health and Telemedicine, Yale New Haven Health

Digital Problems Revisited

Only a couple of decades ago, healthcare policies created incentives to get healthcare systems to adopt electronic healthcare records (EHR). EHR was to be the future of healthcare. With such a large captive audience, EHR vendors grew at an accelerated pace. Dozens of high-quality systems were available, each with their own unique features and price tags. But there was one thing missing… interoperability. None of these EHR systems were able to “talk” well to one another. So, many of the potential benefits that EHR was supposed to offer took much longer to materialize. In a very similar way, virtual primary care is experiencing this problem all over again.

There are hundreds of digital healthcare applications and platforms on the market today. Some are designed to help patients check their symptoms. Other help them find the best provider. Some digital tools help providers monitor patients at home or provide the telehealth infrastructure needed for virtual primary care. Each of these offer significant value and advantages toward the future of healthcare if used correctly. But unfortunately, there is once again too many cooks in the kitchen. Different patients, different providers, and even different departments within healthcare organizations choose different tools. And at the end of the day, there’s more chaos and confusion than there is improvement.

Value-Based Healthcare Requires Collaboration

Over the last several years, there has been a push for greater value-based healthcare. Fee-for-service structures previously failed to place the patient first and led to high costs. Individual provider had incentives to perform a greater amount of services rather than limit them through teamwork. But as value-based programs have now realized, getting all care providers to work together toward a common goal is essential. Collaboration is one of the key ingredients that leads to better efficiency, better use of resources, and ultimately, better patient outcomes. For a better future of healthcare, incentives to promote collaboration are needed.

Naturally, these concepts apply to a virtual primary care system as well. If digital tools are to be used to enhance patient outcomes, then they must work in conjunction with one another. Patients must be aware of which ones the virtual primary care system prefers. Likewise, providers need to utilize platforms and apps that can easily communicate with one another. In today’s digital healthcare environment, managing healthcare’s big data is challenging but not impossible. (Dive deeper into how big data could help fix some of healthcare’s biggest problems in this Bold story.) Healthcare organizations must govern which digital systems are allowed in an effort to promote coordination and collaboration. Those that have already are seeing higher levels of patient engagement, which presumably will lead to better results.

“In order to achieve improved care coordination, several solutions can be considered. In each case, a more integrated, transparent, and accountable system is critical. Healthcare providers must overcome the difficulties in improving information sharing and data tracking to realize these goals.” – Pearl Health

A Concerning Recipe for Privacy and Security Disasters

Wasted resources and less-than-optimal patient outcomes are not the only concerning things with today’s virtual primary care systems. The use of multiple digital tools also poses notable threats in terms of patient privacy and data security. Cybersecurity experts note that a higher number of digital systems creates the potential for hackers to access information systems. And when one lacks adequate firewalls and security, it places the entire virtual primary care structure at risk. This is a concerning area for the future of healthcare as digital apps and platforms increase in number.

A cartoon of a doctor living in a giant phone
The shift to virtual primary care hasn’t quite been seamless, but when it comes to cybersecurity and data management, there are solutions.

Once again, the best way to address these concerns is to effectively oversee the types of digital tools being used. Healthcare systems endorsing a limited number of apps and platforms will be able to install effective privacy and cybersecurity policies. (Cybersecurity is non-negotiable–read why in this Bold story.) Likewise, it will be easier to ensure data communications take place from one to another without a high risk of data breaches. In contrast, virtual primary care programs that fail to do this will become vulnerable targets. Unfortunately, these types of concerns represent the future of healthcare. And designing virtual healthcare systems with this in mind will be important.

“Who can deliver a comprehensive experience, the complete experience that can create value [with] the best clinical outcomes at a total cost-of-care price that’s going to be effective? If you can develop that comprehensive business model, then I think there’s a number of buyers that exist…” – Dennis Weaver, M.D., Chief Clinical Officer, Oscar Health

Fixing the Digital Front Door

Healthcare experts have coined a phrase for the challenges that virtual primary care systems face today. They compare the growing number of healthcare apps and platforms as an organization’s digital front door. At the current time, the front door is in need of repair. Security and safety aspects need to be addressed. And patients and providers need to better understand which door to access. Organizations committed to the future of healthcare will make significant investments in this area. They will be the ones that will ultimately attract the most attention and yield the best results.


The official Bold Business survey results are clear: most favor work-from-home over going back to the office. Read more in this important Bold story!

The Higher Education-During-COVID Riddle

Now that the world is well over a year into COVID, many of us expected things to be returning back to normal. COVID vaccines are accessible for the majority, and millions more have contracted the virus and enjoy some level of immunity. But things are far from normal as coronavirus variants continue to emerge, and low vaccination rates persist. This is particular evident as students return to colleges and universities this fall. Educational institutions struggle over the benefits and risks of remote versus in-person learning. Evidence that online higher education is comparable to in-classroom instruction is lacking. But without question, returning to the classroom definitely poses some challenges.

The debate over remote versus in-person learning in college extends beyond academic quality and COVID precautions. Many students have come to appreciate the conveniences that online higher education offers them. Likewise, some faculty prefer to work remotely as well, given new work-from-home trends. For these reasons, colleges and universities must take a very close look at their approach to education this year. Should they offer online higher education courses to everyone or a select few? Are hybrid courses a better option until the pandemic subsides? These are the questions these institutions are asking themselves, yet the answers to these are far from clear.

“The argument in the past, pre-Covid, was, ‘Of course, an online course is fundamentally different than a course in the classroom. Well, Covid changed all that.” – Arlene Kanter, Disability Law Expert, Syracuse University College of Law

The Facts About Remote Versus In-Person Learning

Over the course of the last year, a fair amount of research has been conducted concerning remote versus in-person learning. With so many college students required to participate in online higher education courses, schools had opportunities to evaluate outcomes. But in many cases, when both options were available, students self-selected the types of courses they wanted. This means that inherent biases could have affected academic performance. The actual educational strategies used may not be the cause of academic results. Better or worse performance in online higher education may have simply reflected the types of students who prefer remote learning.

With this in mind, there are some studies that provide some insights concerning remote versus in-person learning. One study was conducted at West Point where professors randomly assigned students to classroom or online higher education courses. The results demonstrated that, on average, online students’ grades were 0.2 standard deviations lower. In Virginia’s community college network, online higher education also resulted in a reduced course completion rate of 8.5 percent. And consistently, male students and those with lower academic abilities tend to struggle more with remote versus in-person learning. In general terms, online college courses do not appear to be ideal for a larger number of students.

“I just learn a lot better when I’m actually in front of the teacher. But knowing that my health could be at risk, especially with the Delta variant, I don’t know what’s going to happen with school now.” – Cory Lewis, Sickle Cell Disease Patient and Biology Major Student, Georgia Military College

Online Higher Education From a Different Perspective

While online higher education may not be ideal for some, that doesn’t mean it’s not beneficial for others. Notably, the research does show that students with higher academic abilities tend to do well with remote courses. Likewise, with continued international travel restrictions, many students continue to rely on online access to college curricula. (Dive deeper into the inevitable evolution of higher education in this Bold story.) In these instances, remote versus in-person learning choices are not necessarily available. Therefore, these students naturally have greater potential by continuing in a remote learning environment. Though this may not be ideal, it is certainly better than in-person options for such students.

A person who lives in a phone is receiving her degree
The “remote vs in-person learning” equation has shifted greatly with the need for more distance-learning.

These students are not the only ones who have benefitted greatly from online higher education alternatives the past year. Many students with disabilities have also been able to improve their class attendance and course access during COVID. Colleges and universities are required by law to make reasonable accommodations and modifications for those with disabilities. But prior arguments that remote versus in-person learning are not comparable have limited remote access. Given that most colleges chose not to reduce tuition for online higher education during COVID, this argument seems less robust. And many students with illness and disabilities hope to see remote learning opportunities increase as a result.

“Maybe in the future they would think about having them hold like a hybrid class where if you needed to attend online, that’d be nice.” – Sophia Martino, Spinal Muscular Atrophy Patient and Senior Student, University of Missouri

Solving the Online Higher Education Riddle

Interestingly, students are not the only ones encouraging colleges and universities to increase their online higher education courses. Many teachers realized that remote versus in-person learning provided them with some advantages as well. While most had to quickly prepare for online student interactions and lessons, they eventually embraced new teaching strategies. This made them more dynamic, and it also broadened their skillsets in the process. In addition, like many other industries, work-from-home opportunities provide many with a better quality of life. As a result, colleges and universities must figure out how to appease professors in an effort to retain their services.

The challenge for colleges and universities today involves knowing what types of courses to offer. In a post-COVID world, the choice is not simply between remote versus in-person learning. (Read more about the importance of digital transformation in the post-COVID world in this Bold story.) Instead, schools must decide whether or not to offer hybrid curricula with both classroom and online higher education. They must also determine which students might actually do better and thrive in a remote educational setting. Certainly, more research is needed before such decisions can be made with confidence. But it’s no longer enough to refute online higher education as a potential alternative based on opinion. The world has changed, and colleges and universities must adapt along with it.


The official Bold Business survey results are clear: most favor work-from-home over going back to the office. Read more in this important Bold story!

Artificial Intelligence and the Virtual Dressing Room

Like many sectors, the fashion industry saw a noticeable change in consumer behaviors during the pandemic. With customers being unable to go to shopping malls and designer stores, online e-commerce sales boomed. In fact, in 2020, approximately 30 percent of all fashion sales occurred through e-commerce sites. And interestingly, this shift in customer shopping habits is not expected to decline but instead grow. Analysts predict that fashion industry sales for 2021 will exceed $100 billion in total with a sizable percentage from online purchases. As a result, many clothing stores and designers are interested in developing a better virtual dressing room.

Fortunately for the fashion industry, retail technologies now exist that have the potential to meet these needs. Digital wardrobes can be readily created through several apps and platforms today. As a result, there are an increasing number of virtual dressing room startups interested in making a splash. While each one has the means to create 3-D clothing images and models, not all are the same. And based on current development, digital wardrobes have a long way to go before widespread adoption. Regardless, innovations are occurring rapidly, and many fashion retailers cannot wait until a quality virtual dressing room product is available.

“We believe that helping people find the right size and improving the try-on experience could both increase conversion rates as well as reduce the rate of returns.” – Evan Spiegel, CEO and Cofounder, Snap, Inc.

Investing in the Virtual Dressing Room

With the recent growth in fashion sales online, major investors are making moves. Recently, Snap, Inc., acquired a virtual dressing room company called Vertebrae. This company works with Fossil, Herschel, and other European fashion retailers in creating digital wardrobes. In essence, they create 3-D images of the companies products through digital clothing simulations. Customers can then explore these images on 3-D models to gain an appreciation of their look. At the same time, DressX, another virtual dressing room company, received $2 million in seed money funding. Supported by Artemis Fund, DressX allows customers to try on digital wardrobes in real-time online. They too are considered a leader in the field.

As is the case with technological advances, new potential continues to emerge. This allows more recent startups to sometimes gain advantage over older ones. In this regard, represents a newer virtual dressing room company. Based in California, it received its initial funding from Y Combinator worth $125,000. Compared to DressX and Vertebrae, which use 3-D modeling and image editing, has a more advanced system. In addition to being completely automated, it allows customers to create their own avatars that look more like themselves. And their technology allows clothes to hang better, giving it a real-life appearance. Most importantly, is able to scale its clothing images, adding a million catalog images weekly.

“People were stuck at home, and it drastically influenced the way they were shopping, so brands are becoming less conservative in terms of technology and online tools to interact with their community.” – Vlad Vodolazov, CEO and founder, Clo-Z

Additional Developments in Digital Wardrobes

The need for virtual waiting room platforms are relevant currently given the shift in consumer shopping. In fact, some fashion  companies employing digital wardrobes are seeing their sales conversion rates increase three- to five-fold. But there are other areas where digital wardrobes have become popular as well. In recent years, several new companies are offering outfit generator apps to help customers mix and match clothes. These creation apps vary in what they offer, but all of them encourage users to explore different styles and colors. And all utilize some type of machine learning and algorithms to help identify the types of designs someone prefers. (Read more about the explosion of content creation apps in this Bold story.)

Someone trying on clothes virtually and staying germ-free
A virtual dressing room means few contact points for germs–a bonus in the pandemic era.

Dozens of these outfit generator apps now exist today. Though they are not exactly virtual dressing room apps, they do create digital wardrobes for users. The Fashion Robot is one app that allows users to select their size and then upload various pics of apparel. Virtual Outfits is an AI-based application where customers can shop and design while sharing with an online community for feedback. And ClosetSpace is another where users can upload their existing clothes as well as new selections from retailer sites. Based on the number of companies in this field, it’s clear that digital wardrobes and virtual designing have broad appeal.

“Clearly, there is still room for improvement. Real-time cloth simulation is going to be critical for making these experiences feel more authentic.” – Matthew Drinkwater, Head of the London College of Fashion’s Fashion Innovation Agency

Future Directions in Digital Wardrobes

Online clothes shopping as well as the pandemic have fueled the developing of virtual dressing room sites. But adoption of virtual and augmented reality offerings has also. In fact, Facebook’s Mark Zuckerberg suggests that there will be an increasing demand for fashion for digital personas. Imagine users purchasing digital wardrobes online for their own avatars. Some suggest this may be one of the next burgeoning fields in the fashion industry. This would introduce a completely new market for fashionistas to explore. And one that designers may want to begin investing in as well. Consumers have not yet shown such a product demand currently, but that may well change as the digital world expands.

Virtual dressing room sites and outfit generator apps will definitely improve in the years to come. Many are quite limited at present, and some are not realistic enough to be very appealing. But deep learning and artificial intelligence is changing this quickly. Likewise, there is tremendous competition in the field, and investors are beginning to see their potential. Avatar creation will get better, and clothes will increasingly look more and more like real-life images. This looks to be one of the final pieces of the Come-to-Me Economy in the fashion world. (Read more about the rise of the Come-to-Me Economy in this Bold deep dive!) Thus, when this does finally happen, it will clearly be a gamechanger for the fashion industry.


The official Bold Business survey results are clear: most favor work-from-home over going back to the office. Read more in this important Bold story!