This morning Doctor On Demand announced the launch of a multicomponent virtual primary care platform designed to integrate with US health plans’ and employers’ existing networks.

Called "Synapse by Doctor On Demand", the platform offers new clinical capabilities and smart, in-network service referrals to better stitch together gaps in patients’ care and increase their overall access to healthcare services, CEO Hill Ferguson told MobiHealthNews. But the core of this effort is Synapse’s “digital medical home”, a comprehensive personal health data ecosystem that the patient may curate and share both in and outside of Doctor on Demand’s network.

“We’ll be importing data through mobile platforms — Google Fit and Apple CareKit — to full-on data that might come in through connected devices like blood pressure monitors or fitness trackers or stethoscopes, you name it. There’s a whole proliferation of these devices that are now becoming compliant with mobile platforms to transfer data,” Ferguson said. “We’ll be taking that data and enabling a patient to put it in front of a doctor immediately, and have doctors analyze and take advantage of that. We’ll also be making this patient profile portable across the ecosystem so we can share it within our own practice as well as through regular brick and mortar practices via health information exchanges, EMR integrations and even good old fax, which is the lowest common denominator in healthcare today.”

Having these data at hand allows a virtual care service to move beyond isolated provider encounters and better gauge a patient’s longitudinal health, Ferguson said. As a result, Doctor On Demand’s current urgent care and behavioral health offerings are being supplemented with preventive and chronic care support — all of which come together to deliver a package that Ferguson said resembles the flexibility and broad support offered by traditional primary care.

“This preventive side, this can be everything from an annual wellness checkup, which can be done from the comfort of your home, with or without the assistance of a connected device,” he said. “It may be in a longer visit where a physician can give more lifestyle recommendations, diet, things that you would really require from a wellness visit but you might not get from a typical urgent care visit.

“On the chronic conditions piece, we’re doing some of it today but we’re expanding it to include more customized programs that are going to be tuned by our customers. So, for example, a lot of chronic diseases, patients may have multiple conditions at once … and this is where our integrated behavioral health practice is going to be so important, because the care plan for these patients is going to be very different; it’s going to be periodic consultations with a clinician coupled with a monthly behavioral health visit, and perhaps a proactive visit from someone on the care team. … It’s going to be different for each type of chronic condition, but COPD, hypertension and diabetes are three that we’re really excited about.”

Of course, virtual care still has its limits. Should a case exceed Doctor On Demand’s capacity, the platform consults a patient’s records and their plan’s coverage to make an in-network, low-cost referral to another specialist or testing service.

“That’s a critical piece, because we know when you’re going to encounter patients who need follow-on care from a provider outside of our practice,” Ferguson said. “Being aware of their benefits, being aware of their network that they have access to is a very key piece to this, in making sure that we can provide that continuity of care and making sure that we’re leveraging network data.”

What’s the impact

Within the US, nearly a third of adults don’t currently have a primary care physician, and those who do rarely visit more than once a year, Ferguson said. These individuals are at risk of developing a health complication that could be spotted and prevented if they are brought into earlier contact with a provider.

“We’re not really taking full advantage of the physician [as the] quarterback of your health,” he said. “What our platform can do, and certainly what we’re designing for, is to make access so frictionless that you will engage in preventative care, you will seek treatments when you need it versus not, you will keep your care in one profile so that you’re not fracturing your health record.”

What’s the trend

Doctor On Demand closed a $74 million funding round just under a year ago, which it said at the time would be used to expand its telemedicine platform’s capabilities. The company had also been making a few smaller pushes toward a more end-to-end experience, with the integration of laboratory testing services in 2017 and a 2018 partnership focused on streamlining workflows and access.

But the company isn’t alone in its vision of virtually-enabled primary care — 98point6, K Health, Iora Health and First Stop Health are all looking to blur the lines between traditional primary care and digitally-enabled services. In fact, just this morning Crossover Health, which provides medical services to large employers, Apple and Facebook among them, acquired Sherpaa, an asynchronous telehealth company that has also mostly focused on serving employer populations, with the end goal of building a hybrid virtual-physical primary care offering.

On the record

“There’s a proliferation of point solutions, and some of our competitors have acquired a bunch of point solutions, and I think that’s a very different strategy from what we’re doing,” Ferguson said. “We’re building organically on this digital medical home to ensure that the care the patients receive through our platform is always coordinated and always aware of what’s been diagnosed and treated in the past. I think that’s a fundamental building block of Synapse.”