Over the past 1.5 weeks I’ve been going through a long list of telehealth companies. I’ll be publishing the list shortly in multiple segments, but there are groups of telehealth vendors that are coming together. It’s not totally clean yet, but in many ways it’s kind of similar to the way EHR vendors are broken out between hospital/health systems EHRs vs ambulatory EHRs.
When just talking video telehealth, there’s a clear line between those vendors that are real enterprise plays and others that are offering a more point solution. The enterprise telehealth solutions offer video telehealth visits, but they go well beyond this. They also offer specific telehealth devices that provide point to point telehealth which is often popular with specialists who need a certain quality of video. Some offer video language translation services, telequarantine, virtual sitting options, and much more.
What’s interesting is that many of the top Enterprise telehealth vendors also offer their own direct to consumer telehealth options. I imagine in some cases, this was seen as a great offer for a health system that maybe wanted to use their enterprise telehealth vendor to back fill the health system who didn’t have capacity for a certain telehealth visit.
While this may have been a nice offering before, the telehealth world is quickly changing. As health systems have moved their patient visits online, this makes the enterprise telehealth vendor a competitor with the health system. I imagine for now that’s not been a big issues since most health systems were just converting their existing in person appointments to telehealth visits. However, how will that change over time?
It’s not hard to see how from a patient perspective a telehealth visit from your health system or some other direct to consumer application is similar. It’s a little more complicated than this when we’re talking about chronic conditions, but for a large number of visits it really doesn’t matter to patients if it’s “my doctor” or whatever doctor was available to see me when they wanted to be seen online. Convenience often wins. This is especially true for many of us who don’t even have a primary doctor we see regularly.
You can see how this is going to create some interesting channel conflict between enterprise telehealth providers and their hospital and health system customers. In some ways, you could argue that a direct to consumer telehealth company is just a virtual health system. Will health systems sour on that relationship if these telehealth companies start taking their patients?
The comparison to the EHR market fails to help us on this question. I don’t know of any EHR vendor that hired doctors to start seeing patients or had a network of doctors. EHR vendors weren’t and aren’t competitors with their customers the way it looks like enterprise telehealth vendors will become.
Instead, we may want to look to major technology companies. They’ve long used the term cooperatition which combines the terms cooperation and competition. Many tech companies might compete with each other selling computers to customers and then cooperate with each other to sell services, networking equipment, software, servers, or storage. Sounds a lot like what we might be seeing between health systems and telehealth, no?
While I’d love to say that cooperatition works really nicely, it’s actually really hard to predict and the relationship often changes. From my experience in the tech industry, it’s a really tricky thing to manage. How do you show someone that you want to work with them while still competing with them on another front? This basically leads to times where the relationship ebbs and flows. And that’s often dependent on the leader of the organization and whether they’re more interested in cooperation or competition. Yep. It’s just messy.
I’m sure the enterprise telehealth vendors will downplay the competition side of things. That’s a smart strategy by them, but it will only last so long if their actions don’t match. And let’s be honest, there’s a good opportunity for them to grow their own telehealth business if everyone’s visits have to be online. They can likely offer a better direct to consumer telehealth experience than a health system. However, they’ll have to be careful with how that impacts their enterprise telehealth business.
John, looking forward to your list of telemedicine companies. I believe the more sophisticated platforms will be a long overdue disruption to the delivery paradigms of the past. I’m hearing good feedback from consumers on the patient experience and their healthcare outcomes using some of these platforms of care. Also, the feedback is substantiating better and more timely access, and in the majority of cases at a reduced cost compared to a visit to the hospital or doctor’s office.
The healthcare consumer is seeking low cost, high quality care with a growing base of telehealth, urgent care, and retail clinics as well as expanding access to behavioral healthcare that is much needed across the country.
Maybe we should be addressing the need for better alignment of reimbursement on parity with the traditional doctor visit. It appears CMS is starting to create alignment to encourage the growth of telehealth. This could be more of the “new normal’ that health systems need to get onboard with sooner than later, or risk losing thier current market share.
I hope you’re right Christopher on a disruption of past paradigms. I agree completely that reimbursement is going to be key here though. CMS is definitely leading, but if the commercial payers don’t follow along, what does that mean for telehealth?