Addressing Heresy in Healthcare


I’ve worked in enough start ups to know that creating something from nothing can be hard. It is especially tough when you must create a market and explain to people that what you’re doing isn’t nearly as heretical as it may sound. When my friends and I started Subimo in 2000, people wondered why they’d use our product to learn about hospital performance when (in their words) all they really needed was to have their doctor to tell them which hospital they should use. What people eventually realized was that there is variation in outcomes by hospitals and even by service lines within hospitals.

That’s why the recent spate of articles about the newly emerging direct-to-consumer companies in health care – the ones that are condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies that have leveraged all we know about direct-to-consumer marketing and have identified an unmet market need. In some respects, they’re not dissimilar from companies like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a convenient way for people to get what they need (in this case, good vision). Or companies that offer behavioral health services directly to consumers.

What do these companies have in common? Aside from a strong marketing foundation, they have identified a market need that can be met with a new approach that leverages technology. They are convenient, offer a high level of customer service and may even be easier to work with than traditional players.

Does it mean they’re practicing bad medicine? No. Just as the pioneers in telehealth did before them (American Well, MD Live, Teladoc Health) I suspect they employ great physicians who are energized about the prospect of helping more people in a targeted and direct fashion. These organizations describe detailed processes and protocols equipping their clinicians to screen for conditions or medications that are contraindicated. While I am not a clinician, by all accounts, they adhere to the same guidelines we expect to find in traditional settings. And the possibility of forgetting to ask certain questions may even be reduced because of their use of technology. In the case of vision companies, they’ve performed thousands of refractions and virtual eye exams without incident. And in the case of behavioral health, we know that virtual can be as good if not better than face-to-face.

What these companies have done is use the promise of telehealth to reimagine how care can be delivered. Before we rush to judgment about their clinical capabilities, let’s better understand how they work. Our opportunity as an association, as researchers and as an industry is to ensure that when people use their services, they know it is safe, effective and appropriate. These goals are no different from what each of us want and deserve from every healthcare provider, virtual or not. Let’s see how we can partner and learn from them – just as we should with other new entrants (Walmart, Amazon, Apple) – and focus on improving access and quality and reducing cost and clinician burnout so that everyone gets care where and when they need it. While telehealth is not a panacea, it is a powerful tool and an important means to achieving what we all should have.

Continue the conversation at ATA19 happening April 14 – 16 in New Orleans!

Ann Mond Johnson is the CEO of the American Telemedicine Association (ATA).

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