ATA Urges Clinicians to Take Charge, Own Virtual Care Innovation

At the recent American Telemedicine Association conference, some heavy hitters in the telehealth world said the future will be guided by care providers who make virtual care their own.

Health system leaders looking for sustainability in telehealth should be focusing not on the latest technology, but on how providers are adapting virtual care to their own needs.

Roy Schoenberg, president and CEO of AmWell, says the industry is well past proving the value of the audio-visual telehealth encounter. And as the nation looks to move further away from the pandemic, virtual care will be defined by how it's now being used to improve clinical outcomes and clinician workloads.

"If we can always be next to the consumer … we can completely rewrite how we care for them," he said during a main stage appearance at ATA2022 earlier this month in Boston.

Schoenberg's comments were part of a busy three days in Boston for telehealth advocates as the ATA returned to a live event for the first time in more than two years. In a conference attended by healthcare providers and decision-makers, the theme of "Now What?" was seen as a challenge to the healthcare industry to go beyond validating telehealth and get to the job of using it.

A lot of the discussion was shaded by the understanding that the regulatory landscape around telehealth is still uncertain. The industry has been allowed to flourish under emergency federal and state measures enacted during the public health emergency (PHE) to expand access and coverage, but there's no clear idea yet what will remain and what will be lost when the PHE expires.

In that context, Schoenberg said, healthcare leaders need to step up and take the initiative.

"Telehealth is not static—it's changing," he told ATA CEO Ann Mond Johnson during a keynote. And healthcare must keep up.

More specifically, telehealth is allowing healthcare to broaden its horizons to the home and office and giving healthcare providers the freedom to shape more meaningful care management programs to patients' lives and habits.

"We've completely disrupted the old model of face-to-face service," James Mault, MD, the former Qualcomm Life executive and the founder and CEO of BioIntelliSense, a developer of wearable biosensor technology, said during a main stage panel. "Basically, healthcare has not changed fundamentally for somewhere in the realm of 2,000 years."

Mault, referencing a McKinsey report that states $265 billion in care costs will shift from the hospital to the home over the next three years, said the industry has to combine high tech and high touch to deliver care directly to the patient. That means embracing digital health tools that not only enrich the patient's medical record, but AI tools that sift through the data to give providers the information they need to improve clinical care.

Remote Patient Monitoring Picks Up Steam

One trend demonstrating that desire to get next to the consumer or patient is remote monitoring. Healthcare organizations are launching remote patient monitoring (RPM) programs at a quick pace, with the goal of extending care to the home and providing opportunities for real-time care management and population health. Vendors, meanwhile, see RPM as not only a means of partnering with health systems but a direct-to-consumer (DTC) channel to encourage consumers to monitor their health and engage with their care providers.

"This is more than just vital signs collection," said Carolyn Walsh, chief commercial officer for Florida-based BioIntelliSense, which announced RPM partnerships with UC Davis Health and Houston Methodist. "This is a comprehensive view of one's health status."

Withings Health Solutions debuted its RPM program, called Med Pro Care, two years ago with a line of connected devices directed at the health-conscious consumer. This year the French company introduced an updated platform, pairing devices with an app-based dashboard that aims, according to company vice president Antoine Robiliard, "to put the patient back in the center of healthcare."

Robiliard—who has moved to the U.S. to spearhead the company's efforts in advancing the platform in the Americas—said many RPM programs are too complicated and focus on what the provider wants rather than what the patient wants. More effective programs, he says, put the technology in the background and focus on integrating with the patient's lifestyle.

"Patients who are sick know they're sick," he said. "They don't need to be told this every day."

Consumers are also driving the trend toward DTC healthcare. An example of this is Ro, the start-up launched a few years ago to address erectile dysfunction, which has raised more than half a billion dollars in funding and now offers a wide range of services, including pharmacy interactions, virtual visits, and even in-home care.

"I think we all agree that patients are the ultimate stakeholders," Zachariah Reitano, chief executive officer of Ro that now rivals Teladoc and Amwell, said during a main stage presentation.

Reitano said the industry is shaping up to be a "competition over earning the right to take care of someone," a comment echoed a day earlier by digital health expert Joe Kvedar, who wondered who would "win the battle for primary care." Reitano said the battle might well be won by whoever figures out how to best control payment, reducing costs, marrying quality of care to value, and attracting the consumer's attention.

"This patient revolution, as cheesy as it sounds, is going to happen," he said.

Keeping Providers in the Loop

While interest in DTC telehealth tools and platforms is strong, Amwell's Schoenberg was quick to point out that telehealth won't achieve true value unless these services are linked to healthcare providers. That's why many telehealth companies are focusing their efforts now on new platforms and technology that integrate services into an enterprisewide network and improve the infrastructure behind virtual care.

"That's the ceiling for us as an industry right now," he said, likening efforts to "choreographing" the telehealth experience. "What that translates into is a laundry list of things we don't like" but that need to be done to improve the clinician experience.

Automation and AI will play a part in this. In a trend carried over from the HIMSS22 conference earlier this year in Orlando, several companies are pitching tools and platforms that do the back-end tasks that take up much of clinicians' time. And as Mault noted, others are marketing technology that sifts through the data coming in from various, unstructured sources, including wearables and smart devices, to give clinicians the data they need.

Several panelists and speakers said the innovation landscape will focus now on partnerships and mergers, as healthcare organizations look to expand their enterprise platform with certain tools and services. Some health systems have created their own innovation centers, and even set up venture capital funds, to serve as incubators for startups whose solutions can be field-tested in the health system before being marketed to the industry.

"The last couple of years have been a sandbox," Nathaniel Lacktman, a partner with the Foley & Lardner law firm, chair of its telemedicine and digital health industry team and a national expert on digital health law, said during one panel discussion focused on the future of virtual care. "Building upon that, we'll create programs that are more meaningful."

And that's where Schoenberg says the healthcare industry should focus. Healthcare providers now have the tools to improve patient care and the platforms to make healthcare a digital companion, always at the consumer's side.

And if providers really want to choregraph the care continuum, as Schoenberg said, they'll need to lead the dance.