3 Takeaways From the Downfall of Big-Name Telehealth
This edition covers:
- How the burden of primary care pushed the expansion of telehealth
- The dismantling of telehealth among major companies
- The path forward for care innovation
The primary care system is being stretched thinner than ever. At the heart of this issue is the growing shortage of primary care physicians (PCPs) in the United States, particularly in rural and underserved communities. This shortage is exacerbated by the trend of medical students choosing other specialties, a decision influenced by disparities in resources and compensation— a measly 6% of U.S. healthcare spending is allocated to primary care. Complicating matters further, PCPs are burdened with an overwhelming patient panel, averaging more than 2,000 patients each.
In order to provide the recommended standard of care for such a large panel of patients, a physician needs to work an infeasible 21.7 hours a day. And with more people living longer and developing chronic conditions like diabetes, heart disease, and obesity, it’s becoming nearly impossible for physicians to manage patients’ holistic health needs.
This burden on primary care has pushed the expansion of telehealth. Notably during the COVID-19 pandemic, the U.S. telehealth market experienced accelerated growth due to the unavailability of in-person services. But what we’re learning now is, telehealth as an alternative to primary care visits might not be the right solution. Case in point: major players like Amazon Care, Walmart Health, and Optum recently pulled the plug on their telehealth services, citing lack of sustainability and long-term impact.
This dismantling of telehealth among major companies brings to light the nuances of innovating in the primary care space, and offers insights on what it will take to make real change.
How Do We Innovate the Primary Care Space at Scale?
Honestly, it’s a million dollar question that we won’t pretend to know all the answers to. Realistically, it’s going to take a lot of different players in the healthcare system working together to make real change. When it comes to the virtual care space, here are my top three takeaways for optimizing care and enabling the existing primary care system:
1. Quality care. Ensure healthcare services strive to meet the highest standards for safety, effectiveness, and patient satisfaction. Former employees from a large company recently brought to light concerns regarding the safety of elderly patients. Quality care is evidence-based, supported by peer-reviewed research, and adherent to rigorous standards established by accrediting organizations.
2. Care personalization. Tailor healthcare to fit each patient's unique needs, preferences, and health goals. This involves personalized care plans carried out by virtual care teams that address the whole person, and support preventive care and patient education.
3. Care coordination. Facilitate communication among healthcare providers involved in a patient’s care. This approach leverages technology for secure and shared access to health records, reduces errors, and can make the patient’s journey through the healthcare system seamless.
While the hope was that telehealth could be a sustainable 1:1 replacement for in-person care during COVID-19 and beyond, it is clear that’s no longer the case. Primary care at its best goes beyond periodic doctor visits, whether digital or in person; it includes prevention, managing long-term health in the time between visits, and much more.
What Should Care Innovation Look Like?
Care innovation should complement —not compete with— primary care. The aim should be to bolster primary care by developing virtual solutions that include the key elements listed above. What might that look like in practice?
For instance, with the increasing interest in GLP-1 medications and Omada's commitment to obesity management, it might seem like a no-brainer for Omada to start prescribing these medications to our members, like others in the space. However, Omada has consciously decided to entrust this role to our members’ PCPs.
We believe that managing obesity effectively, particularly with long-term medications, requires a strong patient-provider relationship grounded in a thorough understanding of the patient's medical history and health goals.
We’ve also learned that people with chronic conditions value their relationship with their primary care provider. In a recent Rock Health survey, 69% of respondents stated that they prefer in-person care for chronic condition management. This is similar to what we saw with Omada members in the past when we did offer prescribing services to select populations.
So what’s our approach to optimizing care for patients taking GLP-1s? We leverage our evidence-based lifestyle change programs to deliver quality care between PCP visits that is personalized to each member’s health goals – from side effect management to activity regimens that promote lean muscle mass growth. Health data is also monitored and can be shared with the PCPs or healthcare ecosystem to facilitate proper communication.
That is what our programs provide—those extra layers of behavior and lifestyle support to make traditional primary care even better.
As healthcare continues to evolve, virtual solutions will be crucial for tackling the big challenges in primary care, but we must continue to focus on designing solutions that complement the existing primary care system – not disrupt or replace it. Incorporating technology that supports continuous patient engagement and reinforces the patient-provider bond is essential to maintaining a high standard of care and addressing the current healthcare challenges effectively.
