The Emergence of Telehealth

Telemedicine companies range from behemoths serving healthcare providers and insurance plans like Teladoc and Amwell to millennial-centric startups like Hims & Hers. The majority of these companies are privately backed by investors and venture capital firms.

These telemedicine systems work in a variety of ways. You might simply text or video chat with a doctor or have a virtual visit via a computer on wheels—a scenario reminiscent of futuristic sci-fi films. Either way, the goal is to deliver convenient and high-quality health care to patients without the need for physical interaction.

With most of the world still under strict quarantine, telemedicine has emerged from obscurity and, frankly, swamped some of these platforms. “We’ve seen the number of daily visits more than double in the past month, which has been challenging—but we’ve been rapidly onboarding providers and patient support to maintain industry-leading response times,” Brendan Levy, Executive Medical Director at GoodRx, says in an email. GoodRx acquired the telehealth app HeyDoctor in 2019.

Amwell has also experienced an unprecedented rise in users as the pandemic sweeps the United States. “Right now we're up over 600% from normal,” says Mike Baird, Amwell’s president of Customer Solutions. The current average wait time is roughly between 10 to 30 minutes. Amwell has handled the surge in demand by growing their provider base by 800% in the last three weeks.

However, some companies, such as Teledoc, have struggled under the massive influx of customers. Recently, Bob Bracy tried out Teladoc to refill his prescriptions remotely. While he found his visit with the physician pleasant and reassuring, the administrative side was “a nightmare.” He was on hold for hours, his information was inputted incorrectly, and not all of his prescriptions were refilled.

“One thing I can say with absolute certainty is that, under the current pandemic, they’re overwhelmed,” Bracy tells Supermaker. “They’re just simply way in over their heads right now.” Teladoc did not respond to an interview request.

Despite the messy encounter, Bracy agrees with other telemedicine users that virtual visits can be more convenient than driving to a clinic—depending upon the service, of course. Currently, telemedicine services typically include primary care, mental health, nutrition, dermatology, and sexual health. But as Gabriela Barkho recently learned, not every doctor’s appointment can be done online.

“All of my appointments would end with, ‘We just have to wait and you'll need to come in when we're open so I can assess it in person,’” Barkho says, explaining how she had to hold the computer up to her nose during a follow-up after her nose surgery.

With possibly no end in sight for social distancing, this poses the question of what will happen to people who are currently in limbo awaiting a diagnosis or in-person care. Even so, Barkho mentions that some of her past telemedicine appointments have still been successful. “Instead of paying to go in and get your antibiotics, the doctor will call you, ask what's wrong, and you’re diagnosed. I've done that. And that's actually great because it saves a lot of time and money.”

Affordable but not always accessible

Convenience isn’t the only factor driving the growth of the telemedicine industry. Cost plays a significant part, too. HeyDoctor’s visits start at $20—regardless of an individual’s insurance status. Similarly, Hims & Hers doesn’t submit to insurance and tries to be as price-transparent as possible.

“A large segment of our population has high deductible health plans. So, they're paying out of pocket until they reach the deductible. And most folks don't reach the deductible in a given year,” Patrick Carroll, Chief Medical Officer of Hims & Hers, tells Supermaker. “[Patients] are very price-conscious and we price our services according to that.” And yet, even as services are booming, accessibility still isn’t equal.

“It's definitely exposed that the internet isn't available to as many people as I always figured it was, especially in a first-world country,” David Homan, a doctor in Louisiana says. “A lot of my patients just don't have it.” In fact, a 2018 Microsoft study found that half of Americans (about 160 million people) don’t have high-speed internet—a crucial component in delivering safe and efficient telemedicine.

Due to inconsistent access to the internet, Homan has been administering some telemedicine appointments through phone calls, which raises privacy concerns because these calls are not as secure as the HIPAA-compliant chats made through the aforementioned telemedicine platforms.

Yet, under the current emergency-driven climate, privacy appears to be the least of people’s worries when it comes to accessing health care in the midst of this pandemic. “Non-HIPAA compliant phone calls are still safer for our patients than potentially being exposed to COVID-19,” Homan says.

Ultimately, with social distancing measures in place for the possible long-term, it’s becoming increasingly likely that the telehealth industry will continue to grow and evolve with us as we stay at home. To be sure, coronavirus has put telemedicine in the spotlight, but behind the glare are many gaps in America’s infrastructure—and they’re coming into focus faster than ever.