Quest For Care: The Digital Health Arms Race

Take for instance Amazon, which is silently branching out in the sector, who recently launched a suite of virtual and mobile healthcare services, which will initially only be available to employees to provide an app to text with a nurse, launch a video chat with a doctor, receive an in home nurse visit, or to even have prescriptions delivered. 

Shortly after this launch the company announced the acquisition of Health Navigator which is a startup that has developed an automated tool with chat feature to collect information about symptoms and provides direction on care options. There is also the substantial investment into Mindstrong Health, links to NHS data bases on health and wellness, and the online pharmacy PillPack which has licences to supply prescription drugs across the nation. 

Given the company’s seemingly unshakeable retail dominance how long will this stay a feature for employees only? These services could easily even be added to Alexa which has already been identified as one of the AgeTechs to keep an eye one. Strung together these services could be expanded to all Prime users and very well could represent and Amazon led digital disruption of the healthcare ecosystem.

It is not just Amazon looking to cash in on this market, even companies such as Walgreens have put in a dance card. Now when you check out you can receive a coupon that reads “text care5 to 21525 to Find Care Now” this experience starts with an automated text exchange which will lead to being able to talk to a doctor online, communicate with a therapist, or receive a variety of specialty care opinions and services virtually. 

Many organizations, health systems, employers, insurance companies, and tech giants are focussing efforts on developing ways of harnessing technology to make healthcare more convenient and easier. But this corporate surge into mobile and virtual health brings about many questions, of them the most important maybe where do primary care doctors fit into this new equation? Have people really lost track of the importance of continuity, and are people really willing to give it up in the name of speed and convenience??

Best case scenario may be to have the best of both options; easy, innovative and convenient services that are provided by a trusted healthcare provider or team. Healthcare providers have already been working to engineer services for consumers and developing digital front doors to be transaction ready for consumers which started with webpages for provider services, and patient portals offering online result reviews and billing options. This shift has evolved into a facilitated digital journey with tools such as health system developed apps, provider messaging, and video visits. But even this still brings about questions as to actual time spent with patients versus entering information into a database and the processes that come along with it. 

Take HealthPartner as an example, this is a health system that launched the e-visit program call Virtuwell which has completed over 500,000 treatment plans. During an e-visit patient and providers typically don’t talk to each other directly, rather the exchange is virtual or messaged based; this can occur 24 hours a day 7 days a week for over 60 simple conditions such as pink eye, sinus infections, and urinary tract infections after the patient completes a structured online questionnaire sent securely via the e-visit exchange to a provider for diagnosis, treatment plans, and if appropriate an electronic prescription. Compared to traditional care there is an overall lower cost of care of $88 using Virtuwell, according to Health Affairs. 

Besides the cost and convenience savings there are other caveats to take into consideration. Virtual health partners or services don’t know the patient let alone their medical history which includes medications, conditions, allergies, and family history which are all factors that can influence and change a treatment plan. Virtual health partners and services have to rely on the patient providing all details accurately and completely. Working with a trusted team all of this information may be kept together in one place to access as needed; as such a local team may be better equipped to direct patients to local available additional resources like a follow up visit after an e-visit to a local provider to make a better informed recommendation. 

Apparently high quality health systems can prioritize factors that affect overall health such as clinical appropriateness, quality, and safety including not often prescribing antibiotics for a price, rather ensuring those meeting criteria get the guideline recommendation medical therapy for their symptoms; and health systems are also said to be more adept at monitoring for quality and studying effectiveness. 

Not all conditions can be treated virtually without a physical examination, and despite suggested safety there will always be challenges and questions regarding the privacy and security of our personal health data, just for starters. As a supplement in addition to traditional care models these virtual services may have the best value, and they will likely continue to have a growing impact. 

This all brings about a serious question as to who will be the winner of this digital health arms race? Will the big controlling corporate money hungry giants be successful at pushing their digital health systems as a viable product with membership models, or will the healthcare system remain keeping care high quality, close, and personal? The winner may well be a system option that is engineered to operate using the best of both services to provide care for people where and when they need it.