Tia Raises $100M for Hybrid Women’s Care

Women’s healthcare company Tia recently closed a $100m Series B funding round that will help to scale its “whole-woman, whole-life” model to over 100k women by 2023.

Just two years after seeing its first patient, Tia now has $132m in total funding for its hybrid care model that operates physical clinics in Los Angeles and New York, as well as virtual care in Phoenix.

  • Tia’s hybrid approach combines primary care, mental health, gynecology, and acupuncture to offer women seamless care coordination throughout their entire lives. Tia claims that its proprietary software and care coordination teams can deliver care for 40% less than traditional primary care practices.
  • Tia partners with health systems to provide an integrated inpatient/outpatient experience, creating better care continuity around key periods such as pregnancies. These partnerships also allow Tia members to access specialty care not offered at its clinics, like obstetrics.

According to Tia, women control more than 80% of the US’ $3.6t annual healthcare spend, yet female patients have been repeatedly misunderstood and underserved. Investors have taken notice, with Tia’s Series B arriving within a few week’s of Maven Clinic becoming the sector’s first unicorn with over $1b funding. 

Industry Impact

Up until recently, women’s healthcare has largely been fragmented by body part or life stage, creating an ineffective model that rarely supports holistic care. 

Tia believes its “anti-fragmentation approach” is the solution, driving better outcomes by replacing transactional, condition-based healthcare with relationship-based care that can cater to women throughout their whole lives.

Second Opinions for Anthem Members

Anthem recently signed on with The Clinic to begin offering its members easy access to virtual second opinions. 

  • The Clinic began in 2019 as a joint venture from Amwell and Cleveland Clinic that provides virtual care and digital health records to payers, providers, and patients. The service combines Amwell’s telehealth services with patient support from Cleveland Clinic’s 3,500 physicians.
  • Second opinions are expected to be a $7b market by 2024 (up from $2.7b in 2019), according to research from both companies. Cleveland Clinic studies have shown that second opinions result in a modified treatment plan in 72% of reassessments, as well as a change in diagnosis for 28% of life-altering cases.

Looking Ahead

Anthem is initially making the second opinion service available to its large employer clients, with the potential to expand to smaller employers going forward.

The Clinic CEO Frank McGillin signalled that more is on the way for the partnership, saying that the second opinion services are “just the start of our work with Anthem.” The Clinic anticipates a continued increase in demand for routine expert second opinions when dealing with life-changing health conditions.

Lyra Expands Into New Mental Health Conditions

Mental health benefits provider Lyra Health recently announced a trio of new solutions designed to address complex conditions such as alcohol use disorder and suicidality.

Lyra is seeking to effectively support the employees often overlooked by traditional health plans, such as those with serious mental illnesses and substance use disorders.

The new offerings will launch in early 2022 and include:

  • Lyra Reset addresses problematic alcohol use through virtual therapy, group sessions, symptom assessments, peer support, and medication. Lyra Reset promotes a durable recovery by providing resources for the entire family.
  • Lyra Dialectical Behavior Therapy for Suicidality combines virtual therapy sessions with therapist-prescribed skill-building lessons to help patients decrease suicidal thoughts.
  • Lyra Concierge provides personalized support for children, adolescents, and adults who need help accessing specialized mental health support or rehabilitation facilities.

The Trend

Many new digital mental health companies are focusing primarily on patients suffering from depression and anxiety, a large market given the pandemic-fueled climb in mental health disorders. 

However, as these companies begin to mature (Lyra has raised $680m and is valued at $4.2b), many will expand into other serious conditions.

This trend has the potential to help patients find specialized care that fits their needs, while also supporting employers looking to maintain a healthy and productive workforce.

K Health Acquires Trusst, Sets Sights on Mental Health

Digital primary care provider K Health announced its acquisition of text-based therapy app Trusst for an undisclosed sum, expanding its services into the rapidly growing online mental health arena.

  • Trusst offers a proprietary mobile platform that has the look and feel of regular text chats, adding a layer of familiarity to sensitive conversations with a therapist. To use the service, patients download the Trusst app and fill out a short questionnaire about their symptoms before being connected to a licensed therapist.
  • K Health provides a public symptom checker that funnels users into an AI-guided assessment of their health concerns, then allows them to connect to a physician via a telehealth call or explore treatment options through its paid service.

Both companies share a similarly lightweight digital-first approach to healthcare, providing services without the cumbersome overhead of many competitors, and expanding access to mental health professionals who would otherwise be prohibitively expensive or difficult to reach. K Health intends to fold Trusst’s services into its existing offerings, which include 24/7 access to primary care providers and prescriptions for as low as $12/month.

The Hottest Space in Digital Health

According to Rock Health’s H1 2021 digital health funding report, the virtual mental health space attracted over $1.5b during the first six months of the year, making it the leading clinical focus for new digital health capital. 

That definitely seemed true last week. The K Health acquisition took place one day before  Headspace and Ginger’s blockbuster merger, and the timing is far from a coincidence.

With so much investor attention on the space and a limited number of mental health service providers, companies are quickly staking claims through M&A activity, and K Health is betting that Trusst’s text-based therapy could be the answer to meeting the growing demand for accessible mental health services.

Does Telehealth Really Lead to Patient Loyalty?

New analysis from Sanjula Jain, chief research officer at Trilliant and faculty member at the Johns Hopkins School of Medicine, suggests that focusing on the wrong success metrics might be negatively impacting telehealth’s effectiveness as a digital front door.

  • In theory, a digital front door is a consumer-friendly and low-acuity engagement, like telehealth, that provides a health system with an opportunity to earn a greater share of an individual’s downstream services. 
  • In practice, telehealth’s ability to serve as a digital front door is hampered by low switching costs between similar services, with many consumers willing to shift from their current provider to a more affordable new entrant, such as Amazon Care.

Jain analyzed the behavior of insured individuals within and outside one of the country’s largest health systems, referred to as Health System A, finding that downstream capture from telehealth services did not indicate strong consumer loyalty.

  • The Findings – Roughly 13% of individuals within Health System A’s 2.7m consumer total addressable market accessed telehealth at least once in 2020, in line with the national average. Of those telehealth patients, Health System A captured a ~34% aggregate downstream share of care (based on revenue). 
  • The Impact – The low downstream share reflects the ability to capture an additional 65% of follow-up care prompted by the initial “front door” interaction. For comparison, Health System A’s service segment with the highest downstream capture was its Emergency Department (69%), indicating that telehealth might not be as effective of a digital front door as commonly perceived. 

The Takeaway

Telehealth is routinely serving as a digital front door, providing patients with their first exposure to a new health system, but more work is needed to validate its effectiveness. For telehealth to serve as a successful gateway to other services, health systems need better measurements of downstream care capture and consumer loyalty.

Pandemic Leads to Trust Issues

New research from patient engagement services provider SymphonyRM explored the growing distrust patients have for their doctors in the wake of COVID-19. 

A survey of 1,192 US healthcare consumers found that 41% had lost confidence in their doctor because of the pandemic, with a majority of mistrust stemming from preventable causes.

Reasons for Physician Mistrust

  • Infrequent communication about COVID-19 (53%)
  • Slow adoption of virtual care (29%)
  • Under-utilization of digital communication tools (24%)

Reasons for Improved Physician Trust

  • Quick transition to virtual care (61%)
  • High communication frequency about COVID-19 (58%)
  • Proactive use of digital communication (47%)

Patient Communication Needs

  • 41% would like to receive information about preventive screenings
  • 37% would like to receive information related to their chronic condition(s)
  • 37% would like to receive information and updates about the COVID-19 vaccine

Learning From Leaders

When asked what companies are the best at sharing information with users, 40% of respondents cited Amazon as the “gold standard” of communication. 

Amazon’s investments in real time shipping updates and 24/7 status monitoring have resonated with consumers, and it’s clear that patients are now looking for the same level of communication about their health. 

The survey suggests that providers looking to meet these evolving communication needs should look to consumer-facing brands when it comes to creating convenient experiences and driving engagement.

Digital Health Wire Q&A: Zoom’s Healthcare Transformation

With Heidi West
Zoom, Head of Healthcare

As the role of digital health continues to grow, new use cases are emerging and enabling communication between patients and physicians. The rapid adoption of telehealth solutions over the past year and a half has led to a boom in innovation that has expanded the scope of the technology well beyond the “virtual visit.”

In this Digital Health Wire Q&A we sat down with Zoom’s Head of Healthcare, Heidi West, to discuss the role of telehealth today and how the technology is evolving to meet the needs of consumers in a post-pandemic world.

Since the start of the pandemic, Zoom has enabled everything from remote schooling to virtual healthcare visits. How has Zoom’s healthcare business changed over the course of the past two years?

When the pandemic happened, there was a very abrupt shift from in-person visits to telehealth. At the beginning of the pandemic, telehealth was all about the virtual visit, and figuring out ways to engage the patient and provider. Throughout the course of the last year and a half, through the creativity and innovation of nurses and doctors and administrators, it started to focus more on all the ways that we can break down the communication barriers throughout healthcare.

It also served as a family connection point in many ways, helping patients that were isolated and vulnerable during the pandemic. As Zoom for Healthcare’s platform continues to evolve, the focus will be on augmenting or enhancing the communication experience along the entire continuum.

What are Zoom for Healthcare’s top priorities in this space?

Our number one goal is to continue to provide a simple and frictionless experience within healthcare communication. Whether it’s virtual visits, telehealth, or even internal communication between the business and the clinical side, we are looking at all of those strategic communication points and finding ways to simplify and tie more of a ubiquitous familiar experience across healthcare.

There’s a lot of passion in what we do, and a tremendous responsibility to clients and patients. A patient’s health and wellness conversations with their doctor are some of their most private communications, and that’s not lost on us.

A recent survey listed Zoom as the the most used telehealth platform, with 34% of physicians using the service. Why are so many physicians already choosing Zoom over other healthcare-focused platforms?

There’s a couple of reasons. It’s the simplicity, quality, and you’re not becoming tech support when you engage in a telehealth visit. There are niche products that are just telehealth, but many miss the business-to-consumer piece of the puzzle. Zoom is really uniquely positioned to bridge that gap.

It’s the same solution that their kids are using in school. It’s the same solution and look and feel as their trivia nights, or parent-teacher conferences. Zoom serves as a familiar connectedness that we’ve all really needed over the past year and a half.

Many telehealth offerings include services such as text and email notification, payments, and file transfers. Is this indicative of the direction that telehealth is heading?

Telehealth is in no way done with just a virtual visit. With Zoom Apps, any number of those needs that you mentioned can now reside within the Zoom meeting and serve different purposes. We’ll also begin to see more functionality leveraging biometrics and enabling live vital sign monitoring during telehealth visits.

Zoom will always remain simple and easy to use, but simple does not mean non-innovative. The mobile web client is a perfect example of that. Our clients asked for it, and within a quarter we’re already in beta. I’m really proud of the fact that we are customer-driven in the way we’re building the platform.

In the same survey, top physician concerns regarding telemedicine were “technology challenges for patients”, “poor integration with other technologies”, and “new telehealth specific workflows.” How can telehealth technology be improved to address these concerns?

This goes back to the reasons why so many physicians are already using Zoom, and that’s that we have an integrated workflow. Our goal is not to create parallel workflows, but to work within the workflows that clinicians are already sitting in today.

The beauty of our open platform is that it allows our clients to build within their own workflows. Providing that level of flexibility in the way people can develop with Zoom sets us apart significantly in solving a lot of these problems. From a patient perspective, I think addressing any friction point should be the goal, which is why we launched the mobile web client to help anyone struggling with the app.

Safety and data privacy concerns are always a priority with sensitive interactions like a telemedicine visit. How does Zoom ensure patient privacy is protected and that sensitive data is never vulnerable?

First and foremost, Zoom holds privacy and security to the highest level of responsibility. We enable HIPAA compliance throughout our entire platform. We have safeguards spanning everything from end-to-end encryption data to data-at-rest, but it’s important to remember that technology only enables HIPAA compliance. It’s the responsibility of everyone involved in the conversation to protect the information.

So it’s safe to say that patients don’t have to worry about someone “zoombombing” their doctor visit?

They don’t have to worry. Protecting user privacy is Zoom’s top responsibility and something we take very seriously.

Outside of doctor/patient visits utilizing telemedicine, where else is there a role for the technology that might not be as obvious?

I look at the entire healthcare continuum, and telemedicine has a role anywhere from a well-visit, to primary care, to an acute care setting, as well as in the home. There are dozens of communication points along this continuum, and our goal is to look at them and ask if there’s a way that Zoom can improve them or remove friction. For each communication component, we ask questions like: Do you augment this with video? Do you leverage Zoom Phone? Can Zoom Rooms tie different pieces together? The entire healthcare journey needs to be the focus, not just the virtual visit.

I would almost flip the question and ask: Where wouldn’t telehealth fit? Even in just the patient’s room, there’s entertainment, education, food services. All of these can be improved through technology, but so can things like care coordination and family engagement. We’re looking at the patient room as a source of digital transformation that revolves around putting the patient at the center of all of the different communication that goes on within the room.

How do you see the telehealth space evolving over the next few years and where does Zoom fit into this picture?

The biggest thing to remember is that the landscape has changed following the pandemic. Patients have choice. Patients have flexibility. There’s a lot of competition in delivering care today. Never underestimate the consumer’s wants and needs from healthcare.

Look at all of the four hour blocks of care and say, how do I augment in-person with virtual? Do I leverage nurse practitioners? Do I leverage medical assistants? Then augment to provide that flexibility and convenience to patients. Healthcare still uses pagers and fax machines, so the chance to upgrade to a more strategic communication strategy will only continue to evolve.

The healthcare industry just saw 10 years of innovation in six months, and I think it’s made people aware that the consumers and the communities they serve will follow the innovation – and I’ll say it again: never underestimate the consumer.

Telehealth’s Payoff

A new study from MITRE Corporation and Mayo Clinic of over 2 billion claims (plus thousands of patient and provider surveys) found that telehealth was effective at delivering care across a wide variety of specialties, but providers are still worried about its limitations in the post-COVID era.

Claims Results

  • Telehealth claims represented less than 2% of total claims before the pandemic, peaking at 49% in April 2020
  • Every clinical discipline saw usage rise, with the largest spike seen in behavioral health
  • Out of state providers were responsible for 6.5% of telehealth visit claims

Provider Survey

  • 79% of providers offered telehealth following the pandemic (16% prior)
  • Highest quality of care ratings were for chronic disease mgmt (89%) and mental health (83%)
  • Lowest quality of care ratings were for acute care (62%) and perioperative care (59%)
  • Biggest telehealth barriers were low reimbursement (~80%) and patient tech challenges (~70%)
  • Zoom (34%), audio-only (29%), and Doxy.me (28%) were the most cited technologies

Patient Survey

  • An impressive 74% of patients plan to use telehealth services in the future
  • 55% of patients reported that they would have delayed care without telehealth
  • Telehealth drove patient satisfaction by removing transportation barriers (76%), removing need to take time off work (65%), and reducing costs (67%)

The Takeaway

Telehealth studies aren’t exactly hard to come by, but this one is unique given its size and intent. Mayo Clinic’s goal behind the study was to encourage more telehealth research with the hope of influencing permanent regulatory change and reimbursement approaches. The study does a great job of showcasing telehealth’s positive impact on patients and providers, highlighting the need to better understand how the technology can be improved moving forward.

The Telehealth Boom Continues

New McKinsey analysis suggests that telehealth will maintain most of its pandemic-driven usage gains, which stabilized at 38X its pre-COVID baseline and 17% of all outpatient/office visit claims.

McKinsey’s findings highlight three primary driving factors:

Adoption

  • 40% of surveyed consumers believe they will continue to use telehealth, up from 11% before COVID-19
  • 84% of physicians are now offering virtual visits, while 57% wish to continue

Regulation

  • CMS made telehealth coverage for a number of CPT codes permanent in the 2021 physician fee schedule

Investment

  • Total digital health VC funding in 1H 2021 reached $14.7B, eclipsing 2020’s total ($14.6B)
  • Investment surge pressuring companies to innovate and find viable models
  • Top 60 digital health players had combined revenue of $5.5B in 2020, vs. $3B in 2019

The Takeaway

It may have been reasonable to expect telehealth usage to decline given the unique circumstances behind its massive growth. However, the combination of patient, clinician, and business momentum suggests that most of telehealth’s share gains could persist.

Virtual Consults

New research out of MGH shows that point-of-care virtual radiology consultations are well received by patients and primary care providers, suggesting that they could “advance radiology’s value in care delivery.”

  • The Study – The researchers performed video-based radiology consultations with 3 primary care providers and 43 patients at a primary care clinic, surveying the patients and the PCPs.
  • The Patient Results – The patient results were positive – 93% were satisfied with the virtual consultations, 88% stated that it improved their understanding of their condition, and 91% were interested in similar consultations in the future. Perhaps most notably, the patients’ interest in receiving their imaging results from radiologists increased from 56% before the virtual consultations to 88% after. 
  • The PCP Results – The PCPs were satisfied with 97% of the virtual consultations and found that 83% of the consultations helped their management decisions.
  • The Takeaway – The 2020-2021 virtual care boom has largely skipped radiology, but it’s becoming clear that all specialties will have to find a way to adapt to this shift. This study reveals a straightforward way for radiology to increase its role in virtual care that seems to work for both patients and referring providers.
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