Trilliant Health Chief Research Officer Sanjula Jain, Ph.D.

Digital Health

Telehealth Struggles to Live Up to Expectations

Telehealth demand hasn’t exactly lived up to expectations, but that might have more to do with manic forecasting than real-world performance when a 6,000x utilization increase isn’t enough to satisfy the naysayers.

There’s nothing like forced adoption to kickstart a market, and the combination of in-person office closures and pandemic-era legal flexibilities caused telehealth utilization to vault from less than a million visits in Q4 2019 to over 60 million visits by Q2 2020.

(Overly) enthusiastic forecasts quickly followed the early data, but Trilliant Health’s latest telehealth tracker shows that demand has only headed downhill since the initial spike. 

• As of Q3 2023, sustained declines have left telehealth volumes 54.7% below their peak, and the trendline doesn’t appear to have found a bottom.

Recent high-profile retreats from players Optum and Walmart have sparked solid viewpoints from pessimists and optimists alike, although the general consensus is that patients don’t view telehealth as a substitute for in-person care for most conditions.

• Since 2019, behavioral health has represented a consistently increasing share of overall telehealth utilization, and accounted for a substantial majority (67%) of all virtual visits in Q3 2023.

E-prescribing increases closely mirrored the telehealth growth, and now represent a significant share of prescriptions for many drug classes:

• 30.3% of antidepressants, 38.9% of stimulants, and 5.4% of opioids. It’ll be interesting to see the GLP-1 data when it catches up.

The Takeaway

Event-driven demand shocks don’t last forever, and the telehealth slowdown showed that reality is usually more nuanced than an overnight paradigm shift. New modalities don’t magically create better businesses, but they can be the tools that founders use to build them.

Patient-Centered Design for Diabetes Care

Glooko’s recently overhauled Mobile App makes it easier than ever for diabetes patients to organize, log, visualize, and share their data. Head over to this conversation with Glooko’s product and design team for a behind-the-scenes look at how patient-centered design is improving diabetes outcomes.

Elevate Outcomes With Withings Devices

Up-level your remote patient monitoring with Withings Health Solutions connected health devices that seamlessly integrate into your digital health programs. Get in touch to experience unparalleled operational and technical support, build an elevated patient experience, and deliver superior care with high quality patient-generated data.

The State of Payor Enrollment and Credentialing

We’re on the brink of a new era in healthcare. From AI-enabled chatbots to GenAI, Medallion’s latest report sheds light on how healthcare organizations are prioritizing automation, actively shaping their future with it, and hoping it can live up to its promise. Get the full report here.

The Wire

• NeuroFlow Acquires Owl: NeuroFlow acquired fellow digital behavioral health company Owl to round out its end-to-end platform for identifying and managing behavioral care needs. NeuroFlow recently raised new capital to help providers consistently screen for behavioral health issues, triage patients to appropriate care, and engage them between visits. Owl’s tools for allowing patients to report clinical symptoms prior to appointments seems like a solid way to support that mission.

• Nurse Shortage, or Job Shortage? A fascinating debate is stirring over whether there’s actually a shortage of nurses, despite undeniable staffing issues in US hospitals. A JAMA Health Forum study found that the number of full-time nurses was 6% higher in 2023 than in 2019, despite thousands of nurses leaving their jobs during the pandemic. Most of that growth “occurred almost entirely in nonhospital settings,” leaving many wondering if hospitals are keeping staffing levels low as a form of cost cutting in an effort to combat rising labor costs.

• Ardent Files IPO: Healthcare’s public market comeback is heating up enough for provider orgs to start testing the waters, with Bloomberg reporting that Ardent Health is exploring an IPO at a valuation of at least $5B. This marks the second attempt at an IPO for the Tennessee-based system, which last filed in 2018 before its private equity owners scrapped the plans amid the start of the pandemic. Ardent owns and operates 30 hospitals and 200+ facilities with 1,700 aligned providers across six states.

• Bad News for KC Chiefs: The Kansas City Chiefs found themselves back in the healthcare headlines this week after defensive lineman BJ Thompson suffered a seizure and went into cardiac arrest during a team meeting. Thompson quickly received CPR from the Chiefs’ medical staff, and “came back” after a single AED shock, before being transported to the hospital. He’s since been discharged and is home recovering. Thomson’s cardiac arrest comes about 18 months after Buffalo Bills safety Damar Hamlin suffered cardiac arrest on the field during an NFL game.

• US Health Spending Accelerates: US healthcare spending accelerated in 2023, growing 7.5% for the year with total expenditures of $4.8T. The latest CMS figures were published in Health Affairs and show healthcare’s percentage of US GDP growing to 17.6%, from 17.3% in 2022. CMS projects spending from 2023-2032 to grow 5.6% annually, such that healthcare reaches 19.7% of GDP by 2032. On the positive side, the share of the population with health coverage hit 93.1% in 2023 due to gains in Medicare and Medicaid enrollment. 

• Abbott’s OTC CGMs: The over-the-counter continuous glucose monitoring segment gained more momentum this week, with the FDA clearance of a pair of new Abbott OTC CGMs. Abbott positions its new Lingo CGM system for general consumers who are interested in improving their overall health and wellness, while the new Abbott Rio targets adults with Type 2 diabetes who don’t use insulin and instead manage their diabetes through lifestyle management.

• Fatherhood Isn’t Necessarily Healthy: When you’re celebrating Father’s Day this weekend, remember that cardiovascular health might be one of the many sacrifices that comes with being a dad. That’s according to a AJPM Focus study that analyzed 2,814 men (45-84yrs, 82% fathers) without known cardiovascular disease at baseline, finding that fathers have worse cardiovascular health versus non-fathers (CV health scores: 63.2 vs 64.7 out of 100). This was especially true among fathers who had their first child when they were young, and among Black fathers.

• Anterior Series A: Healthcare admin automation startup Anterior scored $20M in Series A funding (total raised now $23.5M) to support its hiring and growth roadmap. Formerly known as Co:Helm, Anterior uses an LLM-powered co-pilot to help streamline clinician prior authorization workflows, and plans to expand to other admin workflows in the future.

• Moving the Needle on Costs: An excellent edition of the Keckley Report handicapped the various players in the quest for healthcare affordability, with a thorough breakdown of the levers that each player has at their disposal. Keckley ranked payors as the most well-equipped to tackle the issue (availability of cost data, growing government market, plan design), while physicians came in last due to uphill battles with care continuity, the inadequacy of primary care, and general fragmentation.

• Oracle’s Rough VA Report: Oracle’s VA implementation continued its cold streak, after a 2,000-person KLAS survey showed that under 20% of the VA’s Oracle Health users believe that the EHR helps them deliver high-quality care, while just 13% of VA users believe that Oracle Health helps keep patients safe. It scored (slightly) higher with the DoD, with 30% of users stating that it helps them deliver high-quality care.

• Heart Failure Detection Gets Smart: A new study shows that smartphones can accurately detect heart failure using CardioSignal’s seismocardiography technology, a method by which sensors in phones measure heart vibrations and cardiac motion through the chest. The REFLECS study enrolled 217 HF patients and 786 healthy controls, finding that CardioSignal detected heart failure with 89% accuracy, 85% sensitivity, and 90% specificity. The tech could potentially transform how heart failure is diagnosed, offering high accuracy regardless of age, BMI, or AFib status.

NextGen Brings Generative AI to the EHR

As burnout and administrative tasks continue to weigh down physicians, Nabla sat down with NextGen Healthcare to unpack how ambient AI can help lighten the load. See why NextGen’s VP of Product Development relies on Nabla to automate clinical documentation and enhance the overall care experience for patients and providers.

Discover Clear Arch Health’s RPM Platform

With ready-to-use devices, data-driven dashboards, and integrated analytics, Clear Arch Health’s turnkey RPM platform is designed to meet the evolving needs of care delivery. Find out how Clear Arch Health can help keep your providers connected to their patients and equipped with the actionable insights they need to improve outcomes.

The Best Partner for Sustainable Staffing

Delivering the best care requires a partner who understands the current staffing challenges. See how connectRN empowers its partners to deliver sustainable staffing through tools and resources designed to enable the best care possible.