The US FDA’s tweet advising against the use of ivermectin as a COVID-19 cure.

Telehealth

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.

Digital Health

Verily Aims to Build GPS for Patient Care

Mayo Clinic and Verily, Alphabet’s life science division, recently announced a two-year strategic partnership to develop a clinical decision support (CDS) tool that caters to a patient’s individual needs. 

Although physicians generally do not love their EHR flashing advice at them, the collaboration aims to sidestep the one-size-fits-all approach of traditional CDS tools with AI-generated recommendations relevant to the patient in the room.

• The Partnership – Mayo Clinic will provide curated clinical content and deidentified health record data while Verily will apply advanced analytics and user-centered design to deliver insights within existing point-of-care workflows.

• The Roadmap – The tool will initially focus on cardiovascular and cardiometabolic conditions at Mayo Clinic, but will use open standards to enable integration with multiple EHRs for possible expansion to other use cases for Verily’s health system partners.

The Takeaway

While announcing the partnership, medical director of Mayo Clinic’s Center for Digital Health Bradley Leibovich MD stated that he hopes the tool can be used as “a GPS for patient care.”

The companies cited the exponential growth in medical discovery and knowledge as making it  nearly impossible for caregivers to keep up with the latest advances in their fields, creating a need for a tool that offers clinical support. 

Verily and Mayo Clinic are betting that their combined expertise in clinical informatics and data science will be the solution to creating a patient-relevant CDS that clinicians actually want to use.

Nuance’s Patient Engagement Must-Haves

Consumer demands are shifting, and they’re looking to get more out of their digital health technology. Nuance outlines the 5 must-haves for your patient engagement strategy here.

The Wire

• New Wave, New Cure: The CDC recently issued a health advisory warning of a rapid increase in ivermectin prescriptions (up 800% from pre-pandemic levels) from online diagnostic sites billing the drug as an effective alternative to COVID-19 vaccines. Originally introduced as a dewormer for livestock in the 1970s, ivermectin has become a commonly prescribed “COVID cure” on sites like SpeakWithAnMD.com, now sold out of the drug due in part to glowing reviews from Reddit users linking to the webpage: “I identify as a horse and can report no ill effects from the directed dosage as recommended by professionals, taken on a weekly basis. I like mine with a side of strawberry jam.”

• Anxiety Chatbot: A new study published in JMIR Mental Health assessed the efficacy of using an integrative AI chatbot, Tess, to reduce self-identified symptoms of depression and anxiety in college students. The randomized controlled trial of 75 participants found a statistically significant decrease in symptoms for test groups with access to Tess, versus no difference for the control group. The study suggests that chatbots could serve as a more scalable and affordable alternative for treating depression than traditional cognitive behavioral therapies.

• Whole-Body Reset: Telemedicine metabolic health platform Calibrate recently raised $100m in Series B funding ($127.6m total funding) to fuel the growth of its One-Year Metabolic Reset program that includes an app-based weight loss curriculum, one-on-one video coaching, and prescription medications. Calibrate sets itself apart from other weight loss programs by focusing beyond the number on the scale, promising a telemedicine-enabled “whole-body reset” that leads to a healthy metabolic response to food, sleep, and emotional triggers.

• Telehealth Survey: Business Group on Health’s 2022 Large Employers’ Health Care Strategy and Plan Design Survey found that 76% of surveyed businesses are expanding access to mental health services due to a pandemic-fueled surge in stress and depression. Nearly 91% of respondents are concerned about the pandemic’s long-term effect on employee mental health, and many are turning to telehealth as a possible solution since it allows patients to discreetly access care from the privacy of their homes.

• Digital Front Door: WebMD and symplr announced a new partnership that allows WebMD’s 75m unique monthly users to go from a health information search to scheduling an appointment with a participating provider in three clicks. symplr’s EHR-integrated scheduling allows WebMD to convert the patient demand it generates into booked appointments, the latest in a series of investments from WebMD to evolve from an information website to a broader digital front door for health systems.

• Stress Texting: University of Oregon researchers recently analyzed the texting language of 25 young adults (positive words, negative words, affective words) to study its relationship to perceived stress levels. All three measures were strongly associated with stress levels and basal inflammatory activity (salivary C-reactive protein and interleukin-1β), with negative words also related to fewer hours slept. The study suggests that texting data may be useful in early detection of stress-related health problems, at least for individuals willing to trade privacy for the benefit.

• Virtual Veterans: The Veterans Affairs Department (VA) is expanding the use of its Extended Reality Network to over 75 sites, allowing veterans to use virtual reality headsets to help with conditions such as PTSD and anxiety. VA Innovation Specialist Caitlin Rawlins states that the technology helps veterans in a “non-pharmacological, non-invasive way that actually brings joy to a hospital where most people don’t feel a lot of joy,” highlighting an often overlooked aspect of virtual reality treatments: they can be fun.

• Generational Engagement: A recent Frontiers in Digital Health study analyzed 41k users of Hinge Health’s digital musculoskeletal (MSK) program, finding that members of Generation X and Baby Boomers did an average of 19 more exercise sessions, accessed 11 more articles, and sent four more messages to coaches compared with Gen Z and Millennial users. The higher engagement among older generations runs contrary to the belief that older populations are less likely to engage in digital care, which researchers believe could be tied to mobility and care-access challenges.

• Digital HMO: Antidote Health recently raised a $12m seed round ($13m total funding) to develop its digital-only HMO platform that offers zero copay acute and primary care services for as low as $29/mo. The company keeps costs down by leveraging an AI-chatbot to schedule telehealth visits with the 50 doctors on its platform and by issuing a preloaded debit card that members can use to pay for medications included in their plans.

• Voice Diagnoses: A recent editorial in The Lancet Digital Health explored using vocal pattern data from consumer devices to diagnose disorders such as Parkinson’s disease or PTSD. Researchers are hopeful for the technology but see several issues with vocal biomarkers, including: the possibility that AI cannot discriminate between respiratory disorders, undetectable biases in audio data, and privacy. Voice data alone can reveal a person’s gender, age, language, and health, with deepfake voice clones threatening to create even more privacy concerns in the near future.

• Hospital App: Virginia Hospital Center released a mobile app to help with navigating its sprawling campus, while also serving as a digital front door with MyChart integration. The app provides access to the MyVHC patient portal and incorporates quick access buttons to schedule appointments, request medication refills, and pay bills. The hospital attributes the success of the app to its design and successful marketing, and the numbers speak for themselves. The app has seen nearly 1k downloads per week since its debut in April 2021.