Telehealth has come of age at HIMSS in 2017. No longer is the concept relegated to footnote or edge-booth status on the conference floor. Instead, telehealth, broadly defined, is now a mainstream concept embraced by healthcare providers, payors and, increasingly, consumers.

I spent time brainstorming telehealth with one of the pioneers of modern telehealth in the U.S., Dr. Roy Schoenberg, who co-founded American Well with his brother Ido Schoenberg, in 2007. As such, the company is among the most mature telehealth entities operating in America, delivering live video health visits to millions of health consumers through the American Well telehealth Exchange and the company’s direct-to-consumer service, Amwell. Today, the company channels through health plans such as UnitedHealthcare and CIGNA, several dozen Blues plans, and healthcare providers.

I watched this company start-up ten years ago, with a public launch at the first Health 2.0 Conference. That’s the historic note where we started our conversation.

Roy noted two key strategic decisions they made from the start: first, to align with the healthcare payor, who was the best aggregator of healthcare at the time. “The only entity that brought together patients and providers was the payor,” Roy said. The second key decision was “don’t make products,” and instead to build an enabling technology for their customers. This required, he confessed, “having humility to understand your piece of the puzzle, and that you are not ‘the’ solution.”

Telehealth via American Well is available to some 120 million people through commercial health plans (non-Medicare). Eighty million people get telehealth as a covered benefit, “a far cry from where we were five years ago when you could handpick payors who said they would pilot with us,” Roy explained. American Well and telehealth is not in pilot phase anymore.

American Well published the Telehealth Index: 2017 Consumer Survey in January, and found that 20% of consumers would switch their current primary care provider if another PCP in their community offered telehealth visits. Additional findings illustrating the consumer embrace of telehealth were that:

• 65% of consumers were interested in meeting with PCPs over video

• Parents with kids under 18 and people between 35-44 were even more likely to want to see a PCP through telehealth

• 60% of consumers willing to have an online telehealth visit would see a doctor to help them manage a chronic health condition.

[For more insights on this survey, see my Health Populi blog which analyzed the poll results here].

These numbers are “a wake up call,” Roy said. “People are appreciating the use of technology as a driving factor in decisions of where to get care.”

Our conversation then looked back ten years, envisioning the HIMSS conference in the emerging age of the electronic heath record. “This is now the age of telehealth,” Roy observed, “shifting from the EHR to the explosion of the next core transformative technology which is telehealth.”

The first growth phase of American Well has been driven by payors. In this next phase, the company expects to grow through health system adoption. The driving force under this growth scenario is value-based care: in the first phase, telehealth was good for payors when it channeled consumers away from ER visits, when clinically appropriate, to a lower cost alternative (i.e., telehealth). For hospitals dealing with population health and value-based financing models, there’s an ROI in telehealth for follow-up care, for urgent care, and for doing virtually what can be done. “We’re seeing VPs of telehealth appointed at every health system,” Roy noted. American Well’s hospital system adoption growth is ratcheting up quickly: the company had 35 hospital clients in 2015, and 70 by the end of 2016, doubling in a year.

Looking forward, Roy sees his company in the business of electronic care delivery, and not “telehealth.” This more expansive concept serves various users: consumers, seeking urgent care in a DIY healthcare workflow; and for providers, ‘prescribing’ virtual care for following up with patients managing chronic conditions or post-hospital discharge.

Roy raised the EHR analogy, saying, “the EHR has become the foundation for data and resource management inside the hospital. Telehealth will be another foundation, for electronic delivery of care outside of the hospital.”

Part of that “out-of-hospital” theme comes out of American Well’s announcement this week that the company has a new partnership with Samsung Electronics. Their joint vision is that health care will reach out to people where they are leveraging technology, whether this is a consumer with the flu, a patient dealing with cancer, or an older patient recovering from a hip replacement at home.

“Samsung is a very big heavyweight [company], saying ‘we are going to open up real estate for healthcare on our consumer electronics,’” Roy explained.

There will be subsequent announcements involving American Well’s customer partners to be part of the Samsung ecosystem. Both hospital systems and payors have expressed support in this concept.
(Read the press release about the American Well-Samsung alliance here).

The EHRecord era is now in place. Welcome to the era of EHDdelivery.

[For a blast from the past, read this article from CNET written in 2009 about American Well’s work with its first client, who’s still a client “like family,” Roy said: Blue Cross and Blue Shield of Hawaii].