Who will be the winner in this digital health arms race?
Amazon recently launched a suite of virtual and mobile health-care services, dubbed Amazon Care. This new service, available initially only to employees, provides them with an app to text with a nurse, launch a video visit with a provider, receive an in-home nurse visit or have prescriptions delivered to their home or office.
Only a month later Amazon announced the acquisition of Health Navigator, a start-up that developed an automated tool with a chat-like feature to collect information about symptoms and provides direction about what options exist to receive care. These services, if strung together and expanded to all Prime users, could represent an Amazon-led, digital disruption of our health-care ecosystem.
It’s not only Amazon that’s interested in this new market. In February of this year, I checked out at Walgreens and received a coupon with my receipt that read, ”text care5 to 21525 to Find Care Now.” After a quick automated text exchange, I found out that I could talk to a doctor online, communicate with a therapist, or receive a variety of specialty care opinions or services virtually.
As clinical transformation officer, my focus is on leading to deploy virtual care options and increase digital engagement. So many organizations including health systems, employers, insurance companies and tech giants have focused efforts on developing new ways to harness technology to make health care easier and more convenient.
This corporate surge into virtual and mobile health raises the question of where a primary care doctor exists in this equation. In the name of speed and convenience, it seems we have lost track of the importance of continuity. The best possible scenario is to have both — easy, innovative and convenient services provided by a trusted health-care provider or team.
Health-care providers — albeit slowly — have been at the drawing board for the last decade working to engineer new services for consumers and develop their digital front doors with the goal of being transaction ready with consumers.
This started with basic functions like hospital web pages for provider searches, and patient portals offering online bill pay and results review. But the shift has recently evolved into a facilitated digital journey involving new tools like health system developed apps, provider messaging and video visits.
For example, HealthPartners, a large integrated Minnesota-based health system, launched an e-visit program called Virtuwell in 2010 and to date has completed over 500,000 treatment plans. The essence of an e-visit is that the patient and providers generally do not directly talk; the exchange is virtual or message-based.
Today, virtuwell offers 24/7 treatment for more than 60 simple conditions like urinary tract infections, sinus infections, and pink eye. The patient completes a structured questionnaire online which is sent securely to providers who then provide diagnoses and treatment plans, and, if appropriate, prescriptions electronically.
When studied in comparison to traditional care, Virtuwell produced a lower overall cost of care by $88, in addition to enthusiastic reports of consumer experience, and strong indicators of clinical quality.
Still, beyond costs there are caveats to consider.
For optimal health-care service, when selecting a new virtual health service or partner, patients can consider someone who knows them — maybe not personally — but at least their medical history. That includes allergies, medication list and family history. These factors can change a treatment plan, and it is a good idea to keep all of this information in one place.
A local care team is better equipped to direct a patient to locally available additional resources. For example, if you need a follow up visit after a virtual visit, a local provider can make an informed recommendation.
Finally, high quality health systems apparently prioritize factors that affect overall health such as clinical appropriateness, quality and safety. For example, a health system will often not prescribe antibiotics for a price, but instead will ensure people are meeting criteria and getting the guideline-recommended medical therapies based on their symptoms. Health systems are also more adept at monitoring for quality and studying effectiveness rigorously.
To be sure, challenges remain on the expanding use of virtual care in any setting. Not all conditions can be treated virtually, without a physical examination, and questions remain regarding the privacy and security of all our health data.
Who will be the winner in this digital health arms race? Perhaps it will be the corporate giants, pushing digital health as a product within popular membership models, or health systems keeping care high quality, close and personal.
The winner may be what system option engineers the best possible service for people where and when they need it.
Amanda Tosto is a clinical transformation officer within the ambulatory transformation center at Rush University Medical Center, adjunct faculty at Rush University Department of Health Systems Management, and a Public Voices fellow through The OpEd Project.