An Investor’s Insight into Telehealth
At the American Telemedicine Association’s (“ATA”) recent conference in Orlando, a panel of strategic investors discussed the growth of the telehealth industry. The panel delved into topics such as the driving forces for telehealth and which telehealth programs they believe have the ability to gain traction across a broad universe of stakeholders. Based on firsthand experience with deals that have worked, and those that have not, the panel shared their insights and discussed lessons learned, which in turn provided listeners with interesting insight regarding the future of the telehealth industry.
During the conference and prior to the panel session, the panelists took time to wander through the vast ATA exhibit hall, where numerous telehealth providers and platforms showcased their offerings. The investors assessed (and discussed during the panel) three distinct models: (1) “doctors on carts” (2) software delivering a “virtual care” experience, and (3) gadgets. The panelists identified a need for differentiation in the market and recommended greater development of telehealth platforms that are additive to solutions that already exist, as well as encouraging the industry to start moving away from standalone technology. Other highlights from this interesting panel discussion follow below.
Challenges facing the telehealth industry:
According to the panel, telehealth remains a huge business and investment opportunity, but one that is still largely aspirational. One panelist described telehealth as a three-legged stool – technology, operations, and provider networks – and said challenges must be carefully evaluated at each point. In particular, from the technology side, investors must consider how potential telehealth technologies fit into existing operational structures. For example, telehealth platforms and technology targeting the post-acute space face particular hurdles because of basic infrastructure upgrades needed in many post-acute settings.
Not surprisingly, the panel identified reimbursement as one of the greatest challenges facing the telehealth industry. General sentiment among the panel members was that until utilization of telehealth increases, the reimbursement landscape for telehealth services will not meaningfully change. Other challenges to greater utilization of telehealth services include a lack of awareness of telehealth’s capabilities “in the moment” when care is being provided, unfamiliarity with telehealth capabilities by comparatively sicker and older populations (for whom utilization of telehealth might be extremely beneficial), and a perpetual perception that the telehealth industry is “stuck in pilot mode.” Health care providers have the ability to change the way care is delivered by utilizing telehealth technology; however, according to the panelists, stakeholders must continue working to raise awareness of telehealth’s benefits for both patients and providers.
What story should telehealth stakeholders tell to empower providers and payers to adopt telehealth services?
The panelists discussed the importance of “knowing the audience” to whom stakeholders are attempting to sell telehealth business ideas, particularly with regard to potential providers of and payers for these services. Demonstrating the strategic value-add that use of telehealth technology provides is key to the equation.
With respect to providers, access to care is core to their mission, and as such, stakeholders should focus on examples of telehealth services or platforms that increase patient access to care. One successful strategy may be using telehealth technology to meet patients where they want to be met – i.e., in the home – and demonstrating that the technology can deliver the needed care in a lower cost setting. With respect to payers, some believe that any increased volume of telehealth services will drive prices up, and as such, stakeholders need to have their ROI case down in order to demonstrate to payers that telehealth will not just drive volume, but rather will reduce costs and/or improve health outcomes. Notably, several of the panelists recommended that those looking to sell telehealth services and/or platforms focus most heavily on potential opportunities for partnership and collaboration.
How should telehealth providers and companies work to raise capital?
The panelists advised that telehealth providers and companies “do their homework” regarding what their technology can do to help and to enhance an existing health system, as a means toward raising capital. Telehealth companies should be prepared to pursue strategic partnerships that would allow a potential health system partner to seamlessly integrate the telehealth services and/or platform into an existing system and/or platform. Companies should push a market-centric story. The panelists advised against companies pushing the message that their telehealth technology or platform will be a “win-win” for everyone; rather, companies should be prepared to explain the losers (i.e., the competing technologies and platforms that have not worked) and how their technology and/or platform will be able to navigate around that. Companies should acknowledge there is tremendous competition in the telehealth market and should resist saying their technology or platform will be the next WhatsApp of the health care industry.
Should telehealth providers and companies focus on the patient or consumer experience?
Some in the telehealth industry have targeted consumers (i.e., tech-savvy millennials who want the convenience of virtual care) as a potential key driver of growth. However, the panelists advised that a focus on consumers may not be beneficial to the telehealth industry. Interestingly, some panelists recommended that the telehealth industry actually pursue the sickest patients who consume the most health care services and, in turn, drive health care costs. The panelists described early but ongoing collaboration between software engineers and clinicians, in pursuit of looking for the right types of patients to target within specialties such as dermatology, wound care, and behavioral health. The panelists felt there is a compelling ROI case with regard to bringing telehealth to these populations.
How will the telehealth industry evolve and what are the most promising investment opportunities?
When asked to look ahead to what the future may hold, the panelists recommended thinking less of telehealth as a technology and more about how telehealth integrates into consumer solutions. The future of telehealth should focus on how tools enable us to change the delivery system and sites of service, so that many health care services can be shifted from being provided at “brick and mortar” sites like hospitals, to being provided at more convenient and less expensive sites of service such as patient’s homes, cars, on the phone, etc. The panelists discussed that another significant evolution in the telehealth space is providers that are building their own telehealth solutions in-house. Finally, the panelists reiterated that greater development of technology and platforms that manage particular high utilization populations, like those with chronic care conditions, also provide growth opportunities. According to the panelists, the major specialty growth areas within telehealth include tele-ICU, tele-stroke, and tele-behavioral health.
Finally, the panelists advised that investors target potential telehealth offerings that are marketed well and that provide a good patient experience, as these tend to be indicators that will convince health plans to sign on. Furthermore, technology and platforms that are easy to use will have the best chance at widespread adoption.