Uber, Telehealth, and Healthcare-on-Demand

July 24, 2016

Quite a bit of press has been given to the idea of an Uber model for healthcare (see the New York Time’s “An Uber for Doctor House calls” and the Wall Street Journal’s “Startups Vie to Build an Uber for Health Care”).

Widespread media coverage and reports of positive patient experience with the resurrected offering indicate that the house call may well have a place in modern medicine. That said, an equal number of nay-sayers warn that “Uber for healthcare” is not the panacea stakeholders might have you believe.

Provider efficiency issues are often cited as a drawback to house call care delivery. House call doctors and nurse practitioners see roughly a third of the patients that their in-office and virtual visit counterparts do per day. Provider transportation burdens and diminished access to medical resources in an at-home care setting limit house calls’ potential for real market disruption. The service’s potential to end up being another concierge care resource for the wealthy also draws criticism.

That’s not to say that the house call market has emerged without some success. UberHEALTH‘s flu immunization initiative is one example of a startup bringing care episodes to patients, conveniently and en masse. Instead of leaving the Uber healthcare approach at the sole discretion of competitive startups, healthcare organizations are buddying up to them to bring new engagement opportunities to patients. MedStar works with Uber to help patients get transportation to and from appointments. Lyft recently partnered with National Midtrans Network on a similar endeavor for senior patients.

Most patients inevitably encounter instances where convenience can make a big difference. House calls won’t replace centralized care settings, but they do have a place in the expanding array of patient engagement options.

The healthcare-on-demand solution really making its way into the fabric of modern healthcare is telehealth. US healthcare providers rank telehealth among their top five investment priorities. Studies suggest that more than half of physician groups and nearly three quarters of hospitals presently offer telemedicine programs, with the 15 million annual remote patient population expected to grow by thirty percent this year.

Telehealth brings great use-case scenarios to healthcare and a more feasible, on-demand care option to physicians and patients. Remote patient monitoring (RPM) solutions help providers better serve rural or underserved patient populations. Video-conferencing solutions make provider peer consultation quick and easy. Telehealth technologies are collectively blurring the lines of institutionalized care in a far more disruptive way than the much bandied house call trend. Telehealth is also a natural fit in behavioral health and geriatric patient care.

Outcomes-based evidence points to telehealth success in the areas of remote monitoring and counseling of chronic condition patients (which accounts for a sizeable fiscal drain on U.S. healthcare), as well as psychotherapy. In the face of parity barriers and perhaps in light of a push to expand Medicare’s coverage of telehealth services, payers seem eager to embrace the emerging field. Anthem and UnitedHealth are each offering their own direct-to-consumer telemedicine services. CareFirst BlueCross BlueShield is investing roughly $3 million in programs aimed at launching or expanding telehealth services.

Clearly, providers and direct-to-consumer entities alike see value in both house visit and telemedicine as new avenues for meeting mounting patient demand for convenience and new engagement mediums. It will be interesting to see what these early healthcare-on-demand markets segue into next.