As I was researching to create our list of live video telehealth companies, it became clear to me that telehealth meant a lot of different things to a lot of different people and companies. The two largest areas of telehealth for healthcare delivery organizations was live video telehealth and chronic care management/remote patient monitoring (Our list of RPM companies is coming soon!). In the case of the former, live video telehealth is largely a competitor to in person visits and visits that never occurred. In the later, it’s about changing how we think about and pay for healthcare.
What’s fascinating to consider is that if I look back before COVID-19 blew everything up, most live video telehealth companies that replaced in-person visits were having a challenge gaining traction and many had shifted their business model to remote patient monitoring and chronic care management. They had to do this change in order to justify why healthcare organizations should invest in their technology. If they couldn’t move the needle with chronic patients, many organizations weren’t interested in buying since their doctors weren’t ready to do virtual visits.
This seems to be illustrated well when you look at the telehealth adoption numbers we shared and in particular CT Lin’s experience trying to get telehealth video visit adoption in his organization pre-COVID-19 and post. There was almost no move to telehealth video visits before COVID-19. That’s not a great result for a live video telehealth company and not a recipe for getting more healthcare organizations to buy your technology.
Due to this, it’s no surprise that “telehealth” vendors started adding on analytics, remote patient monitoring devices, asynchronous text, patient education, and more in order to build out a full chronic care management platform that could lower the costs for ACOs, reduce hospital readmissions, or other value based care options like CCM and the new remote patient monitoring codes.
In many ways, telehealth companies had to focus not just on technology, but using technology and data to modify behavior. It wasn’t a full shift. Many companies were still trying to gain traction for video visits at healthcare organization and we saw some success with specialty video telehealth, telesitters, and remote video interpretation, but those were largely niche as compared to what live video telehealth could become. And it doesn’t touch the holy grail of true virtual care.
Now COVID-19 hit and live video telehealth blew up with it. When that happened, it made total sense why healthcare organizations and telehealth companies jumped all over it. They had to do it. Plus, it’s much easier to replace an office visit than it is to create a chronic care management platform that has to change behavior to be effective.
What does this mean for chronic care management and remote patient monitoring going forward?
I do think we’ll see a battle between the live video telemedicine companies for market share. Plus, we’ll see consolidation of those companies and we’ll see them battling it out with EHR vendors that offer their own solutions. This market will last. How big and how much lasts is still to be determined based largely on reimbursement. However, this won’t be about chronic care management and remote patient monitoring and its not clear to me that these companies will choose to go that more complicated route when the live video visit and associated workflow is now a profitable business.
We’ve certainly seen growth for remote patient monitoring companies since COVID-19 as well, but I don’t think it’s been the same hockey stick growth as live video telehealth. This goes back to the fact that these systems are much more complex and the bar they have to pass of changing patient behavior is much higher than just moving an office visit to video.
As with most things in life, the hardest things often have the most value. Will remote patient monitoring companies be successful and be adopted widely by healthcare organizations? I hope so because true virtual care is amazing when it’s done right. Why do I need a video visit when a text message exchange would be more than sufficient? There’s so much waste with many in person and even remote video visits. However, the reimbursement system hasn’t figured out a good way to pay for the result rather than the action. If we want true virtual care with chronic care management and remote patient monitoring, that’s the real problem we’ll need to solve. Then, we’ll see hockey stick growth of virtual care like we’re seeing with live video visits.