"On the internet," says Ron Gutman, "every headache becomes a brain tumor in four clicks or less."
For Gutman and his colleagues in the world of health tech, this has become a running joke, a cheeky nod to just how far the human imagination can wander after a quick search of benign symptoms. But there's more than a little truth to it. The fact is: the sheer abundance of health information online makes consulting Dr. Google an altogether flawed---and at times terrifying---first step toward getting better.
So, in 2010, Gutman launched HealthTap, an online service that makes it just as easy to get answers to your health questions from a real, trusted doctor. The company started as a kind of beefed-up question-and-answer site, where users can get free responses to their medical queries from thousands of peer-reviewed doctors, and it grew exponentially, serving over 100 million people with some 1.9 billion doctor answers after just a few years.
Now, Gutman is taking things one step further. On Wednesday, his company announced the launch of HealthTap Prime, a new service that gives subscribers unlimited access to live videoconferences with actual doctors for $99 a month, plus $10 for every additional family member.
With Prime, HealthTap is feeding the rapidly growing demand for telemedicine services. According to the research firm IHS, revenue from companies entering this space is expected to grow to $1.9 billion in 2018, a huge leap from the $240 million the industry made in 2013. That's driven in part by the Affordable Care Act, which champions the use of telehealth technologies in an effort to drive down Medicare and Medicaid costs and improve patient outcomes.
>Revenue from telemedicine companies is expected to grow to $1.9 billion in 2018, a huge leap from the $240 million the industry made in 2013.
It's also a reaction to the growing awareness that many patients are wasting their money on costly and unnecessary tests and doctor visits. One 2009 study by Thomson Reuters found that "unnecessary care"---including unnecessary tests meant to safeguard providers from liability---accounted for $250 billion to $325 billion in annual healthcare spending.
While telemedicine may never replace traditional in-person care, it does hold the promise of reducing such extraneous doctor visits, making care less costly and more convenient for both the patient and the provider. And as wearable devices and other at-home monitoring tools become more sophisticated, the scope of care that can be delivered virtually will only expand.
Several companies are already going after a piece of this massive pie. American Well and Teladoc have begun partnering with insurance companies to offer subscribers telemedicine services as an added benefit in their coverage, and others, like Doctors on Demand, backed by television's Dr. Phil McGraw, are targeting patients first. Because the field is so new, says Forrester analyst Peter Mueller, there's still ample room for competition in the space. "I don't think anyone's got a lock on the market," says Mueller, who focuses on health technology. "People are still playing around with models, and this is definitely an interesting one."
But for Gutman, HealthTap is the only company addressing patient needs from the moment they have a question about a symptom to the virtual consultation and, if necessary, all the way through to diagnosis and prescription. That means with Prime, HealthTap is simultaneously taking on giants like WebMD, major insurers with their own telemedicine programs, and the established healthcare system as we know it. "A lot of people who are starting to do telemedicine services take Skype, put it in a wrapper, have doctors here, patients there, put it in the app store, and they’re done," he says. "That’s not healthcare. That's a feature.”
In designing the app, Gutman and his team wanted to make Prime more than just a video conferencing tool. Anyone can access HealthTap’s free database of doctor answers, but only Prime subscribers can pose follow up questions, visible only to them and the community of doctors. HealthTap also creates a personalized feed for Prime users. Similar to Facebook's News Feed, it generates doctor answers users might be interested in and doctor-approved articles that might pertain to them, based on each user's personal health records.
>HealthTap is taking on giants like WebMD, major insurers with their own telemedicine programs, and the established healthcare system as we know it.
Prime users can also see a list of physician-vetted apps for managing their health, a useful benefit given the sheer number of dangerously bogus health apps out there. The company also developed checklists for nearly every possible diagnosis to help patients manage their health after each consultation. The entire platform is HIPAA secure and encrypted so that even HealthTap’s own engineers can't see it.
But by far the most important part of the offering is the video conferencing service, which lets subscribers talk face to face with a doctor 24 hours a day, seven days a week. They can send photos and documents to the physician during the call, and the doctors, who get paid for each consultation, also get access to the patient's health records, including previous activity on HealthTap. That, Gutman says, is a far more information that even the most attentive doctors typically have on hand. "People always go to the doctor who knows them, but really it makes no sense. The doctor may know you, but you're trusting his head to be your database," he says. "There are many more efficient ways to manage data today."
Of course, that reliance on technology above all else is a distinctly Silicon Valley attitude, which most of the rest country still isn't quite used to when it comes to their health. For many patients, empathy, bedside manner, and understanding are some of the most important traits for any physician. Trust is critical too. After all, there are certain body parts that will always feel a little shameful to photograph or flash on a smartphone screen, no matter how professional the person on the other end is. Building that unprecedented level of comfort is a challenge HealthTap, and indeed, the rest of the telehealth industry, will have to overcome.
Then there's the price. At $99 a month, the service is cheaper than the average monthly cost of insurance under the Affordable Care Act, and yet, it's still a substantial amount to pay on top of insurance. That's especially true, considering even Gutman thinks of HealthTap as a "triaging system" and admits most users will have to visit a doctor in-person for tests and further evaluation anyway. As Mueller put it: "It can only go so deep. At some point you’ve got to see a doctor and have a physical checkout, and with lots of illnesses there are limitations to what telemedicine can do.”
>There are certain body parts that will always feel a little shameful to photograph or flash on a smartphone screen.
That's one reason why he says most people might rather go to the doctor directly than pay $99 a month for a middleman. That said, Mueller does believe Prime will be appealing to people with chronic conditions and constant health needs, people with extra money to spend on healthcare convenience, and people with such high deductibles that they might rather pay $99 a month than risk paying hundreds of dollars out of pocket at a time.
In any case, Mueller says, healthcare costs are expected to continue to rise in the United States, as patients, strapped with higher deductibles, are forced to pay for more of their health costs themselves. As a result, he says, "there's going to be a demand for the consumer to come armed with their own tools and ways of dealing with healthcare that are outside the traditional model."
