Depending on the day, you’ll either hear that telehealth (aka telemedicine or telecare) is heading into a decline or it is booming - or both. Part of that is because we’re not segmenting telehealth companies properly. While telehealth, three years ago, might have been a largely undifferentiated concept, practice types and areas have split up rapidly.

What we call telehealth is really a set of market segments, addressing different areas in healthcare: chronic disease management, mental health in a variety of severity segments, occupational health, follow-up monitoring, etc. There’s been attempts to classify these markets, mostly by tagging “tele-” in front of everything - teleradiology, telepsychiatry, telecardiology, but that probably misses the real market segmentation.

The market segmentations are by cash flows. Are they attempting to replace a cash flow, as in mental health, or attempting to create a new market, as in follow-on care, or high-risk pregnancy?

Some of the activity happening in the telemedicine category is a little concerning. Medical practice is getting divided up into profitable and unprofitable segments, and some gigantic companies are apparently determined to skim the profitable work. This isn’t anything that hasn’t happened before in medicine, it is similar to the growth of small private specialty hospitals, which the ACA stamped out. I’m not even sure Amazon is ready to take on the AMA and giant hospital systems.

There’s not a patient shortage, and not a lot of niches where telehealth wouldn’t make often dramatic improvements in care. Investment in telemedicine remains strong, the articles about the decline of revenue growth in telecare are mostly related to what we suspect to be unreasonable standards and extremely short-term investment horizons. There’s also the failure to understand that telemedicine is not a stand-alone product - it is part of a care provision and payment system that will be slow to change.

The news and changes in telehealth, systems adoption, and reimbursement are moving rapidly.

Telemedicine Consumer Interest And Adoption

 

Healthcare Finance News - integration into the overall care structure is needed - ATA2022: Telehealth Has the Ability to Rewrite Care

The Carolina Journal - the objections to telehealth are mostly philosophical, not practical - Telehealth Genie Escaped the Bottle

AARP - older patients like telehealth - Interest in Telehealth Services is Holding Steady

Investment and Development in Telehealth

 

The two types of development in telehealth are systems development and monetary investment.  Both are occurring at a rapid pace.  Hospital systems and practices are working to integrate telemedicine options, and open new contact avenues between patients and physicians.  At the same time, investment in telemedicine services, stand-alone or practice-integrated, continue to rise.

Government Technology - Windber, Pa., Hospital Is Creating 'Telehealth on Steroids'

In certain areas, telecare is already proving viable as a physican-extender, allowing more direct and more frequent follow-up care or condition management.

HealthcareIT News - Telehealth Can Be a Safe Technique in High-Risk Pregnancies, Study Shows

In the US, and globally, dozens of funding deals and investments occur quarterly, with some big numbers attached, to restructure providers into telehealth, or in new startups.  These are not $2m or $5m deals, they're $30m, $50m, $250m. 

Austin Business Journal - Tele-psychiatry Startup Iris Telehealth Raises $40M

Big Money Attracts Big Players

 

The stream of gigantic companies wanting to get into healthcare is both beneficial, and concerning.  Beneficial because national and global reach.  Walmart's entry into diabetes management may give more heft to the needs and costs of patients, and provide care in areas distant from big hospitals, but come with practitioner and systems risk.  Other entrants into telemedicine appear to be little more profit skimming.

Newsweek - How One Retailer Is Redefining Healthcare

TechTarget - Amazon Takes its Telehealth Offering Nationwide

Becker's Hospital Review - Antitrust Advocates are Worried about Amazon's Telehealth Push

Healthcare IT News - Providers' Best Weapon Against the 'Retail Revolution'? Digital Health Transformation

Love Them or Not, Wellness Brands Are Seeing Growth

 

Fierce Healthcare - Consumer Telehealth and Wellness Brand Hims & Hers Ups 2022 Revenue Outlook Driven by Strong Q1 Growth

While Early Problems In Telehealth Relate to Competitive Barriers and Prescriptions

 

PYMTS.com - Teladoc Says Overcrowded Telehealth Field Is Slowing Growth for Fittest Players

PYMTS.com - As Telehealth Spike Slows, Providers Seek Innovation to Increase Engagement and New Use Cases

Input Magazine - Controversial ADHD startup Cerebral stops prescribing Adderall

Axios - The Trouble with Telehealth Prescriptions

Systemic Resistance from Government and Insurers

 

Jamestown Sun - Reimbursement Rates May Be a Barrier to Providing Telehealth

Fierce Healthcare - Plaintiffs Push for Review of Decision Overturning Landmark Mental Health Parity Ruling Against UnitedHealth

They're Coming for the Pets!

 

Pet Food Processing - Pet Telehealth Company Scoops Up Pet Supplement Brand

Which, granted, not spending all day Saturday at an animal hospital office because your cat ate something is a big plus.  Weirdly, restrictions on vets for prescribing to pets via telehealth are more stringent than restrictions on prescribing to humans.  No word on when we can get online therapists for the cat.