UnitedHealth, Walmart, Teladoc, Amwell – they’re either closing their health centres or tanking their stock prices. What does that mean for our telehealth industry?
Back in 2020, at the height of the covid pandemic in the US, pundits were convinced telehealth was the boom industry of the sector, with some saying it would account for anything from 25% to 50% of medical appointments.
Things are different now, with some estimates saying telemedicine accounts for barely 5% of all visits, most of them in mental health.
At the end of April, UnitedHealth Group, a multinational insurer, announced it will close down its Optum Virtual Care telehealth business in July.
Retail and pharmacy giant Walmart announced at the end of April that it would be closing all 51 of its Walmart Health Centers – launched in 2019 – across the US, as well as Walmart Health Virtual Care. In a statement quoted by Forbes, Walmart said it had “determined there is not a sustainable business model for us to continue”.
Teladoc Health’s share price hit a peak of US$293 late in 2020. Yesterday they were worth US$11.48 a share. Amwell’s stock was worth US$35.54 in mid-October 2020. Yesterday they bottomed out at US$0.43.
Professor Spencer Dorn, vice chair and professor of medicine at the University of North Carolina, said in a recent LinkedIn post that it was time to recognise telemedicine’s limitations.
“Telemedicine does not always fit our physical bodies,” Professor Dorn wrote.
“Although physical exams often fall by the wayside, physical presence feels more conducive to healing rituals and forming closer relationships. It’s also much easier to perform necessary tests before/during/after in-person visits.
“Physicians generally prefer in-person care. We were trained to provide in-person care. We don’t like tech glitches. We want nurses … at our side to help.
“We’re accustomed to seeing patients in exam rooms, procedure suites and hospital wards. I’m not arguing that this is all justified.”
It turns out, in the US at least, patients prefer telemedicine less than originally predicted.
“Yes, some love it. But many do not,” wrote Professor Dorn.
“And it’s not just older adults. Three years ago, I was shocked when a 29-year-old web designer told me he’d return to see me in person rather than do a video visit follow-up.”
Finally, he wrote, healthcare “pulls strongly towards inertia”.
“With stay-at-home orders long expired, care has defaulted to traditional in-person settings. There is little incentive to change.”
There are positives going forward, Professor Dorn wrote.
“Moving forward, telemedicine ideally becomes more than simply conducting typical in-person visits over Zoom,” he wrote.
“Ideally, telemedicine occurs within established relationships. Quick ‘visits’ to a virtual ‘doc-in-a-box’ can be great for straightforward issues but terrible for more complex needs requiring follow-up visits, tests, and referrals.
“Finally, telemedicine (or virtual care) offers an opportunity to provide care that was not previously possible.
“Instead of viewing telemedicine as just a convenient, standalone option, we should integrate it into multi-channel care models that blend in-person with asynchronous (e.g., messaging, remote patient monitoring) and synchronous (e.g., chat, phone, video) virtual care.
“The future does not progress in a straight line.”