Roy Schoenberg, MD, is co-founder and CEO of American Well, a Boston-based developer of telehealth solutions – one of the first in the industry, and one of the largest these days.
Prior to American Well, he founded and was president of CareKey, and served as the chief Internet solutions officer at TriZetto following its acquisition of CareKey. In 2013, he was appointed to the U.S. Federation of Medical Boards' task force delivering landmark guidelines for the "Appropriate use of Telehealth in Medical Practice." He is the 2014 recipient of the American Telemedicine Association Industry award for leadership in the field of telemedicine.
An author and speaker in the areas of healthcare technology and national health IT policy, Schoenberg serves on the ATA board and holds an MD from Hebrew University and an MPH from Harvard.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. mHealth promises access to immediate healthcare that’s convenient and inexpensive, bringing healthcare services home for the patient. Imagine having a little live physician as part of your medicine cabinet – healthcare comes to you.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Telehealth will become mainstream in both the practice of medicine and, consequently, in healthcare delivery and acquisition. The reason is simple: It has significant ROI for all stakeholders involved – patients, providers, payers and employers.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. Apple’s HealthKit is a major advance in healthcare. For the first time, a remote care provider is elegantly connected to the patient’s healthcare reality at home (e.g. biometrics and home monitoring). It quietly opens the door for regular telehealth use in patient follow-ups and chronic condition management – the largest $$ sink in healthcare.
In the future, this will unleash a new generation of home monitoring devices that “speak” telehealth or are telehealth-ready (i.e. connect to the health hub on your phone). Such devices will span both tracking (e.g. glucometers) as well as continuous monitoring (e.g. cardiac rhythm).
Q. What mHealth tool or trend will likely die out or fail?
A. Decision-support apps will not break out - and will break investors. The main reason is that even if they provide correct information, it’s unclear if that information can/will/should be applied. Adding knowledge is interesting, but may not get you from Point A to Point B – which is where the ROI lies.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. Rather than name a specific tool, I’d say that I’ve been most surprised by the way in which people have adopted the concept of telehealth on mobile vs. the web (browsers). Although it’s essentially the same telehealth service, there’s a dramatic difference in the way patients view the interaction. When you get healthcare on “your app” that you selected, downloaded and which now lives on your mobile phone, the interaction feels intimate. When typing a URL to go to a website, on the web, patients view the healthcare interaction as more foreign.
Q. What's your biggest fear about mHealth? Why?
A. Telehealth is booming, and eager startups (and some very confident large technology companies) will enter the market with little understanding of the important clinical, regulatory and safety considerations, not to mention how healthcare actually works. “Bad apples” can hurt patients and delay adoption of otherwise good and informed telehealth/mHealth.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. The obvious answer here may seem to be consumers - “consumer-driven healthcare,” right?. I humbly disagree. Consumers will definitely board the telehealth train in numbers, but the payers and the providers are the ones who will operate it and bring that train into the station. How often do you hear consumers say, “I would love to have a hospital built here?” Almost never. However, once the hospital is built, people will access it. Telehealth is the same. It’s vital, it’s going to be a fundamental part of life, but like all other aspects of healthcare, it has its own ecology.
Q. What are you working on now?
A. Simply put, we are working on the convergence of consumer and provider telehealth.
Broadly speaking, there are two flavors of telehealth:
The most common is urgent care, where consumers go to a mobile app (like Amwell) and see physicians for immediate primary care needs. This is the “consumer-acquired” flavor of telehealth. It’s all about immediacy, convenience and out-of-pocket cost.
The other is where a provider uses telehealth to take regular care of patients – those requiring chronic care or post-surgery follow ups, or who are at risk for hospital admissions and readmissions. That’s the “provider-prescribed” flavor of telehealth. This one is all about compliance, care continuity and long-term outcomes.
The truth is these are two co-existing facets of the same healthcare reality. Both are important, complementary and continuous and must blend into one ecosystem. That’s what we are working on right now. That’s the next generation of telehealth.
Got a suggestion for a future mHealth master? Contact mHealth News Editor Eric Wicklund at eric.wicklund@HIMSSMedia.com or @eriwick.
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