The second quarter of 2020, starting in the middle of March, brought an almost frantic adoption of virtual video visits in the wake of the Covid-19 health crisis. Over the next weeks, though, the use of video for telehealth visits quickly trailed off due to technical challenges and lack of familiarity by clinicians to use video visits effectively, being mostly replaced by telephonic care and, over time, a move back to in-person care.
The year 2021 saw wildly differing utilization of video telehealth — not surprisingly, those organizations that had telehealth in place before the crisis have now vastly expanded, solidified and integrated their telemedicine offerings into a sound hybrid care model. And those who were forced into telehealth as an alternative to in-person visits at the height of infection rates and PPE shortages quickly moved away from telehealth, citing mostly “patients’ disinterest” or “lack of patients’ technical capabilities” as reasons to avoid using telehealth.
The Challenges of 4Q2021
The fourth quarter of 2021 was and is a challenging one for many healthcare organizations and the economy overall. Over the late summer months and into late fall, the delta variant once again sent infection rates soaring high with organizations once again scrambling how to respond safely, albeit with a bit more experience now.
Next came the vaccination mandates for healthcare workers that put an additional strain on an already exhausted and burnt out workforce. According to one statistic, nearly 1 in 5 healthcare workers quit their jobs during the pandemic. Another quarter (almost a third of those remaining) have considered leaving. And given some staunch opposition to the principle of vaccination in, statistically speaking, at least 20% of the population, many organizations lost a number of staff, especially in critical supporting jobs, such as billing, scheduling, and case management.
Add to that the expiration of some of the PHE funding, the depletion of cash reserves organizations may have had at the beginning of the crisis, an overall reduction in healthcare utilization and an attempt to go back to “business as usual” amidst these harrowing changes, and it’s clear that the challenges being faced are unprecedented and difficult to manage.
The Innovation and Entrepreneurial Advantage
Whenever there is a crisis, innovative entrepreneurs are attracted to develop and provide solutions to solve the problems. This holds especially true in healthcare, which has long been a darling of the digital health industry – with venture capital funding of startups exceeding $70B over the last 10 years.
What many startups had to find out, though, is that healthcare is not an easy problem to solve. It’s an intricate system that grew organically over many decades into numerous layers, often well-protected through special interest money. The disruption that worked over the past decades in other industries has repeatedly failed to take hold at the same order of magnitude that it has reshaped industries such as retail, transportation, entertainment, travel, banking, investing, etc.
Still, innovative, entrepreneurial organizations are by nature very nimble, highly agile and can quickly pivot — something that many healthcare organizations cannot. There also appears to be a seemingly endless supply of funding as investors are trying to find their own healthcare “unicorn” (that actually proves to be real — unlike Theranos or Proteus).
Yet despite the exits of many well-known companies from healthcare (e.g., Haven and Google) many long-standing players in the video visit space, such as Teladoc, Amwell and MD Live and are doubling down on winning over patients to take advantage of the convenience that telehealth offers, often with support and endorsement of the patients’ health insurance.
Another group of players are the intrapreneurial enterprises of established companies, such as Amazon Care, or BestBuy Healthcare, and the hybrid retail models such as Walmart Health, CVS or Walgreens or, presumably, even Dollar General.