- Covid has caused a massive acceleration in the use of telehealth but as the virus winds down, the question of whether or not telehealth will blossom and enjoy widespread adoption remains to be seen.
- Our analysis found that telehealth players like Teladoc and Amwell are the most influential organisations in the media debate, followed by tech giants such as Microsoft and Google.
- We suggest that PR and comms professionals working in the telehealth sphere should reposition their value offerings post-Covid by focusing on enhancing health equity and promoting telehealth’s benefits for specific therapeutic areas like mental health.
View a one-page infographic summary of the analysis.
The term telehealth has actually been around since the mid-20th century, when radios were used to provide medical advice for patients on ships, and two-way televisions were first used to conduct video consultations. By the time the 21st century rolled around, the practice still wasn’t being utilised at a very high rate. Despite the fact that video-based telemedicine appointments have been available for years, according to a 2017 study, 82 percent of U.S. consumers still did not use telemedicine.
But the situation changed when Covid-19 struck. It’s a bittersweet truth that can be hard to discuss: major cataclysms like the pandemic often ignite new strategies and innovations in healthcare. The utilisation of virtual care skyrocketed as people — asked to socially distance — looked for alternatives to in-person visits. This utilisation remained strong since it originally spiked when the pandemic hit, with claims up more than 3,000% in October 2021 compared to pre-pandemic October 2019.
According to many commentators, telehealth helps resolve the mismatch between care delivery and availability and access. In addition to offering contactless care, virtual care providers can see a higher volume of patients than in-person providers and often operate beyond typical clinic hours.
The telehealth boom in 2020 helped to fuel massive growth for big players like Amwell and Teladoc, but the competition started heating up with Amazon and Walmart both going all-in on telehealth. Pandemic or not, the value of convenient and accessible virtual care has been realised. Now that patients know they can receive high-quality care without leaving their homes, it’s proving less enticing to go back to the old ways of crowded waiting rooms and rushed appointments.
However, as Covid-19 vaccination rates go up and stay-at-home restrictions go down, some analysts worry that health plan reimbursements for telehealth may be reduced. Payers and providers may then be tempted to revert back to the brick-and-mortar-only model of care. If this happens, patients and health systems alike may miss out on the value of complementing in-person care with virtual care.
Regulation is the main media issue
To see how the recent discussion around telehealth unfolded, we analysed 1,260 English-language articles published between May 2020 – May 2022 in a set of pre-defined global publications. These comprised top mass media outlets like Reuters, the New York Times, Forbes and the Guardian, as well as leading industry publications such as British Medical Journal, Fierce Healthcare and Kaiser Health News.
We found that the topic of Regulation/Policy was the most widely discussed, especially in specialised healthcare publications:
Many outlets focused on Regulation/Policy due to the fact that telemedicine is still a largely unregulated new field in the otherwise highly regulated healthcare sector. Many journalists noted that telemedicine regulation has been a grey area for years. In fact, prior to the pandemic, you’d be hard-pressed to come across any regulations that apply specifically to virtual care, other than in a few select countries such as France, Ukraine and Colombia, where virtual care has been around much longer.
The topic provided a constant stream of news as the laws that govern telehealth providers have been in flux during the last two years. In a matter of a few short weeks, regulatory changes that would likely have taken years to pass were resolved virtually overnight. At the onset of the pandemic, the US Department of Health and Human Services removed several barriers to telehealth reimbursement under Medicare. The move helped fuel a massive explosion in telehealth use among providers as patients were afraid to get care for fear of contracting COVID-19. Some of the initial barriers that were lifted include a requirement for an in-person visit from the patient before going through telehealth.
One of the top trending pieces of news was that more than 400 advocacy groups called for the US Congress to act quickly to permanently expand flexibilities for telehealth that could go away after the end of the public health emergency. The 430 groups sent a letter to congressional leadership underscoring the urgency for action now amid concerns from providers that expanded telehealth access could expire abruptly after the emergency ends.
A regulatory change that got much media attention was the FDA saying women can get an abortion pill via telemedicine during the pandemic. The news was widely discussed in daily publications as abortion is a highly contested issue in the US and FDA’s decision represented the latest reversal in an ongoing legal battle over the pill. The regulator announced the policy change in a letter to the American College of Obstetricians and Gynecologists, one of several medical groups that has sued over the restriction put in place under the Trump administration.
As with any rapidly developing field, the Market developments topic was also prominent, covering primarily financial news. Many outlets reported that global telehealth investments increased 169% from the second quarter of 2020, and were up 17% from the first quarter of 2021. The five largest deals were worth $1.6 billion, out of roughly $5 billion in total. Some telemedicine start-ups managed to get media attention within that topic: for example, Babylon agreed to go public, while TytoCare managed to raise $100 million in just 10 months.
The topic also covered some more general market trends. For instance, the American Association of Retired Persons released a study in May this year that found that about a third of older Americans plan to use telemedicine in the future, a number that has remained steady throughout the pandemic. “It appears that telehealth is likely to continue to remain an important tool in the health care delivery tool kit — at least for those with computers and high-speed internet access,” the Association said.
The conversation also featured a fair share of Partnerships news. For example, telemedicine giant Teladoc partnered with Microsoft to integrate telehealth into the Teams app for hospitals and health systems and to simplify the way care providers work by streamlining the technology and administrative processes associated with providing virtual care. Walmart Health partnered with the American Diabetes Association to launch a telehealth diabetes program for patients with Type 1 and Type 2 diabetes.
Meanwhile, several publications spoke of a Mergers & Acquisitions frenzy in the field. The most widely discussed M&A deal was Teladoc‘s massive $18.5 billion acquisition of digital chronic condition management company Livongo in October 2020, creating a health technology giant just as the demand for virtual care began to soar during the pandemic. Rival Amwell, on the other hand, acquired two digital health startups for a combined $320 million as the publicly traded telehealth company looked to expand its platform offerings beyond the Covid-fueled virtual care boom. The two companies—SilverCloud Health and Conversa Health—were seen as part of Amwell’s strategy to work with patients along their entire care journey and not just limit the relationship to one-off virtual visits.
As hospitals and health systems continued the shift to telemedicine, new issues and risks with Cybersecurity have arisen that will require ongoing work to preserve privacy and safe care delivery. A widely covered Harvard Medical School study highlighted the security risks of video conferencing apps and the increase in ransomware attacks on healthcare organisations. The researchers said that while the federal lifting of restrictions on communication apps during the pandemic has increased access to telemedicine and helped boost virtual care adoption, it has posed new security risks for healthcare organisations.
Specialised industry publications also reported on some Lawsuits news within the industry. For example, Teladoc sued competitor Amwell over patent claims, accusing it of infringing on its patents related to telehealth carts, a digital scope and stethoscope. Meanwhile, a lawsuit filed against Teladoc itself accused the company of engaging a third party to sell telehealth subscriptions to consumers without their consent.
Teladoc and Amwell lead the conversation
We used Commetric’s proprietary ‘media conversation impact score‘ metric to identify the organisations with the most significant impact on the media discussion around telehealth in our research sample.
We determine an organisation’s media impact in the context of a topic by looking at its media influence score calculated in terms of coverage by high-profile media outlets, topic relevancy score measuring its contextual relevance, and media visibility as measured by the number of mentions.
Unsurprisingly, we found that Teladoc and Amwell were among the most influential companies in the debate:
As mentioned above, Teladoc was prominent within the Partnerships, Mergers & Acquisitions and Lawsuits topics. It was especially discussed within the Mergers & Acquisitions topic, as the $18.5 billion megadeal with Livongo created the world’s largest full-stack telehealth company.
The company was also discussed within the Market developments topic, as during the height of the pandemic, it was one of the most successful stocks. And despite a more than 50% decline in 2021, Teladoc has quietly risen to be asset management company Ark Invest’s second-largest holding across all of its funds — and it was on the verge of replacing Tesla for the top spot. Most recently, the company was in the news for unveiling a framework to help employers and health plans enhance their healthcare benefits by integrating telemedicine.
Teladoc’s main rival Amwell, which has been growing its number of providers and patients in the first quarter of 2022, came second in terms of media impact. The most recent news around the company was within the Partnerships topic, as its telehealth platform became available through LG‘s healthcare platform LG Electronics.
Moreover, Google invested $100 million in Amwell on the same day the latter firm unveiled plans for an initial public offering (IPO). Google has also agreed on a partnership with Amwell that makes the telehealth company its preferred partner, while Amwell in turn has agreed to switch some of its online services to Google Cloud from its current provider Amazon Web Services.
Like Google, Microsoft also got into the telehealth space, partnering with Babylon to enhance artificial intelligence’s use in preventive healthcare. The organisations will use AI and cloud computing to explore opportunities to increase their health IT offerings.
Similarly, telco giant Verizon inked a partnership with Apple to integrate the tech giant’s Health Records app and features with its BlueJeans Telehealth platform. Verizon launched BlueJeans Telehealth last April as a virtual care platform that can be deployed directly within providers’ existing EHR workflows. The new tool and integration with the Apple Health app will let patients share specific categories of health data, such as heart rate, sleep and falls, with their provider during the telehealth visit.
But it wasn’t just specialised telemedicine companies and tech giants that had a significant impact on the debate. Retail corporation Walmart went all-in on telehealth, which was perceived by many media outlets as opening a new front to compete with Amazon. The retail giant announced that its healthcare division, Walmart Health, plans to acquire multi-specialty telehealth provider MeMD – a move into telehealth that came the same week as Amazon signed its first enterprise customer for its Amazon Care virtual health service.
In the meantime, insurance company UnitedHealth, alongside its partner, pharmacy benefit manager Optum, launched a virtual care business that expanded telehealth across the U.S. with more specialiяed medical care providers and services. Commentators remarked that the move deeper into virtual care could have ramifications for smaller telehealth companies given UnitedHealth’s status as the nation’s largest health insurer and as a massive provider of medical care. Many of the telehealth startups that have thrived during the Covid-19 pandemic rely on round after round of private equity and venture capital and don’t have near the number of medical care providers in their networks as Optum has.
Some pharmacy companies also managed to attract media attention. For example, CVS Health launched a new virtual care solution to create a more coordinated healthcare experience for consumers. And Walgreens, which operates the second-largest pharmacy store chain in the United States behind CVS Health, announced 11 new and four expanded connected health partnerships with care providers on its Walgreens Find Care platform, giving the pharmacy chain’s customers online access to more than 45 services.
The most influential start-ups in the field included Babylon, which partnered with Microsoft and agreed to go public in the United States through a merger with a blank-check firm at a pro-forma equity valuation of $4.2 billion. Another start-up, TytoCare, got in the news as it scored an additional $50 million in series D funding in a development that doubled the company’s valuation.
Telespokespeople
We also found that Seema Verma, head of the Centers for Medicare and Medicaid and the Trump administration’s leading advocate for telehealth, was the most influential commentator in the discussion:
Seema Verma was quoted as saying that expanded access to telemedicine should continue after the coronavirus pandemic recedes and that officials are examining ways to act without waiting for legislation from Congress. But she also said that she doesn’t think telemedicine is ever going to replace in-person visits, because sometimes a doctor needs to put their hands on a patient.
The most influential executive was Teladoc CEO Jason Gorevic, who didn’t appear to be sweating the competition coming from big names like Amazon and Walmart, saying his company’s track record in the market is an advantage. Gorevic described Amazon Care as “overrated” at this point, given that the company only has one enterprise client. He also said competitor Amwell has a “narrow solution and doesn’t match the full scope or scale of what Teladoc delivers.
In a similar manner, Ido Schoenberg, Chairman and Co-CEO at Amwell, didn’t sound too shaken by Amazon’s plans to expand its own virtual care services. “I would just say welcome to the swamp. It’s much more complicated than you think,” Schoenberg said in response to an analyst’s question about Amazon’s expansion into telehealth. He added that Amazon brings an enormous amount of assets in way of drug delivery, in a way of consumer experience and things of that nature and it relates to primary care in certain models that could be a fantastic thing, “which is very, very different from the role of Amwell.”
Meanwhile, Roy Schoenberg, president and co-CEO at Amwell, was cited as saying that telehealth morphed, almost overnight, from a promising technology to an existential platform in the operation of healthcare — alongside EHRs, claim systems and e-prescribing: “We are witnessing a new consensus that the future care of any one patient will inevitably involve a mix of physical, digital and asynchronous/AI-based care.”
Many influential spokespeople from our sample were quoted within the Policy/Regulations topic. For example, Ann Mond Johnson, CEO of the American Telemedicine Association, said that now is the time for policymakers to act on telehealth and that the association is pulling out all the stops “to ensure that the policy gains we’ve made over the past two years do not go away, reverting us back to an out-of-date care delivery system that leaves millions of vulnerable patients out in the cold”.
In response to such calls, Senator Lamar Alexander of Tennessee, chair of the Senate health committee, introduced the Telehealth Modernization Act, which would make some changes permanent. The experience of the pandemic “will likely mean that hundreds of millions of physician-patient visits will be remote or online that were in-person before,” he said.
The widespread adoption of telehealth is what UnitedHealth Group CMO Mary-Margaret Wilson called “one of the most dramatic changes” in healthcare, but the next step is using that development to drive health equity. Wilson said from a clinical standpoint, UnitedHealth Group is viewing telehealth as a means of connecting a patient to a healthcare team. But from a health equity standpoint, she said it becomes a “gateway” for bringing underserved communities into integrated care models and addressing whole person health.
Similarly, Australian Health Minister Greg Hunt said while nothing beats face-to-face health services, telehealth was an important part of the system for people with issues such as mobility problems, those juggling young children and people with less flexible workplaces. “It came about because of the pandemic, but it has changed the way Australians can access healthcare,” he said.
How can telehealth stay relevant post-Covid?
In the short term, it certainly looks like this explosion in adoption is set to continue: for example, Philip‘s 2021 Future Health Index Report revealed that 64% of global healthcare leaders are currently investing heavily in virtual care, with the United States (89%), the Netherlands (83%) and Saudi Arabia (81%) leading the charge. And by the end of Q2 of 2021, global telehealth investment rose for the fourth consecutive quarter, with European investment nearly quintupling.
But although all this progress is encouraging, and a positive step towards our vision of “anytime, anywhere” healthcare, it’s also true that much of it was born out of necessity. Which raises the question: will telehealth remain popular post-Covid-19 or has technology’s role in closing the care supply-and-demand gap run its course?
Based on our analysis, here are a few suggestions on how players in the telehealth field could sustain their growth after the pandemic:
- Give telehealth an ESG image by focusing on health equity. Among everything else, media headlines during the pandemic have highlighted the disproportionate effect of diseases across certain racial and ethnic groups. Data from the Centers for Disease Control and Prevention (CDC) showed disparities in everything from testing and vaccination rates to cases, hospitalisations and deaths. If they want to stay relevant after the pandemic, it’s essential for telehealth players to make forward-thinking investments and take concrete steps to help technology recapture some of its promise as a potential social and economic equalizer instead of serving as another structural barrier to opportunity. This is a great opportunity to tap into the reputational benefits of ESG. For example, telehealth could improve medical access for people in rural areas – for people who live many miles from the nearest medical facility, telemedicine could provide a way to meet with a doctor quickly. Moreover, the trend of hospital closures, especially in inner-city US neighbourhoods, has affected thousands of patients, particularly communities of colour and people without health insurance. Telemedicine could help break this cycle by providing a way for people to see a doctor before they get extremely sick.
- Proactively form your own policy platform and communicate with regulators. As we saw in our analysis, not many organisations were mentioned in the largest topic in the debate – Policy/Regulations. Look at how other loosely regulated sectors failed when it came to proactively communicating their policy – take a lesson from the troubled social media industry. Avoid the mistake that social media companies made by not communicating directly with Washington, DC. For years, US politicians have mulled over whether and how should these platforms be regulated. Social media companies, and especially Facebook, seem to be waiting for the government’s decisions instead of actively participating in the debate around the regulation of their own industry. Telehealth companies shouldn’t wait for something like this to happen – they should be active stakeholders in the conversation from early on, not least because regulation news tends to make headlines when it comes to that sector, as we found in our analysis.
- Promote telehealth’s benefits for specific therapeutic areas like mental health. During the pandemic, the use of telemedicine was “either/or” – patients would either use telemedicine or risk coming in-person for the most severe ailments. The future will likely be hybrid: virtual care will be used as a triage tool, as certain therapeutic areas such as oncology and gastroenterology will return to largely in-person interactions. But the future of telehealth will also be shaped by what we use it for, with mental healthcare at the top of the list, capitalising on the ease of use and access. Moreover, attitudes about mental health are quickly changing. As with telehealth, the pandemic acted as an accelerant, as patients have become increasingly comfortable with candid conversations about this historically stigmatised topic. Telehealth may provide a way to improve access to mental health and substance use disorder care, particularly for people living in areas with fewer providers. Kaiser Family Foundation researchers found that following the increase in telehealth use during the COVID-19 pandemic, patients with mental health and substance use disorders used these services at a high rate, and they continue to do so.