EP329: Virtual-First Health Care Solutions—Their Promise and a Few Outstanding Questions, With Joe Connolly From Visana Health

In a recent article in STAT news, TJ Parker, the VP of pharmacy at Amazon and the founder of PillPack, explained that Amazon’s plan to stand out in the pharmacy space is simple: “Better selection, better convenience, and better prices.” He added, “It really is the Amazon playbook.” 

Better selection, better convenience, better price. The playbook of arguably one of the most successful companies ever, Amazon has decimated and bankrupted anybody standing in its way toward total market dominance.

This same better selection, better convenience, better price trio—maybe with “better selection” inferred to mean “getting the right care to the right patient at the right time”—is the vision of many of the virtual-first health care providers starting to pop up. And when I say “pop up,” I mean that in Q1 of this year, according to data from Rock Health, $6.7 billion was invested in digital health companies. 

In this health care podcast, we’re talking about the proliferation of these “virtual-first” health care solutions. Before we begin, though, let me just clarify that in our conversation, virtual first doesn’t mean virtual only.

Most of the time, actually, virtual first means that the connective tissue of the operation is virtual/digitized. In other words, we’re not just talking about some random mobile app here. There are likely human providers involved, and the goal is to offer patients not only a sticky engaging entry point and journey but then also a continuous longitudinal care experience. The patient journey should be clear, and the virtual-first solution is making sure that the patient isn’t getting lost somewhere in their journey from diagnosis to better outcomes.

Here’s my main point: The big contrast between these newer virtual-first solutions and traditional health care enterprises is that humans involved in these virtual-first solutions are connected to each other and to their patients with technology designed for that purpose—as opposed to software and systems designed to maximize billing, which, sadly, many software tools and systems used in legacy health care were.

The promise of these virtual-first solutions is to fill care gaps for patients who are currently having issues. It sometimes takes 10 years for people to get properly diagnosed. Care for chronic conditions is also abysmal in this country.

Now, this all being said, much of the promise of these virtual-first, also called point solutions when someone is not a fan, has yet to be realized. Tune in to my interview with Al Lewis next week for more on that front.

One area of concern is that if you have a point solution for MSK (musculoskeletal) care and a point solution for diabetes and a point solution for mental health, you wind up with silos. PCPs have complained that they don’t know what’s going on with some of these solutions, and it makes it harder to manage patients. Here’s my inadequate response to these two criticisms: Well, how many silos currently exist in the health care system? When a specialist gets ahold of a patient, do the specialists talk to one another much less the PCP if we’re talking about an average here? Sometimes patients have multiple PCPs even, who, I’m not exactly sure if they hold regular discussions. So, if the status quo is the benchmark to beat, then at least with some of these virtual-first silos, you have the patient getting longitudinal care within that silo. That’s not the case with many specialists who, at best, manage one episodic or a series of episodic visits.

On the other hand, consider that $6.7 billion of investment. Some PE company there is looking for 4x on their investment, so $6.7 billion of PE investment means that they expect to get $28 billion out of health care spend, meaning $28 billion paid for by patients, employers, or taxpayers. On the other other hand, $28 billion is a drop in the bucket compared to the almost $3 trillion that this country spends annually on health care.

I talk about all this and more with Joe Connolly in this health care podcast. Joe was originally in medical devices and has created his share of digital health solutions. Currently, Joe serves as CEO and founder of Visana, a virtual-first solution for women’s health.

You can learn more at visanahealth.com or by emailing Joe directly at joe@visanahealth.com. 

Joe Connolly is the founder and CEO of Visana Health, a virtual-first women’s specialty care clinic focused on high-cost chronic gynecologic conditions like endometriosis. Visana works with payers and self-funded employers to improve access to best-practice women’s health care. Joe also writes a popular blog consisting of long-form, in-depth analyses on the burgeoning virtual-first care industry. Prior to Visana, Joe led digital health and strategy efforts at Boston Scientific, a large medical device company. 

05:01 What does it mean to be virtual first?
05:50 “It’s meeting people where they are and where they want care to be delivered. It does not mean virtual only.”
07:01 How do payers and purchasers know that a virtual-first program is available to them?
07:34 “We need to come up with new ways to increase engagement with these services.”
10:59 Will virtual care replace in-person care?
15:01 What needs to happen in order to have an empathetic care delivery?
18:06 How should employers try to wade through the virtual health space?
19:41 What’s the value in administration within virtual care?
20:27 How does virtual care affect the relationship of the patient with their PCP?
22:05 What does physician abrasion mean?
25:31 What do virtual-first providers need to make sure they’re doing?
27:16 “There is the possibility for perverse incentives, and it’s up to the virtual-first space to make sure that we don’t give in to those perverse incentives.”
28:28 Who is Visana and what do they do?

You can learn more at visanahealth.com or by emailing Joe directly at joe@visanahealth.com.