American Well may make America well…online!
Submitted by Dr. Gwenn Is In
At the recent Health 2.0 meets Ix conference in Boston, MA, I had the chance to sit down with American Well CEO, Roy Schoenberg, MD, on April 25, 2009, to talk about his company’s very innovative system of “virtual doctoring”.
The first I heard of American Well was in June 2008 and then again in January 2009, when multiple news venues reported that Hawaii rolled out American Well’s system as the first state in the nation to provide “online care”.
The press releases, though, didn’t do justice to what I learned about this company and it’s appreciation for not just the Health 2.0 world but our health care system as a whole. Here’s a summary of the interview.
How do you see the difference between Health 2.0 and Ix (information therapy)?
“One pushes and one pulls”, Schoenberg simply stated.
How did your background prepare you for where you are today?
Schoenberg told me his background is in Internal Medicine as well as software development and medical infomatics. He practiced internal medicine a short while in Israel while also running a medical software company with his brother, Ido, also an internist by training. Those early days of practice and software and systems development were the early seeds for American Well. It was during those early years, Schoenberg recognized issues in the current medical system and recognized that the key to rectifying those issues was with technology.
In 1999, the offer of a teaching position at Harvard University brought him to the United States and allowed him to dive more deeply into developing the technological concept that would eventually become American Well, which today is run by Schoenberg and his brother as co-CEOs.
What is the American Well concept?
“The essence of health care is getting in front of a doctor”, explained Schoenberg. American Well marries that concept with the “doctor will see you now” with medical technology and services.
To provide meaningful care, medical services need to be tied into all tools from insurance to health records. In essence, this redistributes medical services by using technology to leverage those services slightly differently.
What does this give to the doctors involved?
According to Schoenberg, doctors engaging in online communications with patients always worry about liability. American Well removes this fear by providing true medial malpractice coverage via AIG for all medical services rendered for care time.
The care given can be for patients in a doctor’s panel or others in the insurance system network. (Docs involved have to be credentialed with that plan to be part of the American Well system). What’s interesting is this covers after hours care differently than other after hours models by providing true docs to patients and giving the docs the freedom for when they can get to the computer.
As Schoenberg explained it to me, “your computer rings. You are told what the conversation is about and given a summary of the health record.” The doctor then decides whether to accept the call or refuse, and can refuse without penalty. What I found interesting is if a doc decides the patient would be best served by seeing a specialist, the system will then facilitate that appointment.
“In office and malpractice expenses are off the table – this gives doctors another model to make supplemental income while saving overhead”.
What’s the business model of American Well?
“We sell to the health plans and then the health plans provide us to the doctors”, Schoenberg notes. The doctors enrolled as PCPs in those health plans would then decide if they wanted to sign up for the American Well program as an extra to their clinical life. This, in essence, would be a form of moonlighting, just online!
What does American Well represent to you?
Schoenberg calls this time “the age of the virtual doctor”.
“There are not enough PCPs – they are becoming extinct”, he told me. “Many who fell off the grid are brought back to the grid with this type of system.”
How does this benefit the health care system?
“Patients want convenience and immediacy”, Schoenberg feels. “American Well Stretches the supply of doctors. We get more hours of physicians. And, it taps into the most experienced doctors so they don’t become burned out and fall off the grid.”
How many States are now involved?
“Hawaii rolled out first and many other states are following suit.”
Does American Well include pediatrics?
“Pediatricians are very accessible as a specialty. Online not as used by them. In our system, parents will engage the system over waking up their own pediatrician at 2am because that doc has more information.”
Schoenberg explains that for the pediatrician, it may be a patient they don’t know well but thanks to technology and having more information than a standard phone triage system where they don’t have access to the medical record, this system provides pediatricians more comfort.
How do patients handle being referred to the ER with this system?
Patients and parents don’t mind if after the video consult they are referred to the ER or another physician for a “live” visit because the video consult reassures them they will not be “burning ER time for no reason”, as Schoenberg put it.
Schoenberg’s thoughts on the social media trend in health care
“Health care is not a social networking kind of thing. There’s lots of quasi health care now such as minute clinics, etc, which reflects excess as an issue. We need to not toss patients at other disciplines but use technology to bring patients to doctors in alternative ways. We stretch the system by making physicians more accessible to patients. We’ve added a new tier of care available to people in their homes where they are the most at ease.”
My Final Analysis:
As the Obama administration looks at how to best spend that $31 billion dollars to overhaul our health care system, this type of system with a re-utilization of our resources and current health insurance structure makes much more sense to me for where to put the brawn and the dollars than in the current EMR project. Getting all docs online with electronic medical records still doesn’t fix the many systems issues and access to care issues. American Well’s system is one of the first innovative systems I’ve heard of that addresses the needs of the patient, insurance companies and physicians. If I were a betting gal, my money would be on American Way to lead the way. They are clearly trying to. It will be interesting to see just who follows and what our health care system looks like at that point.
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