How Telemedicine Is Taking Center Stage in an Increasingly Complex World
As part of an ongoing series that examines the rapid changes to our world and way of life, Artemis Ward is gathering thoughts and analysis from leaders and experts to shed light on what’s already happening and offer insight on what’s to come.
January 15, 2021
By Lindsey Goebel
Sylvia Romm has dedicated her career to making healthcare more accessible. A Harvard-educated doctor and founder of telehealth company Sonder Health, Sylvia’s current charge is to architect the virtual care department for Cityblock, a healthcare company created to address the root causes of health for underserved, urban populations. Cityblock partners with insurance providers to address gaps in care by offering members access to in-home, community-based virtual care through its provider network. It’s a model that splits the cost savings that come with better care with the insurance companies. Their perspective is: “When you’re healthy, everyone wins.”
Sylvia caught up with Artemis Ward Senior Vice President of Strategy & Growth Lindsey Goebel to look at the evolution of digital healthcare delivery.
Why did you begin working in telemedicine?
I got into telemedicine because I wanted to figure out ways to lower barriers to accessing care. We had seen changes in other industries that were making digital interactions much more convenient, like commerce and banking. And as a physician, I hadn’t seen the same sort of changes happen within healthcare.
I’m guessing technology will be a big part of how the industry increases accessibility in the coming years — is that right?
Absolutely. I think as technology gets substantially better, and you have more people who are used to communicating digitally, you’re going to see more people who are comfortable, both collecting and relaying that information through digital means.
Tools that allow us to collect that information are going to continuously get better and become less expensive. Right now, you have some fantastic tools that you could use at home — to collect your blood pressure, your oxygen saturation, even take videos of your ears, nose, throat. And they’re quite useful. But at a few hundred dollars per device, they’re really not accessible to the mainstream public or even a large chunk of the public. In the years ahead, though, we’re going to see those devices become more convenient and much more streamlined.
It sounds like these advancements may change where our healthcare occurs.
Yes, I think you’re going to see a lot less care happen in hospitals. People are going to have much more ability to take care of themselves at home. But, I don’t actually think that the great evolution will come from the devices themselves; it’s going to be from what we do with the data.
Our medical professionals right now have data fatigue. Already, they get more data than anybody can handle on any given day. In part, this is the natural byproduct of more sophisticated technology. But technology is not going to get us out of the bind that it got us into. Machine-learning analysis and better, smarter data will allow us to start turning that data into information that is actually clinically useful to our medical professionals. And the real revolution is going to be there.
Even in the context of data and technology, you’ve spoken a lot about human-centered healthcare. Can you talk about what that means to you?
In short, healthcare should be human-centered. In some other spaces, if you launch something, and people don’t use it, the gut reaction is, “Well, people are just using it wrong or they don’t understand what it’s for.” But the vast majority of care plans that go wrong or plans that don’t work are the result of plans that don’t fit in with people’s lives. Understanding what parts of the care plan work for different people — and how you can make the plan work better — is what’s really going to improve health outcomes.
How does Cityblock’s model apply this principle?
Cityblock has a population that we take care of. For many of our members, they have been either left behind by the traditional healthcare system or, in some scenarios, have even been traumatized due to racism or any other systemic problems that we have within our society that are reflected in the healthcare system. And so they have a lot of appropriate skepticism of getting care within the traditional healthcare system. A lot of what we do is reach out and meet people where they are — and we build a lot of trust.
In human-centered healthcare, you have to evaluate all of the inputs you get from the people you’re serving. You can provide all sorts of services to people, but if a service doesn’t make sense to them — if it doesn’t make sense in their lives — then it’s really not going to be something that’s going to help them.
What’s been Cityblock’s approach during the pandemic?
We’ve done a lot of work helping people with technology barriers be able to connect with our care teams by using technology in ways that are convenient and not as geographically bound. In particular, we now offer three levels of care: first, having somebody on our team remotely help people via their technology; second, dropping off technology for them to use; and finally, a care team coming in and helping facilitate the visit in person. Defining these three levels really was an evolutionary process as we aimed to give our members what they needed in ways that work for them.
Do you think this means broader telehealth adoption is on the way?
Many more people have experienced what it’s like to deliver and receive care through telemedicine — and many people really like it. So, there have been some changes that will likely stick. But the way healthcare has often been funded for physicians and other providers is frequently tied to in-person visits. And if we don’t have reimbursement changes at a large scale to cover telemedicine, then you’re going to see a lot of the care going back in-person.
As we move into 2021 — and hopefully, before too long, a post-pandemic world — how might our perspective on telemedicine change?
People often think of telemedicine as a binary. People will say things like, “Isn’t telemedicine bad because providers need to build rapport with patients in person?” And my response is always that people have a lot of opportunity to have in-person care — and I don’t think anybody’s suggesting that we get rid of in-person care. The question is: Does it need to be that way all the time? If you ask most people, “Do you have a friend that only communicates with you in person?” their answer might be yes, and you might say that that’s a really great friendship. But the reality for most of us is that we can’t have friends that only communicate with us in person.
So it’s about how we use different tools at different times to provide the best way of communicating back and forth. And it’s about maintaining our ability to adjust to circumstances appropriately as the world around us changes.