By Liz Kwo, MD, MBA, MPH - Chief Medical Officer, Everly Health
In recent years, patients have become more preoccupied by how they access the healthcare services they need and by the cost engaged by these services. Taking more interest in managing their health has led many of these patients in searching for easier-to-access, less expensive healthcare services. This, alongside other factors, has contributed to the appearance of a revolution in how healthcare services are provided, a revolution called Direct-to-Patient healthcare.
Direct-to-Patient healthcare is an emerging type of healthcare that uses technology to empower patients as customers, enabling their access to the healthcare they need and reducing the costs of this access.
In 1970, the healthcare spending per person was around $350. In 2019, this cost reached $11,582, which is a 6 times increase judging on the value a dollar had in 2019. One of the most dramatic consequences of this increase is reflected by the young customers’ approach to healthcare: many prefer to pay for a visit to the doctor’s office when they need it instead of contracting a healthcare plan and paying month by month for services they don’t know if they will need or not. By doing so, young customers may have lower costs when they see a doctor, but are not eligible for prescription drugs discounts provided by healthcare companies as benefit for being enrolled in a healthcare plan. Paying on the spot for doctor’s visits is not a problem for patients who seldom experience health issues. But for those with chronic diseases, this approach may be more expensive than they can afford.
Patients, especially young ones, have begun to question doctors why the medication they prescribe is necessary or if there are alternatives to a certain medication treatment. They also use wearable health devices and look for natural alternatives to these prescriptions.
This involvement has been triggered, in part, by the tendency of some doctors to overprescribe medication and by the patients’ acknowledgement of the relationships big pharma creates with doctors who promote their drugs by prescribing them to patients. Except medications that save lives, all the others have been the target of various campaigns aiming at decreasing the number and amount of medications prescribed as long as they do not provide sufficient benefits for patients.
COVID-19 pandemic has presented patients with a new instrument for keeping in touch with their physicians from the comfort of their homes: Telemedicine. Although it existed prior to COVID pandemic, Telemedicine also known as Telehealth, e-health or m-health (mobile health) has been highly used during the peak of the pandemic by patients who needed to protect their health by keeping the social distance.
Among the benefits provided to patients by Telemedicine, the most relevant ones are Remote Patients Monitoring (RPM), patients portal, virtual appointments and visits, personal health applications and access to PHR (Personal Health Record) system.
All these possibilities prompted several companies to take one more step and develop Direct-to-Patient solutions such as clinically-validated tests provided by Everlywell. From nutritional health to general wellness and sexual health, these tests are designed to provide users with scientific-based methods of detecting any health issues patients may encounter.
The main differentiator of Direct-to-Patient companies is the empowerment they provide to patients. By providing them with details regarding the type of care available, the costs involved, the expected results of the treatment and how to access a product, service or treatment, these companies enable patients to make informed decisions regarding their health goals.
Patients evaluate DTP companies based on how transparent, useful and fit to their needs are the solutions they propose. These companies behave as service providers genuinely interested in the welfare of the patients rather than in their own insurance plans or incentives. This interest is driven by the understanding that patients will choose as their partner in reaching health goals those companies who put at their disposal the means to efficiently wield every dollar invested in their healthcare and who, at the same time, meet the patients’ specific demands.
There are also companies that provide patients with something more: the possibility to test their health for certain issues with the help of home-use clinically-validated tests. This enables patients to find out if they are affected by any health problem from the comfort of their home, saving the time it would take to make an appointment and go to a laboratory.
Everlywell is one of the companies who have understood how important it is to provide patients with this tool, by ensuring the testing methods used have been clinically validated against traditional methods. This process is designed to embed in tests the same accuracy and reliability expected by patients from any traditional investigation lab they may use for assessing their state of health.
Technology is used by DTP companies to facilitate patients’ access to high quality care. They develop solutions to overcome obstacles usually faced by patients in managing their health. Often, getting an appointment can mean weeks of waiting until finding a consultation, taking time off, maybe unpaid from work, solving the issue of who to leave the child with while being at the doctor, going through everything all over again in case follow-up is needed.
These difficulties cause some of the patients to postpone or give up completely to taking care of their health.
Companies who have invested in Direct-to-Patient care use technology as a point of access to high-quality care for patients and also as a liaison between the health providers on one side and the patients on the other. These companies do not rely on contracts with employers, but address patients directly by putting at their disposal means to access healthcare when they need and how they need to. These means can be represented by Telemedicine consultations, asynchronous messaging with health providers, at-home testing and Remote Patient Monitoring.
DTP companies must ensure they make the life easier not only for their patients, but also for the health providers, who are a major element in how patients access healthcare services.
Because healthcare has high costs, for some patients taking care of their health can mean giving up on other essentials, not taking their prescribed medication or simply not going to the doctor when they are not feeling well. This state of facts is maintained by main healthcare stakeholders, whose financial targets prevent them from searching solutions to decrease healthcare costs.
An increase in costs by providers draws the raise of premiums for employers who, in turn, pass those costs to employees in the health plans they provide as employment benefit.
The focus of DTP companies revolves around reducing costs with the help of digital innovations. Designing and delivering innovative solutions which will enable patients to save costs is a way through which these companies gain the trust of patients, who will be willing to search for these companies’ services and products more than once.
As with any innovation bringer new-comer on a market, DTP companies must face several challenges, the most significant one being that of collecting user data. Consumers today, more informed than ever, have acknowledged that data collected from them by certain entities can sometimes be sold, exposed by mistake or exploited. That made them more reluctant to sharing their data.
According to a report published in 2019, 73% of respondents declared they were willing to share data with physicians, but only 10% will do so with tech companies and only 19% with pharmaceutical companies.
For companies who need data to create more personalized products and services, this reluctance represents a serious obstacle. Without trust, consumers (patients in this case) do not wish to share their data, especially with new companies. This means that new companies must make all efforts to gain that trust with whatever trustworthy means they have such as customized techniques and e-commerce strategies. Enabling customers and potential customers to publish products and services reviews, to ask questions about them and to receive answers to these questions is one of the least expensive and at-hand methods to build a relationship of trust and validity with these customers.
Another proven method is to deliver products and services of high-standard and quality. This ensures the consumers will feel comfortable in sharing their user experience and hence help define and grow the reputation of DTP companies’ products and services.
E-commerce has created the means through which consumers can receive almost anywhere in the world products they find online. This provides DTP companies with a great opportunity to deliver their test and treatment products for home use directly to customers, without any middleman. This helps establish a direct connection that companies can use not only to sell their products, but also to educate their consumers, making them more aware about their health and how to be more involved in taking care of it. By maintaining a 24/7 communication with their customers with the help of notifications or by providing access to the information these customers need, DTP companies offer the type of personalized approach that customers require more and more in recent years from the interaction with the companies they purchase products and services from.
DTP companies such as Everlywell invest in innovation to enable patients to dispose of more cost-efficient, high-quality, right-addressing-of-problems solutions. Patients’ data protection is a sensible area and DTP companies who will prove they have in place visible, tested solutions to provide this protection will gain the patients’ trust and build a good reputation.
The main benefit brought by DTP companies in the healthcare market is the stimulation of competition. By delivering performance, these companies push other healthcare companies to do the same or better in everything related to products designed for patients.
While building the vision focused on patient will require a lot of effort, constant innovation and overcoming obstacles sometimes created even by players in the healthcare industry, Direct-to-Patient care has the potential to improve the lives of patients and to redefine how health is provided to them, all while innovating and successfully managing costs.