How Remote Primary Care Can Close The Home Healthcare Delivery Gap

Virtual care has made strides toward public adoption, accelerated by Covid-19 when remote care suddenly became an attractive, and sometimes the only, option for receiving care in the most convenient, desirable location – the home. This resulted in skyrocketing utilization rates, peaking at 38X higher than pre-pandemic levels. But while virtual care technology exists and is widely known, there is a major delivery gap between how virtual healthcare is being deployed and utilized in the home and how it should be used to help healthcare organizations meet their goals of reducing the cost of care while delivering the best possible care for patients.

I recently spoke with Dedi Gilad, CEO and co-founder of TytoCare, a virtual care company enabling accessible, high-quality primary care from home, about the challenges facing virtual care and how it can be transformed to better support patients, clinicians, health plans, and health providers and solve this home healthcare delivery gap.

Gary Drenik: How has the way people engage with primary care changed since the beginning of the Covid-19 pandemic?

Dedi Gilad: With Covid-19 came the rise in popularity of existing one-dimensional point solutions for virtual care, allowing families to chat or video call with healthcare providers from home as they struggled with limited in-person appointments, geographic and transportation barriers, clinician shortages, and more. According to a recent Prosper Insights & Analytics survey, over 37% of US adults used telehealth services during Covid-19, with telehealth visit volumes reaching over 73 million at its peak.

These years of widespread usage generated substantial behavioral science data ripe for the study of what has worked and what hasn’t when it comes to virtual primary care in the home. Utilization levels of audio/visual-only telehealth solutions have since dropped by 37%, with ample room for improvement among healthcare providers, health systems, and health plans seeking to truly make home the center of primary care.

Drenik: What do you think is still missing from telehealth solutions on the market today? Why isn’t everyone using it if it’s so convenient?

Gilad: When it comes to primary care, traditional audio/visual-only telehealth solutions are severely limited in their ability to support accurate remote diagnoses, leaving families without the consistent, high-quality care they require without making major sacrifices. Simultaneously, audio/visual-only solutions for primary care do not adequately encourage user engagement or trust, nor address healthcare organizations’ business KPIs. For example, many patients are skeptical about virtual visits with unfamiliar “doctors-in-the-cloud” versus their own primary care physician (PCP). This combination of factors leads to low utilization and engagement across patient cohorts, leaving the promise of telehealth unfulfilled: The home, the ideal first stop for primary care, is still ill-equipped to deliver quality care compared to in-person visits. The recent Prosper Insight & Analytics survey demonstrates this lack of trust among patients, showing that patients still prefer to see their family doctor in person for non-life-threatening illnesses by wide margins, with 61% of Adults 18+ preferring to go to their family doctor or walk-in clinic versus 7.8% who prefer telehealth services.

While patients and families desire care at home, saving them time, money, and the hassle of going into a doctor’s office or clinic, telehealth so far has been unable to deliver comprehensive solutions that fully address the diverse needs of individual family members across chronic, acute, and primary care. The result is a jigsaw of point solutions for different needs and populations, and patients, health plans, and health systems are tasked with putting the pieces together, resulting in sub-standard and less accessible care.

Drenik: How does TytoCare differentiate itself in a competitive market that huge companies like Amazon and CVS are now eyeing?

Gilad: The growing number of virtual care solutions on the market illustrates that the home is the ideal place for the first line of care, and this has been our focus from TytoCare's inception. Today we have clear evidence from our partners that our Home Smart Clinic solution achieves significant increases in user engagement and utilization, allowing our partners to resolve 98% of visits without necessitating an in-person appointment and obtaining a high average NPS (net promotor score) of over 80.

We understand that in order to make virtual care in the home successful, it’s crucial to not only have advanced remote exam capabilities beyond audio/visual, but to also support health providers and plans in generating high engagement and utilization, cost reduction, and long-lasting behavioral change. The Home Smart Clinic achieves this through user engagement support, the ability to tailor virtual care across primary care modalities and for different patient populations in the home, and AI-powered diagnostic support for clinicians in addition to the remote examination device.

Additionally, we honed in on primary care in the home as a key use case for successful virtual care, with our solution serving patient populations across chronic, preventative, and acute care. Tailored solutions for different modalities serve the diverse needs of family members, culminating in 59% more accurate diagnoses and a 10% reduction in total cost of care (TCC) on average.

Drenik: What should health plans and providers look for when choosing a telehealth partner, and how will they know what successful telehealth implementation looks like?

Gilad: It’s clear that traditional telehealth offerings face challenges in delivering expected ROI and outcomes; patients sacrifice on quality of care and healthcare organizations must compromise on their performance as a business, reflected in their quality of care, market share, and total cost of care. Health plans and providers should look for solutions that enable them to meet their KPIs and facilitate comparable care to in-person care.

We recently established metrics for the industry to measure and identify successful telehealth implementation, looking beyond utilization on the patient side alone. We feel that our D.R.I.V.E guidelines enable healthcare organizations to assess their virtual care implementation using indicators that directly impact critical business metrics: Diagnostic capabilities; Retention of existing members/patients and acquisition of new ones; Inclusion, i.e., equitable access to care; Visit resolution; and Engagement. Successful virtual care reflects significant improvements on all these crucial fronts.

Drenik: What role do you see AI having in the evolution of home-based primary care?

Gilad: AI can guide patients to better utilize virtual care tools to ensure accurate data collection, while also enhancing providers’ ability to identify more conditions and provide more accurate remote diagnoses. We achieve this by offering Tyto Insights™, AI that guides patients conducting exams, helping them place the device’s modular tips (stethoscope, otoscope, etc.) in the right position to capture health data accurately, and that also supports clinicians in detecting conditions and making accurate diagnoses. This increases the quality of exam data for clinicians, improves remote diagnoses, and provides patients a more intuitive and simplified examination process. AI can also help tailor solutions to different patient populations and care modalities quicker, accelerating support for different patient populations over time.

Drenik: Dedi, thank you for sharing your insights on the current obstacles facing virtual care in the home, how to overcome them, and where the virtual care industry is headed.