Touch has always been a sensitive topic, but even more so today with The Rona demanding that people keep their hands off one another. It’s a shame, because touch is beneficial for so many reasons. Waiters use touch to build trust with customers, couples use touch to gauge sexual compatibility, and doctors use touch to comfort patients. Today, all of these use cases seem to be going the way of the dodo.
For better or for worse, the healthcare industry is increasingly moving towards a model where artificial intelligence (AI) augments everything from diagnosing the patient to figuring out which treatment will be most effective, what we’re calling personalized medicine. It’s been nearly three years since we wrote our piece on 8 Telemedicine Startups to Watch – Half Use AI, and today there are some key players emerging in the area of primary care telehealth apps.
A primary care provider acts as the first contact and principal point of continuing care for patients within a healthcare system.
Whenever someone believes they need medical attention that doesn’t warrant a trip to the emergency room for urgent care, they’ll usually go to see a doctor. Back in the day, that meant a trip to your family physician’s office where you sat in a waiting room waiting to be seen. Nowadays, it’s all about being able to consult with a doctor without leaving your living room. Today, we’re going to look at nine companies that are emerging as leaders in telehealth primary care – five startups and four publicly traded stocks.
Five Telehealth Startups
|Startup Name||Date Founded||Funding
|Doctor on Demand||2012||235|
Founded in 2013, London England’s own Babylon is disrupting the heck out of the NHS after taking in just over $631 million in funding, most of which came from a summer 2019 Series C round of $550 million led by the Saudis. Back in 2017, we asked, Is Babylon’s AI Chatbot the Future of Healthcare? Today, the answer is clearly yes. From our last piece:
Babylon started out as a telemedicine app, providing live chat and video consultations with medical professionals, saving Londoners (and the National Health Service) the cost and time to visit a doctor in person. What the app does currently is what Babylon calls its “triage” function where patients use the app to get medical advice—a more sophisticated version of WebMD in a way—rather than call the NHS hotline for help.
An article by TechCrunch in early 2020 talks about how the company is now deploying their app across the entire city of Wolverhampton for 330,000 people. Prior to that, Babylon’s biggest accomplishment was probably the chatbot they built for the NHS in the U.K. (they’re now in the process of rolling out similar services in 11 countries in Asia). Says the article:
In August, Babylon said it was delivering 4,000 clinical consultations each day, or one patient interaction every 10 seconds; covering 4.3 million people worldwide; with more than 1.2 million digital consultations completed to date.
Credit: Tech Crunch
Babylon’s international expansion ambitions extend well beyond Asia. In May of 2020, Babylon decided to make their technology available to the Yanks with a debut that saw millions of New Yawkers getting access to the app. That move probably raised some eyebrows at our next company.
Founded in 2016, New Yawk startup K Health has taken in just over $271 million in funding from investors that include Kaiser Permanente, one of the largest nonprofit healthcare plans in the United States with over 300,000 personnel. All that money has been used to build the most downloaded medical app in the United States with 4 million users. K Health came across our radar several weeks back when they raised their biggest round yet – a $132 million Series E. The company’s telemedicine platform utilizes AI algorithms to make triaging patients more efficient.
AI algorithms are only as good as the data you feed them. The K Health app was built by doctors and trained on millions of real medical records to give you more accurate results. After a simple conversation with the app, it will share how doctors have diagnosed and treated people with similar symptoms and backgrounds. It tells you other symptoms to watch for, medications you can take, typical recovery times, and more. If you choose to speak with a doctor, it only costs $19. For a subscription of $9 a month, chat with the doctor as much as you want. It even prescribes pills, something that’s seen as a key value add in ‘Murica.
Credit: K Health
The ability to triage incoming patients using AI algorithms is also an approach being taken Silicon Valley startup HealthTap among others. On the topic of AI and natural language processing (NLP), we would simply assume that every company offering chat-based telehealth uses NLP and AI algorithms to better serve their patients using less manpower. With all the startups discussed today having taken in $200 million or more in funding, they certainly have the means to staff some AI engineers.
Doctor on Demand
Founded in 2012, San Francisco startup Doctor on Demand has taken in just over $235 million in funding, the latest round being a $75 million Series D in summer of 2020. The long list of investors includes Google, Qualcomm, Goldman Sachs, 23andMe, and Virgin Group along with their charismatic founder, Sir Richard Branson. The CEO of Doctor on Demand, Hill Ferguson, wrote an article over at Stat titled Telehealth’s critics have it right: The industry must evolve. Any time the CEO of a company writes a 1,000-word article, you can be sure he’s sending a message or two.
In his article, Mr. Ferguson writes about how the COVID-19 relief package contains a policy change that says patients and providers need to first meet in person first before moving online. He talks about how critics see telemedicine as eroding the quality of healthcare by commoditizing it. Patients fall into a queue where they move along a conveyor belt where information gets lost and services become over-utilized because it’s so easy and cheap to see a doctor. Doctor on Demand believes that telehealth can provide a much lower cost of care, and they’re putting their money where their mouth is. This year, they’ll be offering “virtual-first health plans and sharing the financial risk of caring for patients in those programs with plan partners.”
Another thing Mr. Ferguson talked about was the importance of telehealth care providers prioritizing client-patient relationships, something our next company believes in strongly.
Founded in 2007, New Yawk startup Zocdoc took in around $226 million in funding which was originally used to build out a doctor scheduling platform. Patients could choose from a large database of doctors with various specialties and ratings, then schedule time slots based on any doctor’s current availability. When it came time to do the COVID 19 pandemic pivot, Zocdoc wowed everyone with a simple video integration that gave the platform telehealth capabilities. The company is betting on the fact that consumers will still want to choose their physician, not be placed in a queue to speak to the next available random pick. That way the doctor-patient relationship can be maintained throughout the entire patient experience.
According to an article by Engadget, Zocdoc’s video visits went from essentially zero at the beginning of March 2020 to 30-40 percent of overall bookings in just several months. It makes you wonder how many other healthcare organizations out there might be able to quickly offer a telemedicine service by implementing video conferencing capabilities, EHR companies for example. If you’re already connecting healthcare providers to patients, offering video is a no-brainer.
Founded in 2009, Florida’s own MDLIVE has taken in nearly $199 million in funding from investors that include $71 billion insurance provider Cigna. They were the first telehealth provider to bring virtual psychiatric services to consumers in all 50 states, a division that’s seen a lot of growth lately because of you know what. (MDLIVE has increased its behavioral health footprint to include 34.6 million members as of March 31, 2020.) Across both behavioral health and primary care, MDLIVE offers virtual healthcare services to over 60 million members nationwide. In an announcement discussing their latest round – a $75 million debt/equity raise in September 2020 – the company talks about recent growth. With 2,000 clinicians in their network, the company quickly scaled to meet increased demand which reached an all-time high of approximately 20,000 virtual visits a day.
Four Telehealth Stocks
It was last fall when we wrote about The Only Telehealth Stock for Telemedicine Investors which was indeed at that that time, the only pure-play telehealth stock out there. Today, we can think of four companies that would be considered plays on telemedicine.
The first is the undisputed leader and one of around 30 tech stocks we hold in The Nanalyze Disruptive Tech Stock Portfolio – a telemedicine company called Teladoc Health.
While all the telehealth companies we’ve talked about so far are emerging as leaders, one company is leading the race at the moment. The Dom Perignon of telehealth companies, Teladoc Health, is thinking well beyond just connecting doctors with patients. Their recent acquisition of Livongo means they’ll be extending the patient’s “telehealth journey” to include remote monitoring for chronic conditions which affect about 60% of adults in the United States, diabetes for example. As of their last quarterly filing, Teladoc had 51.5 million paid memberships, all of which can be sold medical services using existing telehealth channels.
Teladoc was first out of the gate with a commanding size advantage and we have every reason to believe they’ll be able to maintain their leadership position by growing organically and through acquisition. The success of the company’s IPO led one of their competitors to also go public, making Amwell the second publicly traded pure-play telehealth stock.
After the success of Teladoc’s 2015 IPO, Amwell (AMWL) made the plunge in September of 2020 with their own offering that raised $742 million. We wrote about the IPO in our piece on how “Telehealth is More Than Just Virtual Doctor Visits.” At about 5X the size and 5X the revenues, Teladoc dominates Amwell, but there’s room for both companies to grow. Where Amwell might look to expand into telehealth is the relationship they have with Google and Verily. As we’re already shareholders in the largest Teladoc provider there is, we don’t see the need to also own Amwell.
In an interview with MedCityNews, the CEO of Amwell, Dr. Roy Schoenberg, talks about how his company saw 4.3 million virtual visits for the first nine months of 2020. Going into 2021, he’s hoping the new administration will look favorably upon telehealth with policy changes that include “recognizing the home as a valid place of care … changing some of the Medicare rules around reimbursement, [and] changing HIPAA rules to accommodate the fact that care is rendered outside facilities and hospitals.”
Mental health is as important as physical health, something we talked about in our past piece on 10 Telepsychiatry Companies For Your Mental Health. One of those companies was behavioral telehealth provider Talkspace that’s now decided to make hay while the SPAC sun shines. After taking in nearly $107 million in funding, they’ve decided to merge with a special purpose acquisition company (SPAC) called the Hudson Executive Investment Corp (HEC). They actually filed a comprehensive S4 document which is a whole lot better than the usual glossy investor deck. Unlike most other SPACs, they’re not only growing revenues ($38 million in 2019 vs. $28.7 million in 2018), but they’re also turning a profit. We might just have to take a closer look at this SPAC, especially considering the wankers at Robinhood haven’t managed to pump it through the roof yet. Still, it’s currently trading at a +20% premium, which makes no sense considering the deal hasn’t even closed yet. (The transaction is expected to close late in the first quarter at the earliest.)
Finally, we have a stock that wouldn’t be considered a pure-play on the telehealth thesis, but it’s interesting enough to merit a mention. It’s all part of the larger remote connectivity investment thesis that’s seeing a lot of interest from investors these days. We mentioned earlier how Zocdoc quickly pivoted into telemedicine by plugging in some video conferencing capabilities. Another company that also pivoted into telemedicine was GoodRX, a $22 billion prescription drug price comparison platform, with their purchase of a telehealth platform called HeyDoctor. That bolt-on acquisition supplemented their free-to-use website and mobile app that tracks prescription drug prices in the United States.
The Americans absolutely love their pills, so GoodRX has made quite the business out of it, bringing in $388 million in revenues for 2019 and $66 million in profits. While telehealth isn’t a core offering of the platform, it’s easy to see how it soon could be. Fifteen million people visit GoodRx every month and they’ve collectively saved $20 billion to date.
As we wrote about before, Telehealth is More Than Just Virtual Doctor Visits, and primary care is the first point of contact – the gateway drug for future telemedicine customers. Get them hooked on virtual doctor visits and before you know it, they’ll be using all of your remote monitoring offerings. As Teladoc asserts their leadership position, expect more acquisitions and consolidation alongside strong levels of funding from investors.
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