How to make healthcare better, faster and cheaper

HealthTap is one of the World Economic Forum’s 2015 class of Technology Pioneers. The company uses digital technology to provide immediate access to medical experts and advice. Founder and CEO Ron Gutman discusses the company’s history and plans.

What was the inspiration behind HealthTap?

Our thoughts evolved considerably before we came up with our current business. We’re technologists, and we initially were looking at new opportunities in cutting-edge therapeutics. But we came to realize how big an opportunity there is in the healthcare sector to optimize the resources we already have.

There are issues with engagement. For example, more than half of people don’t adhere to doctors’ advice when they’re prescribed a treatment or medication. Maybe you take your pills for the first couple of days, then you feel better and you forget about them, and you don’t finish your prescription or follow up with your doctor as recommended. Whatever the condition, engagement and well-being outcomes are connected. We also identified issues with how information flows through the medical profession: it can take years for state-of-the-art knowledge to percolate fully and become common practice among doctors. As the saying goes, the future is already here, it just isn’t evenly distributed.

So we started to look at how we could apply technology to find elegant solutions to these problems that we could propagate, inexpensively, on a very wide scale.

What does HealthTap currently offer?

HealthTap offers three ways to help you manage your health and well-being: information, communication and engagement. We’re the first company offering an end-to-end experience in virtual care – from the moment you have a question or feel ill, to feeling good again.

The first thing you need when you have a health concern or don’t feel well is information, because before you can do anything you need to understand what’s going on. When someone asks a question on HealthTap we use machine learning to understand it and ask follow-up questions – your age, gender, weight, medications you’re taking, and so on. Then we try to match it to an answer in our repository that was previously provided to someone in a comparable situation. Or we pass it to one of the 71,000 US-licensed physicians who have volunteered to answer our users’ questions.

But these doctors do more than simply answer questions. They also provide other helpful content, like concise health tips, reviews of health apps, and recently we even added treatment ratings. This last feature, which we call RateRx, lets doctors provide one-to-five star ratings for different treatment options for specific conditions, which is an easy way for consumers to learn and understand what doctors think about different treatments. Everything doctors do on HealthTap is done openly, and is tied to their names, photos, and location; it’s a way for them to build their reputations.

Next comes communication. If you want a face-to-face consultation, we can connect you to a physician, 24/7, over video on any digital channel: web, Android, iOS, and even wearables. Because when you’re in physical pain, “patient” is the wrong word – you’re impatient, you don’t want to wait for an appointment, you want to talk to a qualified expert straight away. Our doctors can refer you for a lab test, or write you a prescription that you can pick up from a local pharmacy.

Many people think of the doctor’s visit or prescription as being the end of the healthcare experience. But it’s not: it’s just the beginning. What comes next is engagement: one of the most critical parts of care. We create and sustain health engagement by a feature that lets doctors create checklists, written in consumer language and not medical-speak; to help you make the most of these health “to-do lists,” we send you reminders by email or push notification to help you remember to take your medications and follow up with doctors throughout the recovery process.

Which parts of the service are free and where do you make your money?

The core of our basic service is completely free, and will always remain free. This is most of the information module as well as the non-personalized checklists. I’m motivated by the belief that healthcare is a human right, and building this repository of knowledge is our contribution to making that a reality.

If you want to follow up with a consultation, that’s the premium part of the service, and how our doctors get paid. For example, HealthTap Prime costs US$99 a month and gives you a concierge medical service – unlimited access to video consultations with primary care physicians, anytime, anywhere. We’re currently exploring the possibility of partnerships with insurance companies and major U.S. employers.

What has the reaction been to HealthTap from medical professionals?

From the beginning we involved doctors in the development of our product, and had thousands of doctors participating in this process starting early in our existence. We understand that our expertise is technology, so we approached doctors in a spirit of partnership, asking them to teach us what they need to practice medicine more effectively and efficiently, so that we could think about new ways to create the software that would make it easier, faster, cheaper – all the things technology is good at.

The organic growth of our doctor network is a natural response to our efforts to serve doctors well with our products and services, which is why our network has grown to 71,000 licensed doctors without advertising or traditional marketing efforts. Doctors are smart and critical people, and I believe that getting and sustaining this level of engagement is possible only if they believe that we’re in it for the right reasons and that we’re listening to them, even when they’re telling us things that are uncomfortable for us to hear.

Given the inherent limitations of remote consultations, is there not a tendency for doctors to err on the side of caution in advising people to see a physician in person?

Consultations are both reviewed by peers and star rated by patients themselves, so if a doctor is being routinely over-conservative and advising patients to go, for example, to urgent care and the patient is later told they didn’t actually need to go in, this would show up in doctor ratings, just like doctor advise that went too far in the other direction. Just like they do in their office practices, doctors on HealthTap are exercising their best judgement about the appropriate levels of care and interaction that patients need. Our peer review system helps to provide our doctors with reassurance that the recommendations provided to patients are the right calls.

Indeed, making remote consultations available 24/7 should reduce the incidence of people going to the emergency room unnecessarily. A lot of the time people go to the emergency room because it’s the only way they can see a doctor outside of office hours.

Healthcare systems differ greatly in different countries. How portable do you see this model being beyond the United States?

We are very excited about the potential to take HealthTap global by offering our platform as a service. Through partnerships with existing hospitals and healthcare systems that will allow them to use our architecture, we can help them become more efficient and cost-effective in delivering care to their patients using the methods and language and culture they’re familiar with.

Another aspect of our model that’s portable is the expertise we’ve accumulated in engaging with doctors at all levels of technical knowledge. Our 71,000 doctors average 21 years in practice, meaning that we’ve developed effective ways of quickly getting them up to speed using our technology.

We can see ourselves eventually working with any kind of healthcare system, however structured, even systems like the United Kingdom’s National Health Service. If we can help them be more efficient, why not? I’m especially motivated by the opportunities to reach places that currently have no access to healthcare. It’s awesome to think that we could give some people access to the best medical knowledge in the world before they even have running water.

Aside from international expansion, what are your plans for HealthTap?

The big thing we’re asking is how we move from reactive to proactive – instead of just helping people when they fall ill, how do we help them to stay well? Think about how advertisers can now predict what you want to buy before you’re even aware of it yourself, and imagine what that would be like if you apply it to healthcare – if we could know enough about you to see when risks are building up, and give you advice that stops you getting ill before it starts.

One thing we’re never short of is motivation. We’ve received now millions of notes of thanks from patients, and more than 22,000 messages from people saying we saved their lives. There aren’t many companies where a software engineer can say that.

Full details on all of the Technology Pioneers 2015 can be found here. 

Author: Ron Gutman, Founder and CEO, HealthTap

Image: Doctors diagnose a patient remotely at the First Hospital of Zhejiang Province in Hangzhou, Zhejiang province, September 24, 2014. REUTERS/Adam Jourdan