Friends,

Our guest today, Dr. Roy Schoenberg, is one of the most significant contributors and accomplished entrepreneurs in the domain of telehealth & virtual healthcare. In this episode, he’ll share some unique perspectives he’s gleaned from over 25 years as a trailblazer in telehealth. He’ll also discuss a transformational initiative that he and his colleagues at Amwell are introducing, as well as what he considers to be the next revolution in healthcare delivery.

Dr. Roy Schoenberg is President and CEO of Amwell.  Since co-founding the company in 2006 with his brother Ido, Amwell has grown to become one of the largest telehealth ecosystems in the world.  Among numerous accomplishments and recognitions, Roy was appointed in 2013 to the Federation of State Medical Boards Taskforce that issued the landmark guidelines for the “Appropriate Use of Telemedicine in the Practice of Medicine.”  He is the 2014 recipient of the American Telemedicine Association Industry Award for leadership in the field, and in 2020 he was named one of Modern Healthcare’s 100 Most Influential People in Healthcare. Roy holds over 50 issued U.S. Patents in the area of healthcare technology. He speaks frequently in industry and policy forums, and serves on the healthcare advisory board of MIT School of Business. He holds an MD from the Hebrew University in Israel, and a MPH from the Harvard School of Public Health.

In this interview Roy shares a number of critically important inflections that reframe our understanding of the virtual and telehealth era. I’ll list the five most significant ones that I gleaned from our dialogue.

First – contrary to what most people believe, telehealth encompasses much more than video visits. It is fundamentally a new and emerging multi-channel ecosystem for the distribution of healthcare that engages a broad spectrum of telecom, digital & data analytic capabilities.

Second – we are just at the dawn of the telehealth era and its major transformational impact has yet to occur. Listening to Roy, it’s clear that there is no turning back, and we’re not going to return to some pre-pandemic ‘normal’ when it comes to virtual & digital health.

Third – telehealth and the digital health movement will transform the way healthcare engages with its consumers. It will shift the provider/patient relationship from being reactive and episodic to being proactive, continuous, contextual and longitudinal. In Roy’s own words, “We are interacting in healthcare within the construct of the ‘visit’ – which is short, hard to get and expensive. That whole notion is going to be thrown out the window because there are so many other ways for us to interact with patients, inside their reality. It will not only change the experience and expectations of consumers, but will also dramatically move the needle on costs because we can much more appropriately use healthcare resources where they’re needed.” Roy goes on to remind us that most of healthcare actually occurs outside of ‘visits’, in what has been referred to as the ‘between-visit’ space. Yet, we have little access to understanding patients in that space, or intervening effectively and efficiently. The emerging telehealth technology will enable us to cost-effectively connect with our patients in this continuous and longitudinal fashion. It is probable that the ‘between-visit’ space can and will become the dominant place of healthcare delivery.  As I reflect on our dialogue, it seems to me that we are applying a 20th century mindset to 21st century technology.

Fourth – Roy outlines three domains of care delivery in the future. 1) The physical care cluster of services – in hospitals, operating rooms, clinics…. 2) The digital care cluster of services – telehealth, asynchronous communication, messaging, assessments…. 3) A whole new generation of automated interactions – literally a vigilant presence next to the patient – tracking and following patients during the course of their healthcare journeys and lives.

As Roy puts it, once we get into the continuous and longitudinal space and apply automated care, there will be so many more dimensions of patients’ lives that we can begin to understand and respond to, offering much more proactive, personalized and contextual care.

Fifth – Perhaps the most transformative impact of telehealth and digital health will not be as a communication channel, but instead as a supply-demand management system. As Roy states, “The part that has changed is that we are beginning to look at telehealth and related technologies as more of a logistical infrastructure rather than just as a video conferencing capability.” Similar to the ways that Amazon transformed the retail industry, the platforms being created now, including the Amwell Converge platform, will create an unprecedented ability to connect providers and care to patients and consumers – literally revolutionizing how healthcare is distributed. Roy continues, “If you think of telehealth, not as a way for a patient to see a doctor through video, but rather as an infrastructure for the digital distribution of healthcare, it begins to sound much more like a logistical infrastructure than a way to carry out a visit.”

Roy was also insistent on informing me that this is not an Amwell-only endeavor; but a major market movement. And he’s right. I’ve heard others refer to this as the ‘platform war’ and even the ‘era of the platform’. There are over 100 “platform” companies in the S&P, and within healthcare there are dozens of companies working on a platform infrastructure. What’s important to understand is that while technology is the enabler for these infrastructures, the power of platforms is in their network effect, the ability to automatically connect the right provider to the right consumer, the transformation in consumer convenience and choice, and most critically, the new strategies and business models that platforms unleash.

While many are concerned about the future of healthcare, the picture that Roy paints is incredibly positive, hopeful and attainable. From the patient side, virtual & digital technologies have the ability to democratize healthcare – allowing people to access care from whom they want, when they want it, and how they want it. The telehealth era will enable care that is more accessible, convenient, personalized, affordable and equitable, and it will provide greater consumer choice. From the provider side, virtual and digital health will liberate the tremendous value proposition locked up in the hearts and minds of clinicians. Imagine a healthcare world where clinicians can offer their services not only to the patients within their immediate geography, health system, or network, but to all patients across the country and around the globe. From the public health and industry perspective, virtual and digital health will lead to greater efficiencies, effectiveness, and equity – at far lower costs – and will allow us to leverage providers’ time much more efficiently and effectively, creating unimaginable advances in capacity and population health management. I have to admit that I share Roy’s realistic optimism for the future of American healthcare delivery.

Until Next Time, Be Well.

Zeev Neuwirth, MD