Camille Baxter:
Hello, and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. Today we are joined by Dan Trencher, Senior Vice President of Corporate Strategy at Teladoc Health. In this role, Dan is responsible for developing the organization's long-term strategic vision. Under his direction his team ensures the alignment of short and long-range plans, strategic investment roadmaps, and channel-level strategies and objectives.
Today, we are talking to Dan about the role virtual care plays in achieving whole person health. Before we dive in, we'd like to thank the sponsor of this episode, Teladoc. Teladoc Health is the global leader in whole person virtual care, offering the technology to connect, expertise you can trust, and the power to improve health for all. Dan, thank you so much for your time today. I'm really looking forward to our conversation.
Dan Trencher:
Thanks Camille. I'm really excited to be here as well. Looking forward to it.
Camille Baxter:
Great. Well, before we dive into the topic, I'd like to talk a little bit more about you. Can you tell us a little bit about your time at Teladoc Health?
Dan Trencher:
Sure, absolutely. I've actually been here for almost 11 years, so a long-timer so to speak. It's been really fascinating to see the trajectory of the company, as well as we've been driving the trajectory of the industry. Today the company's actually celebrating our 20th anniversary as a company this year, which is amazing. We've done 35 million telehealth visits just over the last decade while I've been here, over 15 million visits just in 2021. And more than one in four Americans have access to Teladoc Health services through their insurance or their employer. So really excited about the difference we're able to make.
Camille Baxter:
This area is so exciting to the impact that it's having on the delivery of health care. Let's talk about whole person care. Can you share with us what that means to Teladoc Health and how the company defines it?
Dan Trencher:
Yeah, absolutely. It's a great question to start off with. As we talk about what it means to care for the whole person, you have to start by recognizing that responding to the health needs of a consumer just one-off is not enough. Let's see the range of connections between the varying different needs that a consumer has over time, and seamlessly provide care for the whole person. Similarly, we must recognize that each consumer in a population is different, with their own unique combination of needs. So a broad solution is critical for meeting the needs of the widest range of individuals within a population.
And we have to recognize today's health care experience, whether in the community or honestly with most virtual health offerings, is still disjointed and out of sync with what consumers expect now and really need, resulting in fewer people engaging to proactively manage their health. But to answer your question more directly, in general, a whole person care delivery model is one based on addressing an individual's full set of needs, physical, and mental, and taking into account socioeconomic factors, a lot of talk around social determinants of health as an example, to help a consumer be healthy and realize better health outcomes.
At Teladoc Health our whole person care model reflects a new kind of health care experience, a modern experience designed from the ground up to be virtual, native, connected, personalized, and frictionless, where individuals along their health journey and across a population can meet the widest range of their personal needs for accessing care and managing their health. We don't see ourselves as a disruptor. That's not our goal. Our goal is to empower people to address their own unique set of needs with a tailored solution. So overall, as we approach whole person care we see it as delivering the broadest set of clinical services, primary care, and mental health, and chronic condition management, acute care, specialty care, and doing it in a way that bridges socioeconomic barriers that are huge contributors to driving positive health outcomes for all.
Camille Baxter:
Really making it accessible and available to all. That's great. Can you talk about how virtual care acts as the entry point to providing whole person care?
Dan Trencher:
Yeah, absolutely. I think the first thing to recognize, that whole person care is a goal and a destination. It's not a specific product. So as our clients, whether they're employers, or health plans, or health systems, as they adopt a broader range of integrated virtual care services across all the different dimensions that I talked about earlier, they advance along the path to offering their members, or employees, or patients, whole person care. Whole person care can be accessed via multiple what we call on-ramps, such as primary care, such as mental health, such as chronic condition management. Each of which is comprised of products which can be purchased individually or as bundles, and so we're really meeting buyers where they are in their own journey to adopt virtual health care.
Some other interesting stats we see along these lines is, consumers can really benefit across a population from virtual care. We did a claims-based study and based on taking a standard commercial population and looking at all their claims for a year, we found that 80% of that population could have benefited from one or more Teladoc Health services if they had had access to all of them. That's what I mean about really catering to a broad population. We also have seen in terms of consumer expectation that over three quarters of consumers prefer a single unified experience for managing their mental and physical health. So having that common pathway, the common entryway into health and into virtual care is really critical.
But if you take a specific example, so let's say a consumer who their primary need to start off with is they want to engage with a new primary care physician. The experience is very different than what they might normally expect in the community. They get to start by selecting a doctor from a wide roster of doctors that can be more personalized and they have more insight about going in. They are able to schedule an initial visit within a week, rather than weeks and weeks that you have to wait generally. In between, when the visit is set up and when it happens, there's a whole pre-appointment process. So the shipment of a blood pressure cuff and other supplies. Then when the patient does engage with that physician it's not a quick 10 or 15-minute encounter where the doctor's looking at their EHR screen. They're really focused on that patient.
We see 40-minute on average plus initial visits, and the patient's matched up with a full-care team. A lot of health care is delivered in between visits. It's also delivered outside of the individual patient and doctor encounter. It's working with a full-care team who can create a full personalized care plan that can help drive additional engagement in additional programs that could benefit that consumer. Just as an example, with our virtual primary care offering we've seen that many of those patients haven't seen a physician or a primary care physician recently before and they're getting newly diagnosed with conditions like diabetes and hypertension. Over a quarter of those diagnoses are new to that patient. So it's really important that we're using virtual care to really pick up new conditions that are sort of getting missed in the system to date.
Camille Baxter:
So it really is engaging them so much more, not only in the actual visit but in between the visits. But in some situations there's still the episodic events. So why is virtual care still being siloed to episodic events rather than being integrated into a person's whole health, and what are the barriers that are being seen?
Dan Trencher:
Yeah. It is a great question, but I think the way you started it is where I'd started also, which is that I see it changing today. We are moving beyond virtual care just being episodic and sort of complimentary care for when you can't get to your own physician so to speak. It's moving towards delivering longitudinal relationship-based and a relationship with that virtual physician or care team becomes the central role for a consumer. So it is in the process of changing. That said, one of the industry challenges we've seen has been this tidal wave of what we refer to as point solutions. Which are individual sometimes very sub-segment, very narrowly defined, virtual care offerings. You can think of mental health. There are multiple different apps for different components of mental health, for sleep, and stress, and anxiety, and meditation. Just to name a few.
Those are what we call point solutions. And it's creating experiences that frustrate purchasers because it's too many different vendors to manage. And it's also frustrating consumers because they can't be expected to sift through all these different apps and different sites and know which one to go to for what. And they don't talk to each other. They're all separate and disconnected. So that's the promise we see from whole person virtual care is bringing those together into integrated experiences which are easier for consumers to interact with, easier for purchasers to interact with, and tearing down some of those barriers that are almost getting put up as we speak by having so many point solutions.
Another element that has really been a barrier I think over time has been, as virtual care got started it really was pretty narrowly focused on doing live synchronous visits between a patient and a doctor. Whether they be video-based or phone-based that was the only modality essentially. That's itself very limiting, and so we've expanded over time to different modalities. There's asynchronous, it can be used for different types of conditions such as dermatology. There's messaging. There's device data collection and then the delivery of behavioral change nudges to empower a consumer to manage their own health better. There's sort of continuous sort of synchronous messaging applications. So we see that as really expanding out how it can be much more relationship based versus really just focused on a 10- minute, or 15-minute, or whatever specific encounter.
Then the last piece I'd say is, really trying to go where consumers are and how they access care. So not always bringing the consumer to your own site and your own app, but going to where they are. Examples are partnerships we'd have with navigation companies, that we've done with Amazon Alexa. So if consumers are using a voice device in their house, we want to be there. If they're using different apps from complimentary companies, we want to be there too. If they're accessing through their health plan's app, we want to be fully integrated there. That's really about going to where consumers are, and that helps bring virtual care to be top of mind throughout a consumer's journey rather than just when they have that very specific episodic need.
Camille Baxter:
Yeah, and it sounds like it's redefining in the consumer's mind what virtual care is. Because I think most consumers just thought about telehealth, that one type of interaction. So it's really kind of broadening their perspective. With all of that that's happening with virtual care, what's the role that traditional in-person visits play in the virtual first whole person care approach?
Dan Trencher:
Yeah. It sort of builds from the last part of our conversation. So as we're taking on a broader role in the health care lives of our consumers and becoming the central sort of focal point for let's say providing primary care, we know that we won't be able to deliver everything virtually. That's not realistic anymore. So we have developed capability so that sometimes we can resolve a patient's needs fully virtually. Sometimes we can bring in expertise and bring it to bear from a specialist for instance. But sometimes we have to refer into physical care of one sort or another, and so we think about that in a couple different ways.
One is doing referrals into high quality in-network providers, specialists or otherwise, who can provide those services and in a way that's really important that we maintain the patient's journey so we're not just kind of throwing them over the wall. So we're helping find that physician or clinician, and we have certain expectations set about how quickly that patient's going to get seen. We get the clinical data back so we can maintain that full patient clinical record. That's really powerful for health plans who want to manage those referrals and employers and other constituents. Another element is what we call last-mile services.
Sometimes services can actually be brought into the home. Examples might be, if you need a lab test. It's great if you do the whole virtual experience, but then you still have to go to a community lab center. That a little bit breaks the spell. Right? So why can't we bring lab services into the home, or through a mail-based kit where you just take the sample yourself and it's drop back in the mail? Mobile phlebotomy, so we're bringing a human being into the home. Or maybe it's for a foot exam for a diabetic. You can think of many different use cases.
But for us that's sort of closing that last mile and making it as seamless to the consumer and bringing as much of it to the consumer rather than making the consumer travel to the care we think is really important and an important element of how we think about sort of a hybrid care model. That's both the best of in-person and the best virtual. Then a last example I'll use is, we've talked about having a partnership with Microsoft where we're deepening our relationships with community providers and acting as their platform for delivering virtual care for their patients. This creates more opportunity for integrated hybrid virtual plus in-person models down the road as well.
Camille Baxter:
So connected in real time data is a huge part of providing whole person care, but it's still difficult to obtain, as you've spoken to. How is Teladoc Health addressing that challenge?
Dan Trencher:
Well, let me start by saying data exchange is always a challenge in health care. But we do have more than two billion health and engagement data points today at Teladoc. Which I know sounds like a lot, but it really is a function of the scale that we've reached. It includes clinical and coaching interactions, connected device readings, lab results, data from public data exchanges. About 60% of that data is sort of generated by us, proprietary so to speak. But the rest of it is from other sources so we have a lot of data connectivity as well. But as great as the data points are, the real secret sauce is around the data science that utilizes that data. That tells the story of how we turn this data into actionable insights. The term we often use is applied health signals.
We see those as the bridge to an individualized health care experience. It's utilizing that data that generates signals and allows us to change behavior of one sort or another. Some examples, we use the data to make referrals to mental health or chronic condition management programs, or smart referrals within our family of products. Automated triggers for clinical interventions, if a certain data value goes outside of a range, we've got automated triggers that can drive the next action. And nudges to drive a member, or a clinician honestly, to behavior change. That's one of the most powerful elements of our chronic condition program from a patient perspective. As an example, what that might look like.
Let's say a member checks their blood glucose before lunch and the blood sugar reading is high, which automatically triggers for some digital coaching for that patient to take an action in terms of their diet at that exact moment. Then they check their blood sugar again after lunch and find that that blood sugar is in range now. So that's then captured as a data point on that consumer. It's also captured as a data point about the impact of the intervention, the clinical intervention, that was put in front of that consumer in a very seamless way, and allows us to then adjust and build an even more personalized approach for this member while also sort of making our overall data engine even smarter. This is just one example of how we use data and data science to really create a whole different kind of whole person health care experience.
Camille Baxter:
Dan, you have offered us such insight into virtual first whole person care. Any final thoughts you'd like to add?
Dan Trencher:
I guess I'm really excited about the fact that we're even having this conversation now about whole person virtual care. It isn't the conversation we might have been having five or 10 years ago, even six or seven years ago. Teladoc was a one product company. What we did was what we now refer to as virtual urgent care, sort of general medical care. And that provided a lot of value, but it's amazing how the scope has changed of what virtual care can do and is doing, and the difference it's making in consumers' lives today in terms of outcomes, in terms of experience, in terms of helping overcome barriers to health equity. All these things are really important elements of what whole person care is today, so I'm just excited to be having the conversation.
Camille Baxter:
Yeah, and it sounds like there's so much more that is yet to be realized and yet to be expanded into. Thank you so much Dan. I've really enjoyed our conversation, and the opportunity to learn more about the connection between virtual care and whole person health.
Dan Trencher:
Great. Thanks Camille. I agree. We're just scratching the surface, so looking forward to talking to you again.
Camille Baxter:
Great. This has been a sponsored episode of Healthcare Insider, created in collaboration with Teladoc Health. For more information about Teladoc, visit teladochealth.com. I'm your host, Camille Baxter. Look for more episodes of Healthcare Insider at modernhealthcare.com/podcast, or subscribe at Apple Podcasts or your preferred podcatcher. Thanks for listening.
