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The Future of Telemedicine

With Use of Technology, Teladoc Pioneers a New Kind of House Call

By Larry Teitelbaum

n the early years of the Internet start-up boom at the turn of the century, an engineer-physician in Texas saw a future for something called telemedicine, a foreign notion in the conservative world of healthcare, which is sometimes slow to embrace new technology.

It must have seemed crazy at the time, much in the way that selling books over the Internet struck people in publishing as folly. But, nearly 20 years later, Teladoc Health, Inc., is riding a wave as more and more patients sign on to a new model of medicine: virtual doctor visits.

Aided by the pandemic, during which patients have been reluctant to visit doctors in person, Teladoc reported a 156 percent increase in total visits in 2020 over the previous year, translating to 10.6 million remote visits. And, according to McKinsey & Company, 76 percent of consumers are now interested in trying virtual care, as compared to 11 percent prior to COVID-19.

Which leads Adam Vandervoort L’99, Teladoc Health’s Chief Legal Officer and Secretary to the Board of Directors, to declare: “The revolution is upon us. The expectation has been created now that you can access medical care through the launching of an app rather than calling on the phone and talking to a receptionist and arranging something in the future. If you’re using the Teladoc app and you’re requesting a visit, in 10 minutes you’ll be communicating with a board-certified provider.”

Vandervoort joined the company in 2015. He came to Teladoc from Independence Holding Company, a health, life and disability insurance business where he was General Counsel. Prior to that, he was an in-house attorney with the FedEx Corporation and a corporate associate with Sullivan & Cromwell LLP.

In Vandervoort’s view, telemedicine is the wave of the future because it offers a practical alternative to in-person visits without sacrificing quality of care. Teladoc contracts with 7,000 licensed providers, so patients don’t have to wait weeks or months to see a specialist or get a second opinion from an expert. Services are available anywhere in the world at any time of day or night every day of the year. And with the advent of smart technology, you don’t have to leave home to monitor your chronic condition with the help of a physician. All you need is a smartphone, tablet or computer to submit medical records, receive e-prescriptions, or talk to a doctor, therapist or nurse, provided you’re covered under your employer’s health plan. More than 40 percent of Fortune 500 employers, as well as thousands of small businesses, labor unions, and public-sector employers, offer Teladoc’s virtual care services to their employees.

Vandervoort said patients who want to avoid the doctor’s office for reasons of safety or convenience can now get treatment for common conditions such as upper respiratory infections, recurrent urinary tract infections, flu symptoms, conjunctivitis, skin conditions and a range of mental health disorders, to name a few. And there are instances when telemedicine can save someone’s life in an emergency, Vandervoort said, describing a scenario where a rural hospital which lacks a neurologist to treat an incoming stroke victim turns to a Teladoc-supplied robotic assistant who shares information on vital signs with a specialist located at a distant city hospital.

This is heady stuff for a company that started with a handful of employees in 2002. As recently as 2015, when Vandervoort came aboard, there were only 200 or so employees. Today there are 4,500, he said. Teladoc operates 17 offices worldwide and provides services in more than 175 countries. One of the oldest companies in the industry, Teladoc has been extending its presence and market dominance with the licensing of its platform and network to more than 600 hospitals and health systems.

It has also made a round of strategic purchases over the last several years — acquisitions that include a market leader in technology-based diabetes management, a provider of robotic medical equipment, a company that provides online health coaches who connect patients with nutritionists, exercise physiologists, nurses, diabetes educators and doctors, and a company that helps patients address the most costly and complex health problems with the aid of world-class specialists.

Evan Falchuk L’94 ran the latter company, Best Doctors, for several years. Ever since its sale in 2017, he’s been tracking Teladoc’s evolution.

“I think they’re doing something absolutely transformative in healthcare,” said Falchuk, now CEO of VillagePlan, which provides technology-enabled help to families caring for an aging or ill loved one. “The Internet has democratized every aspect of our economy. Teladoc has done the same thing for healthcare, and I feel like they’re just getting started. A lot of noise is made about ‘Oh, Amazon could disrupt healthcare.’ Well, Teladoc’s already doing it. It’s the one I look to as the driver of change in healthcare for the next number of years.”

A market research company projects major growth in the area of telemedicine. The $55.9 billion global market is expected to expand by 22.4 percent from 2021 to 2128 due to the lack of access to care and the rising acceptance of telemedicine, according to Grand View Research, which contends that the emerging practice has the potential to reduce emergency room visits and hospitalization rates.

Certainly, there is room for growth on the mental health front, where Teladoc is already, according to Vandervoort, the largest online provider of services in the world. The U.S. Department of Health and Human Services estimates that approximately 96.5 million Americans live in areas where there are shortages of mental health providers. Teladoc also seems well-positioned in the areas of home care, post-hospitalization care, wellness and screening, chronic care, and remote surgery.

Vandervoort shares Grand View’s optimism. He foresees growth for Teladoc and the industry, predicting that more people will soon be connected to technology, such as smart watches, blood glucose monitors and blood pressure monitors, that will facilitate home care. “The scope of what can be treated effectively remotely (will increase),” he said.

“For a while we said we’re going to reach an inflection point, and I think 2020 definitely represented the inflection point. I think that expectations have fundamentally shifted and that patients in the future are going to expect to be able to access the health care system via virtual care where it is appropriate.”

Larry Teitelbaum is the editor of the Penn Law Journal.