The tipping point for virtual care in Europe
Diffmed #1 Your newsletter about the future of healthcare
Hi, this is Antoine from Idinvest Partners. I am a VC and I write about healthcare technology and stuff.
Two weeks ago, a friend in quarantine with me lost his sense of smell and had a mild fever. We were aware that those symptoms were often related to Covid-19 so we isolated him immediately (he feels better now). In 15 minutes, we also used all virtual care tools available: asynchronous texting with a GP, video consultation booking, online self diagnostic questionnaire.
And we were obviously not the only ones: Since the beginning of the Covid-19 crisis, virtual care has been growing fast and at an unprecedented scale. In 2019, the French Government registered 60,000 tele-consultations total in 2019. Doctolib reached 100,000 consultations per day last month.
For the first time, Europe is experiencing virtual care at scale.
And what is also remarkable is that it is fueled by European startups:
Teleconsultation platforms are among the first forms of primary care now, they can screen and route patients in the right direction without overflowing hospitals. TeleClinic, leading platform in Germany, has more than doubled in size in March month-over-month.
Digital care companies are playing a major role, especially for diabetes management, mental health and online physical therapies. (See Kaia Health, Oviva…). MyDiabby will monitor more than 90% of women with gestational diabetes this year in France alone.
Medical communication platforms are expanding their reach and fostering better coordination within healthcare teams and between hospitals, general practitioners and patients (see the great products at Pando, Siilo…).
Most of these startups were founded as recently as in the past 5 years, and they attest of a new lively and still nascent ecosystem. As we witness part of the healthcare system switching to online, virtual care can feel obvious to us, consumers. But it has been particularly slow to emerge as a cornerstone of European healthcare systems.
Why did it take a global pandemic to get there?
In Europe, the main reason for virtual care restrictions until now has been the fear that it would be too successful. Postponing the rise of digital health in Europe has been a conscious choice made by states. In France, data storage compliance rules has resulted in keeping tech companies out of the healthcare sector for years (whilst not protecting patient data in any meaningful way…). In Germany, telemedicine was simply illegal until 2018. I see two main reasons for this delay:
For European states, opening up the gates to digital health meant risking the often fragile status quo with care providers. Doctors have indeed been reluctant to embrace new tools that would radically change their day-to-day practices. It is certainly not helping that the widely used legacy administration software come with their whole lot of inefficiencies and daily repetitive tasks resulting in distrust for software innovation.
Reimbursing virtual care was also believed to risk uncontrollable costs. But it is now largely accepted that it can be cost-efficient. Virtual care will reduce healthcare expenditures by preventing costly chronic disease, offering alternatives to surgeries, making therapies more efficient…
Digital health laws are now being passed everywhere in Europe and the stage was just set for virtual care to grow before the epidemic started. But this crisis is accelerating adoption rates ten folds: pushing doctors to use virtual care, patients to trust it and public institutions to rely on it. Now I believe we are at a tipping point for virtual care to grow massively in coming years.
Now virtual care can merge with the current system, not replace it.
Growing too fast could diminish the quality of care overall. As the risk/benefit ratio of using virtual care will shift back to the situation before Covid-19, we will need to decide what changes were for the better and what needs to go back to normal. Virtual care alone has a lot of room to grow but only if it blends well with in-person care. Adoption will hit a natural asymptote when the system strikes the right balance.
Here are models of how you could build better hybrid healthcare solutions:
Integrating vertically: A tele-consultation is not just a Zoom call with your doctor on the other side. Retention at providers like TeleClinic and Kry is high for a reason. They personalize the experience for patients, integrate with public electronic health records, target specific conditions. They offer lab testing, online prescription and pharmacy deliveries in the same care journey. They automate triage and paperwork for physicians to optimize their time. They use machine learning to assist, not to replace doctors. They push patients to in-person care when it is more relevant.
Democratizing access to care: Some virtual care solutions are even easier to integrate. Digital Therapeutics companies democratize access to best-in-class therapies. In the case of chronic pain that affects 40% of the population and cost more than 100 billion dollars a year, only a fraction of patients have access to in-person physiotherapy, often the only alternative to opioids or surgery. DTx solutions could be the only therapeutic option that works at scale and should be prescribed by doctors as a drug and reimbursed as such.
In the future, digital products will scale only if they enhance the virtual as well as the in person experience. If we collectively seize this opportunity, this will create a flywheel where digital care integration with day-to-day practices helps to provide better care, while keeping human touch at the center of the system. It could also inspire a new generation of entrepreneurs.
Full disclosure: Eurazeo-Idinvest Partners is an investor in TeleClinic & Doctolib.
🚑 Go further
Health innovation sees funding boom in the lead up to COVID-19. Link
Mental health startups boom as pandemic anxieties worsen. Link
Virtual health care in the era of COVID-19. Link
Doctolib shares some metrics on video consultations. Link
Millions of Chinese, cooped up and anxious, turn to online doctors. Link