what Teledoc is

I have seldom written more than a comment here or there. Usually, by the time I read about one of our holdings on the board, I am too late to add much value. Except now.

I think many have not realized what Teledoc is. It is not simply a Zoom for doctors. It is a medical service where you can call and talk via video to a health care provider, who can offer advice, a subscription, or a referral. Your child has flu symptoms that make you nervous, you can call Teledoc. Nervous about a growth on your arm and don’t know whether you need to see a dermatologist? Call Teledoc.

Teledoc is not going to conduct blood tests, or take your blood pressure. In my life, I have had to wait for long periods to see a doctor, when a five minute video call would have solved my problem. It will not cause people to supplant their family physician, but could well serve as an adjunct to non-critical conditions.

Imagine such as service tied to Livongo. Now we have an entire network of medical professionals who are tied into telemetric data about your health. I don’t know how this could be anything but additive.

I am not going to go into numbers, I think Bert did an excellent job of covering that. I too worry about LVGO being diluted as a result of the acquisition, but also think the combination could lead to further growth for Teledoc, which has not been a slouch in its own right.

Gordon
Long Teledoc and Livongo

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Gordon,

The merger is certainly a good move for health and humanity, if somewhat less exciting for investors given LVGO’s torrential growth pre-merger.

As a nurse, I am ecstatic about the possibilities. I work primarily with the elderly who are still living independently. For many, it’s immensely challenging to keep their blood sugar, blood pressure, cholesterol, etc. under control, and often it’s total guesswork trying to figure out how things are going at home. Even just basic home monitoring of vitals and blood sugar that are automatically uploaded to the cloud will result in better outcomes and avoidance of some of the worst case scenarios (stroke, heart attack, etc.)

Now imagine that these people had had remote monitoring since they were diagnosed. It’s the lowest of the low hanging fruit for improving people’s health. Many of these diseases (for example, high blood pressure) are not really dangerous in the short or medium term when diagnosed, but are very dangerous after decades due to bodily changes that put you at immense risk. For the 35 year old diagnosed with high blood pressure who may not be able to make it to the doctor frequently, remote monitoring from the onset (with clinician engagement, of course) really has the potential to extend his/her lifespan.

And then there’s the immense potential for rural communities. I grew up in Alaska. Many communities have no road access and do not have a health clinic. People seek care only when it gets so bad that they have no other option. I don’t think I need to go into how impactful remote monitoring and telemedicine could be.

I’m off my soap box now and very excited for the future of medicine.

Cheers

41 Likes

And this response from alkaline119:
https://discussion.fool.com/gordon-the-merger-is-certainly-a-goo…

As a nurse, I am ecstatic about the possibilities. I work primarily with the elderly who are still living independently. For many, it’s immensely challenging to keep their blood sugar, blood pressure, cholesterol, etc. under control, and often it’s total guesswork trying to figure out how things are going at home. Even just basic home monitoring of vitals and blood sugar that are automatically uploaded to the cloud will result in better outcomes and avoidance of some of the worst case scenarios (stroke, heart attack, etc.)

Now imagine that these people had had remote monitoring since they were diagnosed. It’s the lowest of the low hanging fruit for improving people’s health. Many of these diseases (for example, high blood pressure) are not really dangerous in the short or medium term when diagnosed, but are very dangerous after decades due to bodily changes that put you at immense risk. For the 35 year old diagnosed with high blood pressure who may not be able to make it to the doctor frequently, remote monitoring from the onset (with clinician engagement, of course) really has the potential to extend his/her lifespan.

And then there’s the immense potential for rural communities. I grew up in Alaska. Many communities have no road access and do not have a health clinic. People seek care only when it gets so bad that they have no other option. I don’t think I need to go into how impactful remote monitoring and telemedicine could be.

Enjoy,
Brian

Sorry, my post was meant for Teledoc premium board – I will be more careful. Thanks for the great post alkaline119.

Enjoy,
Brian

For people who wants to find out how Teladoc is different from zoom below information might help.

https://forum2020.intouchhealth.com/innovation-showcase/

You can click on any for example AV integration or wearable or managed network & services items within above link to learn more. Hope this helps clarifying questions with respect to How Teladoc is not simply a virtual video call between patient and provider.

Thanks
Raj

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Apologies for missing this earlier. From recent earnings call here is Teladoc CEO response w.r.t Zoom/MS Teams comparison.

Stephanie Davis – SVB Leerink – Analyst

Hey, guys. Congrats on a really strong quarter. And Joe, welcome to the team. So I had a question on the hospital space.

Can you talk a bit to your differentiation versus some of the tech pure-plays like Zoom or Microsoft Teams as we see more HIPAA-compliant solutions come to the forefront?

Jason Gorevic – Chief Executive Officer

Yeah. Absolutely. Thanks, Stephanie. First, let me talk a little bit about InTouch and the tremendous momentum that we’re seeing there.

We’ve seen RFPs actually triple from Q1 to Q2 as Hospitals & Health Systems moved to rapidly embrace virtual care in a changing landscape, 50% more client expansions in the quarter versus the last several quarters and over 20% increase in new clients. So really tremendous momentum. I think I mentioned in the call the success of our international expansion. We activated that channel much faster than I expected to.

And I think all of that points to the change that we’re seeing in how hospitals are thinking about virtual care and the technology that enables it. It’s much more important, and some of them did put in sort of band aids, if you will, stopgap measures in order to meet initial demand for single use cases. What we’re seeing is that hospitals are looking for an enterprise wide solution that is secure, that is managed, that is medical-grade reliability and that can both bring the doctor to the bedside, as well as into the home. And InTouch and Teladoc Health together are uniquely positioned to be able to do that, unlike any of the sort of off-the-shelf video platforms that aren’t really designed for healthcare and aren’t integrated into the healthcare system.

And we really see that that is going to continue to be a rapidly growing channel and a competitive advantage for us.

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I think what I’d call the “Zoom Revolution” will be good for TDOC/LVGO as people get more used to doing things virtually. I’ve had a virtual visit (don’t actually know what service was used) and I thought it was a fine replacement for a maintenance checkup. The provider didn’t take any readings in this case.

Gordon,

When you use Teledoc, how much choice do you get over which doctor you talk to? Do doctors’ offices contract with Teledoc directly, or is it more typically the insurance company?

My doctor’s office provides virtual video visits through their web site and mobile app. It is integrated into their online appointment request system, so you choose whether you want to see a doctor in person, or virtually. You choose the doctor and the time of the appointment. You can use a web browser or their mobile app. I have no idea whether they use Teledoc, a competitor, or rolled their own.

I prefer the continuity of seeing the same doctor for everything, so I choose to use whatever service my doctor uses, not the one my insurance company provides, nor going to the telehealth service directly.

My doctor’s health system (company) also provides virtual urgent care. I suppose I might use it for after hours needs, if I didn’t think the doctor needed to physically examine me. This is a case where I’m not seeing my usual doctor, but I’d still prefer to go through the doctor-related web site (not my insurance company), because their urgent care shares the same electronic records system.

Even if traveling, I would prefer a virtual visit with my own doctor or another doctor in the same practice.

I suppose that being able to schedule a virtual visit with which ever doctor is available would make sense if I rarely saw a doctor, so wasn’t particularly looking for continuity. I don’t have a sense about how common that is.

As for the Teledoc/Livongo merger, I’m wondering if that makes it easier for the doctor to access your Livongo-managed records/devices, which might give Teledoc an edge (thinking of them as more like a Twilio for doctors, not a Zoom for doctors). Generally, putting all remote health monitoring data in one place, in a way that is convenient for the doctors, seems like an advantage.

-Mark

1 Like

Mark,

I have never used Teledoc, and. can’t tell you whether you have a choice in doctors. From my reading, I understand that you call in with a problem and are connected to an appropriate health care provider. I am now 64, but for much of my younger years I did not have a family physician. My issues were generally one-off - - - no chronic issues. Many of those might have been handled by a video appearance.

Currently, even with my family physician, I may have to wait two to three days. This is not terrible, but for non-critical issues, I think it would make sense to call Teledoc and get treated ASAP. Even with a family physician I have used local Patient First, which is a doc-in-the-box.

Chronic issues, such as recent hip issues, which resulted in hip replacement, are obviously going to have to be handled in person. But, I am guessing that my swimmer’s ear from last summer could have been handled telephonically.

Also, I read that the results of your visits to Teledoc can be sent to your family physician.

My post was mainly to disabuse folks from thinking it is only a means for doctors to conduct a video chat with patients. Video is how it is done, but it is a means, not an end.

Gordon

3 Likes

Apologies if this seems nit-picky but this is starting to drive me a little nuts.

Folks, it’s TelAdoc not TelEdoc.

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When you use Teledoc, how much choice do you get over which doctor you talk to? Do doctors’ offices contract with Teledoc directly, or is it more typically the insurance company?

My spouse takes calls for both TDOC and her affiliated hospital. Yes, you may schedule an appointment with a specific TDOC health care provider if requested. Otherwise, the calls are put into a queue.

Dr’s, NP’s and RN’s are contract workers with TDOC and employees of their Health Plan or Affiliated Hospital System. For medical purposes, think of it like a doctor having privileges at a hospital other than their own. They are employees or have contracts with hospital A and occasionally work out of hospital B. For legal purposes, it’s like being a UBER driver.

To be considered for TDOC, you must supply your license number or Board Certification, fill out an application and there is a two-hour On-Boarding process. Health care workers are contract employees working under their own medical license however TDOC provides malpractice insurance (a very nice perk for retired health care workers).

TDOC does not contract for services directly with your Dr’s office. If your Dr’s office provides telemedicine, they either do it as part of their HCP network or are reimbursed by your insurer as they would for a visit (different codes and rates). If they work contract for TDOC the entire visit must be scheduled and facilitated through Teladoc. Teladoc negotiates rates with insurers based on volume/service. The same insurer/service provider relationship they have with hospital systems.

“I’m wondering if that makes it easier for the doctor to access your Livongo-managed records/devices, which might give Teledoc an edge (thinking of them as more like a Twilio for doctors, not a Zoom for doctors). Generally, putting all remote health monitoring data in one place, in a way that is convenient for the doctors, seems like an advantage.”

That is one of the synergies behind the TDOC/LVGO merger however ultimately, they are your records so they are available to your designated HCP as well. It’s not a closed system so I’m not sure there is an advantage. In the same way that TDOC/LVGO may gain access to your medical records, your TDOC/LVGO records are available to your HCP. Most records are held and transferred by EPIC, the largest medical records system, holding about 65% (230,000,000) of US records and 4% worldwide.

You also bring up the point of chronic care patients. To address this TDOC has launched Teladoc Medical Experts. These are Board Certified specialists in most areas. Again, they are contract employees who typically have their own practice or are employed by a health care system/hospital. As you point out, the question of patient willingness to use audio/video for these conditions remains to be seen.

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