Zoom and Telemedicine

Apparently, Zoom is into TeleMedicine with its Zoom for Health:
https://zoom.us/healthcare

Check the following post on Zoom’s board by DocBoston, who said that his/her organization, Partners Health Care just left Doxy.me for Zoom. Partners Health Care, which is a large orgnization with 75,000 employees.

https://discussion.fool.com/4056/we-just-received-notification-t…

Does it mean Zoom is eating TDOC’s lunch?

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Based on a recent Zoom Dr. appt that with the Vanderbilt Eye Institute, I believe that Zoom is being used for medical appointments across the country.

Dug out more info on Zoom Health.
Zoom is HIPAA (The Health Insurance Portability and Accountability Act ) compliant through its offers Zoom for Health, which started in 2018

“Zoom is a HIPAA compliant web and video conferencing platform that is suitable for use in healthcare, provided a HIPAA covered entity enters into a business associate agreement with Zoom prior to using the platform and uses the platform compliantly (i.e. adhering to the HIPAA Minimum Necessary Standard).Feb 19, 2018”

Check out the following site
https://www.hipaajournal.com/zoom-hipaa-compliant/

Pay attention to the update note at the bottom:
“Update March 2020: There are now serious concerns about the security of Zoom. This creates doubts about using Zoom for communicating medical information, which needs to be fully protected under HIPAA. Zoom has publicly committed to upgrading its security and fixing all security problems. Until the security issues with Zoom are resolved, alternative telemedicine solutions should be used.”

Now that Zoom is putting behind the security issue, the above note may be removed soon, hopefully.

Here is what Zoom put together about the HIPAA compliance:
https://zoom.us/docs/doc/Zoom-hipaa.pdf

Following on from previous poster this gives you a clear idea where Zoom is going but open the link to see their comments on security and a short video how it’s done. No wonder Facebook and Google and all the rest want to get in on the action, but you boys are a bit late to the main party and try as hard as you like to discredit us, not going to happen as we are only going to get stronger so “Zoom Off” children!

Main points below.

"How we are keeping your telehealth visit private and secure.

You can rest assured that your telehealth visit is private and secure.

Vanderbilt Health uses a technology called Zoom to provide live video telehealth visits with/for patients. Zoom has been the subject of news coverage in recent days about security threats involving its platform, including a tactic called “Zoom bombing.”

Vanderbilt Health has licensed and implemented Zoom in such a way that there is no opportunity for such attacks to occur. Zoom is embedded inside My Health at Vanderbilt, a secure online tool that Vanderbilt Health patients use to manage their health care.

Visits are fully compliant with the requirements of HIPAA, the Health Insurance Portability and Accountability Act.

Safeguards include:

Calls are encrypted, start to finish.
Visits include – and have always included – a secure connection for each appointment.
Video or audio is never recorded – appointments are as confidential as being in person.
Patient data is not shared from the electronic health record during the telehealth visit on Zoom.

https://www.vumc.org/coronavirus/your-appointment-vanderbilt…

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Zoom for Healthcare, direct from the Zoom website:

Video conferencing that keeps you connected and compliant includes HIPAA/PIPEDA enabled plans that start at $200per month per account, which comes with 10 hosts.

Of particular interest is the fact that video conferencing for HIPAA enabled compliance includes “1, 2 and 3 year pre-paid packages.” https://zoom.us/healthcare

In addition, the Fact Page For Zoom Video Communications for Telehealth includes endorsements from Phoenix Children’s Hospitals and Access Physicians
https://zoom.us/docs/doc/Zoom%20for%20Healthcare.pdf

Finally, from the “Ask Erik (Yuan) Anything” teleconference this afternoon, the recent security upgrades to AES 256 GCM security features provide users with the same security features approved for top secret military usage by the federal government.

sjo

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Last year several hospital networks switched to Zoom because it was easier and HIPAA compliant. One of the main issue with telemedicine is reimbursement. Last month there were several policy changes to address the COVID-19 Public Health Emergency (https://www.telehealth.hhs.gov/providers/policy-changes-duri…). It included HIPAA flexibility and several waivers. Assuming other healthcare systems see the convenience with Zoom and/or are reimbursed, we should see more of them paying Zoom.

Regarding Teladoc, we shall see what happens after this situation. If more Telemedicine services are reimbursed after the public health emergency, then more hospitals, clinics, healthcare systems and probably independent practitioners will be able to have direct contact with patients via telemedicine. How many of them will attempt to do what Teladoc does? On the other hand, Teladoc might be able to expand their services directly to patients and increase their addressable market.

Side note: Do you Zoom? Up till February only my tech friends used to ZOOM, nowadays anybody does. The word is now synonym of the company similar to what happened to the word apple.

sp

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Last month we talked about it becoming a verb.

I just had my annual checkup using Zoom. They have a “waiting room” you wait in until your doctor is ready for you.

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I have had a couple of these meetings with doctors on multiple services. I am in pharmaceuticals and deal directly with physicians and the consensus has been that they love the telemedicine. I truly believe this will be the way of healthcare going forward. Follow up appointments will be held on some web service while emergency and new patients visits will be held in office. If Zoom can get in on this it will be something that will increase their business over the next few years.

Also, don’t forget that Covid won’t be going away for at least 18 months but more than likely 2-3 years. Since the weather is nice and states are lifting restrictions everyone thinks things are getting back to normal and that’s why we’ve seen the drop in TDOC. I really believe this fall/winter will be worse than what we just saw and there will be lockdowns enforced again. I am long on ZM and TDOC, even though it hurts watching the prices plunge with no available funds to get more.

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<Does it mean Zoom is eating TDOC’s lunch? >

When a patient (such as myself) decides to use telemedicine, the first consideration is my out of pocket cost.

When I had private health insurance, the insurer encouraged us to use Teladoc (presumably because they paid much less than a physical visit to a doctor’s office). The cost to me was nominal since the insurer had a deal with Teladoc. I was very satisfied with Teladoc and would readily use it again.

When I went on Medicare, I found that Medicare does cover Teladoc at all. With Covid-19, Medicare has expanded their rules to include phone calls (in addition to video calls which they previously covered) but only for the patient’s existing physician – NOT for Teladoc. My out-of-pocket cost would be $45 for a phone call to Teladoc but free to my own primary care.

Needless to say, millions of elderly people on Medicare will be using a lot more medical care than young people. If Teladoc could get Medicare to reimburse then I would go back to using Teladoc since their doctors are always at the phone and are more available than my primary care.

Until then, I will use telemedicine with my own primary care using whatever platform she chooses.

Wendy

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FYI, just had a tele-med conference today. My doctor used Zoom. 1poorlady’s doctor used something called “doxy.me”. Free for us.

Here’s the website:
https://doxy.me/

Front page says they are HIPAA compliant (among other complainces). Says it is “free for all”, also. Though that is contradicted on their pricing page:

https://doxy.me/pricing

It was a clean connection, easy from our end (they just sent a link to the “waiting room”, signed-in, and the doctor came online at the appointed time).

Specifically tele-med, not general use like Zoom (though you could probably use it for personal).

Again, I don’t see the moat. Seems like anybody can get into this space. Heck, Zoom proves that since its founder was a former WebEx guy. For medical it is important to be compliant with various privacy laws, but otherwise it seems one needs to have something extra. Microsoft has the advantage of a huge customer base already, for example (which is sort of a moat). Ease of use, quality/stability of connection, platform compatibility, and price seem to be the key factors.

Anyway, thought I would list a competitor that hadn’t been discussed (to my knowledge) that I had first-hand knowledge of.

1poorguy

Again, I don’t see the moat.

You neglect that the brand can be its own moat.

Also, a number of times in this series of exchanges it has been mentioned that the other major services were initially designed and built at a time when the only visual was screen sharing while Zoom was built from the ground up for video. This might explain why they were able to respond so transparently to a massive increase in volume almost over night. If one of these competing services starts to get significant volume, will they hold up as well? Certainly one of the things about Zoom which is remarked on over and over again is that it just works without fiddling and hitches. Superior underlying architecture could be the reason for that and may provide a sounder foundation for future enhanced offerings.

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Yes, brand can be its own moat. Apple, for example. There are people that will ONLY buy Apple.

I was merely trying to report on another tele-med service that I could relay first-hand experience. In this case, doxy worked as well as Zoom (no better, no worse). Just one data point, of course. I hadn’t heard of doxy before this, as I had not heard of Zoom before my doctor scheduled a tele-med a few weeks ago.

I cannot deny Zoom (ZM) is paying off for people. And I could be dead-wrong about the future (I frequently am). There are a lot of services (evidently), and at least those I’ve used work comparably well. Are you saying that the brand “Zoom” is its own moat, and will protect the company from competitors? Perhaps it is, but that would surprise me.

1poorguy (no position in any company we are discussing, or have discussed in relation to this topic)