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January 13, 2009

Is American Well the disruptive innovation to unseat retail based health clinics?

To paraphrase Mark Twain, are rumors of the death of the retail based health clinic highly exaggerated?  There have been widely-reported dips in retail clinic growth, and growth has not kept pace with optimistic projections from an earlier, happier time.  Why is that? Is it the economy as a whole?  Is it the health care marketplace fighting back with newly-flexible doctors' offices?

While we ponder these questions -- and I hope I will see many of you coming to ponder them at the Retail Based Health Clinics Congress January 26-28 in Las Vegas, where I will be speaking -- a disruptive innovation has come along to disrupt the disruptive innovation of retail clinics.

American Well (one of the Health 2.0 companies I was first introduced to at the Boston Health 2.0 event last fall) has rolled out a statewide version of its service in Hawaii.  All residents of the state -- not limited to subscribers of the local BCBS affiliate, which is sponsoring the project --  now have access to online and telephone consultations with physicians across a full range of specialties, through the American Well portal.  The decision was made to offer services to all residents of the state due to its unique geographic access challenges.

Per the NY Times:

Patients use the service by logging on to participating health plans’ Web sites. Doctors hold 10-minute appointments, which can be extended for a fee, and can file prescriptions and view patients’ medical histories through the system. American Well is working with HealthVault, Microsoft’s electronic medical records service, and ActiveHealth Management, a subsidiary of Aetna, which scans patients’ medical history for gaps in their previous care and alerts doctors during their American Well appointment.

The Hawaiian health plan’s 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor.

Will services like American Well's pose a serious threat to the continued growth of retail clinics?  They probably will, but only in the more wired (or these, days, wireless) communities around the country.  I will be very interested to see how these two models of care delivery intersect in the future.   

David Harlow
The Harlow Group LLC
Health Care Law and Consulting


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One thing is certain, the healthcare industry will be radically transformed in the next couple of years and "cloud based" solutions are going to play a key role.

The economics of the cloud in healthcare, and in lots of other industries, it too compelling to be ignored. Clinics and other primary care providers will have to get on board.

Nice post !
There's a company in the UK looking to extend this service the video-chat with a physician model onto 3G mobil telephones

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