Telehealth is a feature, not a company

Urgent care and telehealth exist because PCPs made themselves inaccessible. Both urgent care and telehealth are symptoms of dysfunction.

Healthcare, at its core, is just communication. Now that humans communicate with far more modalities than just in-person meetings, why should some doctors say “I only talk with you via a quick video chat and you can’t ever talk to me again” and others say “I only talk with you in an exam room and it takes a few weeks to get an appointment.”

Shouldn’t all doctors say:

“I communicate with you in an ongoing way in whatever modality is best suited for the situation— sometimes that’s in-person and others online via messaging, sharing photos, collaborating in the cloud, and phone or video chats. And I also collaborate with my team about your care so you don’t just get one person’s opinion, you get a consensus.”

Dictating which communication modalities a doctor exclusively uses is dysfunctional and irrational. Doctors should use the right tool for the problem, every single time.

As you can see, this is a wonderfully complex challenge to solve. Hence the radio silence as I’m leading the team here at Crossover that’s building the platform to power this new delivery model.

At Crossover, we had to make a decision. Do we reappropriate Sherpaa’s platform for Crossover? Or do we take all lessons learned over the last 7 years and build a new platform free from technical debt? We chose the latter.

You learn a ton by pioneering a process the world has never seen before. Sherpaa was and is unique. During that process, you make lots of great and poor decisions. Also, decisions need to be made based on something you couldn’t possibly have predicted.

Big insights critical to the do over: Health issues are projects to be managed over time best managed by a team of experts (consensus over opinion). Humans have overwhelmingly chosen asynchronous communication. Care should be primarily online and strategically in-person.

Radical transparency enables 100% effective care. People forget 85% of what a health professional says during a visit. This means all healthcare professionals are 15% effective at communication and you have no easy way to access your records. These are damning stats.

Brick and mortar of the future will be more confirmatory than exploratory. Just as the retail landscape of America is changing to things you can’t get on the internet, the physical center of the near future will exist to perform tests and procedures that can’t be done online.

And without a structured way to capture a baseline, intervene with a structured care strategy, and easily obtain status updates and outcomes, all of healthcare will be living in a data void dependent on highly inflated highly inaccurate claims data to learn and iterate. So sad.

So, the best way to describe what we’re building: An EMR-like platform meets Slack meets team-based project management to power a primarily online, strategically in-person primary care, physical therapy, behavioral health, health coaching service for ~600k people.

And these 600k people all work at Facebook, Microsoft, Comcast, etc. These are activist employers who know healthcare is 30 years behind what we all expect. So they’ve decided to pay us in a way that unlocks totally rational, intelligent, convenient care. Amazing.

And after having lead the teams that built the tech powering Hello Health (2008! Way, way too early!), Sherpaa (2012! pretty early), and now Crossover, in 2019, I’ve got a few EMRs under my belt and, more importantly, our culture and the industry is catching up to the vision.

Healthcare is 20-30 years behind our culture. This is a massive advantage. We know how this is going to play out. And we can let pop culture do the experimenting. And then when the time is right, we can bring the best of now normal pop cultural processes into healthcare.