American Well’s UnitedHealth Coup: Perspective from CEO Roy Schoenberg

6/4/09Follow @wroush

Boston-based American Well, in a one-two punch of advances announced this week, has added substance to its dream of giving consumers with health problems a way to consult with doctors over the Web and avoid more costly office visits. On Tuesday, the company said it was upgrading its Web-based “Online Care” platform to provide doctors guidance tailored to specific patients. And yesterday, a division of the UnitedHealth Group, the Minneapolis, MN-based company that is the largest private health insurer in the U.S., said it would begin deploying American Well’s platform to hospitals, practices, and patients across its huge network of more than 70 million members.

That’s a big win for the three-year-old startup, which introduced its Web-based patient communications platform last summer and, up to now, had signed up only two customers—the Blue Cross-Blue Shield plans in Hawaii and Minnesota. The deal with the division of UnitedHealth (NYSE: UNH), called OptumHealth, does a couple important things. It gives American Well access to that company’s so-called “clinical analytics” technology—which mines patient records for examples of gaps in care that can then be highlighted to physicians—and also clears the way for the platform to be made available to millions of people in all of the states where OptumHealth and UnitedHealth do business.

After the OptumHealth announcement, I reached Roy Schoenberg, CEO of American Well Systems, and asked him to explain both developments in more detail. (American Well Systems is the operational side of the venture; Roy’s brother and co-founder Ido Schoenberg is CEO of American Well Incorporated, the business side.) He talked about how the OptumHealth agreement will speed up deployment of American Well’s technology. And he differed with my own diagnosis about the slowness of the rollout so far, saying that he believes the platform is being adopted at a “staggering, unbelievable pace” considering the conservative (some would say anti-technology) nature of the healthcare industry, which still relies heavily on old-fashioned paper records.

Here’s a full writeup of our interview, which was conducted Wednesday.

Xconomy: Before we talk about your agreement with OptumHealth, can you explain the core of the news you released yesterday, about an upgrade to your own Online Care platform?

Roy Schoenberg, CEO, American Well SystemsRoy Schoenberg: The release that came out yesterday was about the unveiling of what we call internally Version 3.0 of the Online Care platform. It has better, broader administrative capabilities and other things that improve the experience based on what we’ve learned from users in Hawaii and Minnesota. But probably the most important feature that has been added is a thing called Online Care Insight. It’s very possible that a patient [using our system] will be seen by a provider with whom they have not had a previous encounter. Which means that anything we can do to equip the provider with insights—not only about who the patient is, in terms of their medical record, which has been there from the very first release, but really what needs to be done for the patient, what are the gaps in care, the appropriate medication changes—will go a long way to make sure the encounter represents a higher quality of care.

The way this is done is by taking advantage of expert systems, called clinical analytics systems in the business, which are very large computer systems typically deployed by large organizations like health plans to review the current healthcare activity of patients to identify such gaps. A typical example would be if a patient has diabetes and they haven’t had an eye exam, which is very important to prevent blindness. These systems will pick that up and drive communication to a physician or a care manager to say, “Listen, you really need to do an eye exam.”

Many such insights are generated by these systems, but until today, typically the results of those insights are, in the best case, the plan would send a letter to the physician saying that when you see the patient next you need to advise them about this thing. But as you can imagine, physicians typically don’t read mass mail, and don’t necessarily follow them. What we have now is the opportunity to engage those [expert] systems in real time when the patient is about to come together with a physician on our system. It brings them directly to the console. So the first time we are literally harvesting the immense computer power of these systems and bringing them into the care encounter.

X: From what I’ve read about OptumHealth’s eSync platform, it sounds like the expert systems or clinical analytics that you’re talking about is a big part of what they provide.

RS: ESync represents the front end of all of these analytics systems that Optum has developed and put in place. They have the ability to generate all of these messages about what needs to be done for the patient. But the big change is to be able to inject that information into the right place at the right time, so the physician can take advantage of it with the patient they are encountering right now. That ability is unique to Online Care. Before Online Care, when a patient was seen by a physician, there was no computer between the two.

X: Well, actually, there has been a computer in the room during almost every medical encounter I’ve had in the last several years.

RS: There is a computer. The question is whether the physician is going to log onto a system and read what that system is telling them about … Next Page »

Wade Roush is a contributing editor at Xconomy. Follow @wroush

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