I recently had a conversation with a head of benefits from a Fortune 100 company about the problem they’re seeing with video-based telehealth and the search for a messaging-based alternative for their employees. As this benefits leader explained over the phone, there are very few private spaces where employees feel comfortable joining a video conference for a sensitive health-related consult. Most of their employees are now back in the office, given return to work mandates post pandemic.
In 2025, many patients would be eager to chat with their care team. So why are we still so reliant on video and in-person visits? Why isn’t more care delivered via messaging, particularly in specialties where there are often a lot of lower acuity needs like dermatology, pediatrics, primary care, and general mental health?
For this piece, I teamed up with Josh Tauber, a health-tech entrepreneur and operator who’s gone deep on messaging-based care while building for a Gen Z user base. We’ll argue throughout this piece that the benefits for the patient experience are clear, particularly for younger generations of patients. Multitasking comes naturally to most of us, so existing appointments and meetings don’t need to be cancelled for patients to get access to medical treatment. Who among us hasn’t sent a few texts while sitting on a Zoom conference call? Another benefit? If a patient’s symptoms come and go, it’s possible to send progress updates or images to a care team versus relying on what can be gleaned fortuitously during a synchronous consult. There’s a reason patients so often gravitate to texting. Sending a text might feel more private and a bit more impersonal, which is comforting for patients managing sensitive or embarrassing issues. When we talk about privacy, we often discuss it in the context of security. But there’s also the emotional dimension. For many, a text feels more private because it can’t be overheard by a spouse, a child or a co-worker.
Using messaging in care delivery–and not just patient engagement or administrative tasks where we more commonly see it–may give companies an edge. But after talking to a dozen operators, we also believe it’s so complex that the companies that do it well have effectively created a moat. There are challenges related to coding and reimbursement, patient experience, compliance, benefit design, provider workflow, unit economics, legal considerations, and more. “It’s hard, but when done right, I don’t think people in this industry realize how much of a secret weapon it really is,” said Ellen DaSilva, CEO of Summer Health, a pediatrics SMS messaging service.
So it’s worth learning from those who have done it. For Second Opinion’s paid subscribers, we dug in.