Next-gen care provider Crossover Health has quietly shuttered Sherpaa, the virtual primary care company it acquired in 2019. Sherpaa founder Jay Parkinson broke the news in a farewell blog post, in which he also revealed he has parted ways with Crossover after two years there.

Sherpaa, a longtime digital health stalwart founded by Parkinson in 2012, is no more as of December 2020, following a six-month wind-down period. But much of the DNA of the company, as well as the majority of its staff, will continue under the Crossover Health banner. In fact, Sherpaa customers who have opted in are the vanguard of a new direct-to-consumer offering Crossover Health is planning to launch at scale next year.

“The best way to describe it is Crossover is a $100 million revenue business, and Sherpaa never really got to that scale,” Parkinson told MobiHealthNews. “The strategy was for Crossover to really sort of marry the digital online care delivery [of Sherpaa] with their physical care delivery. 

"You don’t want to start from scratch in learning how to deliver care online. It was really like, let’s get deep, learn to operate it, figure out what’s unique and interesting about delivering care online, learn as much as we can, incorporate the principals and some of the clients into our business. There was just no reason to keep it open.”

Dr. Scott Shreeve, CEO and cofounder of Crossover Health, agreed with Parkinson’s assessment.

“When we picked up Sherpaa, we didn’t just bolt on their technology. We actually rewrote the platform based on all those lessons learned,” he said. “And I think once Jay saw that that was actually incorporated, adopted and ready to carry on, I think he was ready to take a little mental break and move on to whatever the next thing is going to be for him. We really appreciated his contribution. It really jump-started and accelerated our learning.”

First-mover liability

In his blog post, Parkinson wrote about being a “too early” innovator in digital health.

“In some industries being the first mover is a significant advantage,” he wrote. “In healthcare, it’s a massive liability. That’s why me raising $12M for Sherpaa starting in 2012 was such a challenge when today, it’s common to see investors throwing $120M at a similar concept, mostly because a shared language around digital health has evolved over the last decade.” 

MobiHealthNews previously reported on how Parkinson built a one-man business providing smartphone-powered house calls in 2007 – a business model that would generate serious investor interest eight years later.

Now Parkinson finds himself in a similar situation with some of Sherpaa’s key innovations, like team-based asynchronous care, gaining traction nine years later. When he started, Parkinson said, it simply wasn’t possible to do what virtual care companies are doing now, because the infrastructure didn’t exist.

“Back then, if you wanted to order lab tests, basically Quest and LabCorp were only used to doctor’s offices being regional and state-based. So they were only set up [to work with] regions and states,” he said. “It wasn’t like a medical group could have a national contract. So we spun our wheels for so many years, and now it’s like Quest and LabCorp got their act together.”

Parkinson, who says his departure from Crossover was unrelated to the Sherpaa shuttering, is taking time off to recharge and tour America with his golden doodle Roux. But he plans to return to healthcare entrepreneurship when he gets back.

“What I think is so fun about where we are right now is so many of these things now are just turnkey solutions, and if you can sort of mash these turnkey solutions up, I feel like you can get a much more streamlined, easier to develop kind of service out there,” he said.

“It would be dumb if I was too early constantly for the rest of my life, so I’m definitely going to be thinking about, what’s the mashup of turnkey solutions that resonates with a lot of people? I just don’t know what it’s going to be yet.”

Sherpaa’s legacy at Crossover Health

The concepts from Sherpaa that have changed Crossover Health’s hybrid physical and virtual care platform aren’t just asynchronous messaging. It’s also about the platform that makes that messaging work for providers.

“The great insight Jay had from the very beginning is he always used to talk about how it’s more of a CRM [customer relationship management] tool than an electronic health record,” Shreeve said. “Because an EHR is very good at documenting and helping you submit bills, but that’s never what we were trying to do.

"We’re trying to engage people in their health and facilitate communication back and forth. … So we’ve now incorporated all those lessons learned, and we’ve bundled it around this idea of an episode of care, which is that project, and that’s really the insight that’s been very helpful for us to organize how care gets delivered and really differentiate from the market too.

"Because this isn’t just an urgent care app that you can connect to to talk to the doctor. This is managing conditions over time with multiple team members, and that required new technology.”

Parkinson put it more colorfully.

“Imagine a doctor trying to manage a constantly active Slack channel,” he said. “And if they’re trying to do that in their EHR, it’s a losing battle. Granted, video and things like that, but the vast majority of what folks are talking about, if it’s not video, it’s just old-fashioned, unstructured email and traditional patient portal, which is also a nightmare. It’s kind of like managing a panel of 2,000 people with very basic 2003 Gmail.”

Rethinking care as akin to project management turns a lot of preconceived assumptions on their heads, Shreeve said. It creates efficiencies by greatly reducing time spent making, keeping and breaking appointments.

It allows doctors to more naturally diagnose symptoms that might take time to play out. And it changes the needs of physical facilities, which can now focus entirely on those services that can’t be handled online.

“It’s not just technology[ it’s a care model that’s enabled by that technology,” Shreeve said. “It’s a care team that is in communication with the member and each other because of the technology, and we can produce outcomes and be accountable because of the technology.

"So I think that’s really unique and differentiated, that relationship-based care, technology-enabled care teams and the outcomes that we stand accountable for.”

Future moves at Crossover

According to Parkinson, Sherpaa patients were offered the opportunity to sign up for Crossover Health, even though the company normally works only through payers and self-insured employers.

Shreeve confirmed that this is something the company – which just raised $168 million to support its growth – has in the works for the future.

“At some point, we’d like to go back and offer really a solution to anyone off the street, a retail solution,” he said.

“Right now, we service employers and payers who bring large populations. But once you’ve set up that infrastructure, your ability to offer that to anyone is really there. And I think one of the things we did with Jay’s help is get to where we had 50 licenses in all states, and we were able to really take that to scale.”