After years of telehealth investment and validation, 2020 finally saw the future of telehealth come to fruition. Across the board big telehealth companies reported a rapid adoption of the technology and financial numbers to go with it.

Amwell specifically went through a metamorphosis this year, not only seeing new market growth, but also taking the company to the public market through an IPO. MobiHealthNews sat down with Amwell CEO Dr. Roy Schoenberg to discuss 2020 and what’s in store for next year as we move into a more digital world.

Schoenberg said that telehealth use in 2020 was more than just a quick fix. It changed mindsets about the tech for the future.

“I’m old enough to be part of the class of the beginning of telehealth. It was really tough to explain and convince people – particularly at the medical boards – that telehealth was a safe way of delivering medicine.

“That generation of the holy wars of telehealth went on for a good number of years. Then there was the next generation that was all about, 'Well, maybe it can be an alternative for physical healthcare in a world where people don’t have access, whether that be urgent care or whatever it is.' We are now, literally within a couple of months, skipped maybe two generations forwards, where the thinking is no longer about what kind of inferior simple medicine can be done with telehealth. …

"People realized you can do a lot of very good healthcare that is almost equal or as good as people had in person for, especially for chronic patients. Now the conversation is all about, 'Let’s reinvent the balance between using physical and digital by using telehealth as a systematic change that will be with us for a long, long time.'”

Inevitably patients will return to retail clinics and urgent care centers, said Schoenberg. He predicts that in the future telehealth will be used more in chronic care management.

“The truth is the vast majority of telehealth we have seen at Amwell hasn’t really been about urgent care. It’s more about clinicians and patients learning how to use this technology as part of their existing relationship for managing diabetes and heart failure, especially patients who are elderly or frail, or have trouble leaving their beds,” he said.

“That reality is not going to change after [COVID-19], and this kind of re-envisioning of chronic patient management and longitudinal relationships can be had in telehealth. That train has left the station and is never coming back.”

As for the future of Amwell, Schoenberg said that going public is allowing the company to mature and develop new types of technologies that can meet the growing demand, especially for fragile populations like the elderly, who may be housebound.

“The other thing I would say about being a public company is it does force you in many ways to create more of an understanding and verification of all of the pieces of the puzzle – not only the technology you develop, and think, 'How cool is this going to be?,' but it forces [on] you more rigorous governance on how technology is going to be there, how the clients' markets are responding to the technology, much more of a collaborative effort in what the payers are going to do, what regulations are going to do, and what the delivery side is going to do that is actually a great, great evolution from a cultural standpoint. It puts us in a better position to deliver value.”

In 2020 we saw a lot of M&A activity from big telehealth companies. Notably Amwell’s rival Teladoc acquired chronic care management company Livongo for a whopping $18.5 billion. Since then, digital health newsletter Exits and Outcomes published a report that Amwell was in talks with chronic care company Omada to make a similar deal. The deal has never been confirmed with the company, and when MobiHealthNews reached out about the talks in November, a spokesperson replied that the company does not respond to rumors.

While Schoenberg was tight lipped about any specific M&As in the future, he said he could see the digital health industry benefiting from acquisitions and partnerships to fill different needs.

“Obviously, as a public company I can’t say what you can expect from Amwell,” he said. “One thing I will say from a market standpoint is that exactly because of the things we just talked about – the new understanding of what telehealth can do – the opportunities for companies and innovation come together to create 'one plus one equals three' has never been larger.

“When we think about 'How are we going to manage elder patients in their home?' It’s one thing to bring telehealth into their home. You know you have devices they are comfortable with. Remote patient monitoring, sensors [and] behavioral health support the balance between digital services and services that are available in their communities, like visiting nurses and so on.

"How do you bring all of these to create a way of enveloping patients at home so they can safely stay there, be comfortable, their clinicians feel comfortable, their families feel comfortable? This requires a village. It’s more than one company, and that’s where the opportunity for a lot of M&A and partnerships comes in.”

Looking ahead to 2021, what is Schoenberg looking forward to the most?

It’s been so many years where so much of the effort of running a telehealth company was about convincing people of the plausibility and the safety of telehealth,” he said.

“I think the experience of walking into 2021, where you don’t have to do that anymore. That’s gone. Now it’s really more about everyone being united in how fast, how broad, how much more expansive can telehealth be to help the healthcare system do a better job than it does today.”