How Telemedicine Can Tackle Inequality

Hampleton’s last Healthtech market report (which can be read here) noted how the lockdown era turned telemedicine from a niche vertical into one of the most societally significant and sought-after tech sectors. 

With remote consultations abruptly becoming the norm in 2020, investor and acquirer interest in telemedicine companies soared. It in turn led to speculation about whether this would be a flash in the pan development, or a permanent shift in how patients and clinicians interact.

Evidence suggests that we have indeed witnessed a fundamental transformation. An in-depth survey by McKinsey last year found that 40% of consumers said they would continue to use telemedicine services going forwards. Another recent review found that one third of millennials and 41% of Generation Z favour interacting with doctors online rather than in person. And, according to a new report by Meticulous Research, the global telemedicine market is expected to hit almost $540 billion by 2029. 

As Robbie Schwietzer of VC firm Khosla Ventures has put it, ‘This high utilization has proved the value of safe, high-quality, accessible, equitable and affordable care provided through telehealth.’ 

A standout word there is ‘equitable’, because – having allowed patients to receive care in a safe way during a once-a-century pandemic – telemedicine is also proving to be a critical tool for alleviating inequities in healthcare.

Here are some of the ways that startups in the telemedicine industry are addressing longstanding issues around the globe.

Access to care for rural and isolated communities has long been a challenge for the world’s health services. It’s a problem that blights even highly developed countries like the United States. As the CDC reports, rural Americans suffer poorer health outcomes due to a number of factors, including higher rates of smoking and obesity, and what tech entrepreneur Dr Jennifer Schneider has described as a ‘crisis of access’ when it comes to healthcare.

Earlier this year, Dr Schneider’s startup Homeward announced $20 million in Series A funding. Its aim is to correct the healthcare issues impacting rural communities by providing online consultations and, if necessary, in-person treatments. It places a particular emphasis on linking patients with specialists as well as general practitioners, since, as Dr Schneider has said, ‘Specialty care is eight times less frequent in rural settings than in urban areas and now a lot of it can be provided virtually.’

Telemedicine is also making a real difference across the African continent, where so many countries suffer from a worryingly low patient-to-doctor ratio. Ugandan startup Rocket Health, which provides virtual consultations and drug delivery, raised $5 million in Series A this year, and its co-founder Davis Musinguzi is determined to leverage tech to cover the healthcare shortfalls in Uganda and beyond. ‘There’s no way we’re going to build enough hospitals to be able to reach everybody with the healthcare that they need,’ he said. ‘I think telemedicine really helps breach the gap of availability.’

Greater awareness of trans and non-binary identities has led to surging numbers of people seeking specialist services to allow them to manage gender dysphoria and/or undergo gender reassignment surgery. This unprecedented demand has caused a bottleneck effect in many healthcare systems. To take the UK as an example, 2021 saw a 47% year-on-year rise in the number of people waiting for their first appointment at a gender dysphoria clinic.

Delays in receiving help can force many people to put their transitions on hold, and exacerbate anxiety, depression and even suicidal thoughts. The good news is that telemedicine can provide vital, even potentially life-saving, support for the many patients who are left languishing. An example startup is Plume, which recently landed $24 million in Series B. 

The Denver-based company provides online gender-affirming care, including remote consultations with clinicians, access to virtual support groups led by trans and non-binary facilitators, and access to a care team through the app. Prescriptions and process monitoring are also part of the Plume service. Plume’s co-founder Dr Jerrica Kirkley believes this platform can help patients in both urban and rural areas, as mainstream services struggle to deal with demand.

Telemedicine is increasingly helping patients who are dealing with concerns of a sensitive nature, relating to reproductive health. Virtual consultation platforms can allow people overcome barriers – both geographical and social – to get help for conditions that may carry a perceived stigma, or which require the attention of specialists.

A prime example of a startup that’s boldly tackling a particular area of concern is Allara. The New York-based tech firm bills itself as providing an ‘all-in-one virtual care team for polycystic ovary syndrome’ – the latter being a condition that affects one in 10 women of childbearing age and can cause infertility, irregular periods, diabetes, and excessive hair growth. 

Raising $2.5 million in a seed round last year, the platform pairs patients with PCOS specialists who provide one-to-one support through video calls and messaging. Patients can also interact with a community of other people with PCOS, which can be an empowering part of the treatment plan for a condition that, as Allara advisor Dr Heather Huddleston puts it, ‘falls through the cracks in terms of medical specialities.’

Another femtech startup that’s been on our radar – and was indeed namechecked in our 1H2022 Healthtech report – is Wisp. The target of a $41.3 million majority interest purchase by WELL Health Technologies in 2021, the Californian startup discreetly delivers everything from birth control pills to treatments for UTIs and other intimate health conditions. Online or phone-based consultations with doctors and pharmacists allow Wisp users to get the most appropriate prescriptions in privacy and comfort. The site sums it up wittily: ‘Wisp helps you treat your privates, privately.’

While telemedicine must yet overcome key challenges – such as digital illiteracy being a barrier to usage for many potential patients – it’s clear that such startups are playing a crucial role in improving healthcare outcomes for all kinds of people, all over the world. It will be fascinating to see how inequities will continue to be tackled head-on by visionary founders in the months and years to come.