How the telehealth trend is revolutionizing medical care as we know it
From backing an app that connects Black women to caregivers of color to developing a digital platform that supports surgical recovery, Johnson & Johnson is helping drive the surge of innovation in telemedicine.
Before the pandemic, having a video appointment with your doctor was virtually unheard of. But in the last year and a half, the rapid adoption of telehealth has helped many people get the medical treatment they need from wherever they are.
According to data from the U.S. Centers for Disease Control and Prevention, 95% of health centers in the United States offered telehealth options during the pandemic, compared to just 43% in 2019.
True, managing your health digitally isn’t an entirely new concept, says Manoj Raghunandanan, President, Global Self Care and the Consumer Experience Organization at Johnson & Johnson Consumer Health—think the Apple Watch, among many other recent innovations. “We were already living in a world in which technology and healthcare were colliding, creating patients who are more empowered and educated,” he explains. “But in 2020, our access to everything was suddenly all based on technology.”
While the pandemic hastened the adoption of telehealth, also known as telemedicine, out of necessity, experts predict that virtual and digital healthcare services represent the future of healthcare.
“Think about what else is available virtually or on demand. We can call for a car through apps, we can have groceries delivered to our door, we can watch movies from anywhere,” says Stacy Feld, Head, Johnson & Johnson Innovation, West North America, Australia and New Zealand. “Technology is enabling businesses to be established in this way, and that includes healthcare businesses. Now we just have to focus on better integration of telehealth across the patient journey.”
As the world’s largest and most broadly based healthcare company, Johnson & Johnson is poised to help deliver on that much-needed integration, through investments in everything from innovative software that allows surgeons to monitor patients remotely to entrepreneurs and companies that are focused on leveraging telemedicine to help close health equity gaps.
“At Johnson & Johnson, we have over 130 years of healthcare knowledge, but we also have an incredible ability to be agile,” Raghunandanan says. “We know the telehealth boom is here to stay, and we have the influence and responsibility to ensure that patients are put first.”
From diagnosis to disease management
Together with Johnson & Johnson Innovation’s corporate venture arm, JJDC, Feld invests in and partners with dozens of startups each year. One particular area of focus for her is discovering and nurturing telehealth innovations that go beyond simply substituting a virtual house call for an in-office visit.
“Early iterations of telemedicine focused on diagnosing or treating acute conditions, such as a rash, through a virtual consultation,” she explains. “Now we’re seeing the next wave, which is about finding new ways to approach long-term management of chronic diseases that require more personalized care.”That’s why Feld’s team is working with several companies that approach telehealth across the continuum of care—from remote diagnosis to virtual provider visits to online pharmacies and delivery of subscription services for healthcare products. “It’s a category that we see as an end-to-end journey, inclusive of a digital platform that can allow a provider to maintain a relationship with a patient or a consumer,” she says.
Cue Health is more like a digitally connected health monitoring system, which starts with a rapid at-home diagnostic test that links into a telemedicine provider who can then write a prescription based on the test result.
Take Cue Health, a rapid point-of-care diagnostics company originally focused on influenza that JJDC first backed in 2018. In early 2020, the U.S. government awarded the company $13.7 million to pivot their focus and produce a rapid diagnostic test for SARS-CoV-2, the virus that causes COVID-19. Johnson & Johnson’s infectious diseases and vaccines team helped the company navigate U.S. Food and Drug Administration (FDA) protocols and study execution, and in March 2021, Cue Health received Emergency Use Authorization from the FDA for its molecular diagnostic test for COVID-19, which can now be purchased over the counter and used at home.
“Since 2019, we’ve also been evaluating whether their technology could be used to empower consumers to self-diagnose and access healthcare options,” Feld adds. As a result, today Cue Health is “more like a digitally connected health monitoring system,” which starts with a rapid at-home diagnostic test that links into a telemedicine provider who can then write a prescription based on the test result. In May 2021, the company announced it had closed $235 million in financing to further accelerate its evolution into a digital-first, consumer-centered company.
In 2020, JJDC also made an investment in Thirty Madison, a telehealth company that provides a similar end-to-end experience for patients suffering from chronic conditions. Co-founder and CEO Steven Gutentag was diagnosed with a chronic condition as a teenager and has experienced his share of frustration at how difficult it can be to access the right treatments and quality care.
Through Thirty Madison’s brands—Cove, a service for migraine patients; Evens, which helps people with gastrointestinal conditions; Keeps, which is focused on men’s hair loss; and its newest brand, Picnic, aimed at treating allergies—customers can access individualized care via virtual visits with specialists, plus a wide range of therapeutic treatments, tools and educational content.
“My partner, Demetri Karagas, and I believed that if we could help patients navigate specific chronic conditions—from diagnosis to treatment to ongoing disease management—we could improve their ability to access the right care and drive superior health outcomes,” says Gutentag. And there’s evidence that they’re succeeding. In the last year, Keeps patients have reported a 92% medication adherence rate, while 77% of Cove’s patients reported an improvement in migraine severity.
The platform also aims to help close gaps in access to specialist care.
Almost half of Cove’s patient population, for example, lives in a county with no headache specialists, and most Thirty Madison users overall live outside of major cities. “For many people, this is the only option outside of going to the emergency room,” Gutentag notes.
After raising $140 million in additional funding in 2021, Gutentag says that Thirty Madison intends to continue launching additional brands with a focus on conditions where the company can improve experiences and outcomes for large numbers of patients.
“In 2020, our business tripled,” he says. “While so much of the world was put on hold, we knew our patients depended on us so we were determined to provide high-quality healthcare, especially during such a stressful time. And we plan to continue on our trajectory of growth to treat as many patients as possible.”
Digitizing the surgical experience to enhance patient care
Over the past 50 years, there have been hundreds of advances in surgery, from laparoscopic techniques to robotic-assisted procedures. The next frontier for surgeons: digital solutions that go beyond a virtual doctor’s visit to combine the power of data and artificial intelligence to help improve patient experiences and outcomes.
“What we care about as a company is reaching the greatest number of patients, making sure they have access to high-quality care and the best interventions to deliver the right kind of outcomes,” says Ashley McEvoy, Executive Vice President and Worldwide Chairman, Medical Devices, Johnson & Johnson. “Digital technologies and data insights allow us to do all of that—at scale.”
Enter VELYS™ Insights, a new integrated clinical support solution developed by McEvoy’s team at DePuy Synthes to help coordinate care and guide patients who are receiving total knee, hip and shoulder replacements. VELYS Insights, which helped address the rapidly changing surgical dynamics during the COVID-19 pandemic, allows surgical teams to stay connected with their patients remotely, using patient-specific data to make decisions that support care before, during and after surgery.
This platform is meant to pull patients, surgeons and care teams closer together along the journey, from pre-op to post-op. Digital applications can help enable a good outcome before patients are in the OR, and they can help improve the post-op experience, so patients don’t feel like they’re all alone.
VELYS Insights helps in two ways: through care coordination, which enables real-time coordination between the doctor’s office and the operating room (OR) team to help improve how surgery is managed in the most efficient way possible, and through patient path management, which helps care teams educate, support and communicate using the VELYS Patient Path mobile app during their knee, hip or shoulder replacement journey.
Through the app, which is compatible with activity trackers, including FitBit and Apple’s Health app, patients can receive personalized action plans and reminders; access education materials, including daily exercises to perform; communicate directly with care teams about issues ranging from pain levels to how an incision is healing; and monitor their progress.
The eventual goal is to connect all of the company’s digital solutions, says McEvoy, so that data from VELYS Insights can be integrated with data from devices like the VELYS™ Robotic-Assisted Solution, which is designed to help surgeons plan and perform total knee replacements.
“This platform is meant to pull patients, surgeons and care teams closer together at points along the journey, from pre-op to post-op,” McEvoy explains. “Digital applications can help enable a good outcome even before patients are in the OR, and they can help improve the post-op experience, so patients don’t feel like they’re all alone.”
Supporting technologies that tackle healthcare inequities
In November 2020, Johnson & Johnson launched Our Race to Health Equity: a five-year, $100 million investment in solutions for better healthcare access for people of color in the U.S.
Johnson & Johnson Impact Ventures (JJIV) is at the forefront of that work. “In addition to supporting impact-driven start-ups, we aim to address the ways that technology can unintentionally exacerbate inequities,” says Alice Lin Fabiano, Global Director, Social Innovation and Investment, Johnson & Johnson. “We need to invest in building technology specifically for people who are the most vulnerable—people who are often the hardest to reach.”
Lin Fabiano, a first-generation immigrant, knows this firsthand, having grown up helping her family navigate a healthcare system that largely “did not consider or respect differences in language, culture or beliefs.”
Promoting cultural competency in healthcare is critical to removing some of the hurdles to equitable healthcare. It can also help save lives.
In the U.S., you imagine we have the best care in the world, but it doesn’t always feel that way and it can result in really different experiences and outcomes based on the color of your skin. At Johnson & Johnson, we’re trying to change that.
Take, for example, this fact: The U.S. has the highest rate of maternal mortality in the developed world, a dismal ranking that is largely driven by persistent racial disparities in pregnancy- and childbirth-related deaths. Black women are three times more likely to die from pregnancy-related issues than white women.
Georgia has one of the highest maternal mortality rates among all states. The Johnson & Johnson Health of Women team, together with the Office of the Chief Medical Officer, is collaborating on two telehealth pilots with Georgia-based universities, healthcare leaders and community organizations to help improve pregnancies and health outcomes for Black mothers.
“That the U.S. maternal mortality rates are this high shows that the current system of care is not working,” says Joy Marini, Senior Director of Maternal Health, Office of the Chief Medical Officer, Johnson & Johnson. “We are developing or testing two technology-enabled seamless care experiences for women in Georgia with the goals of reducing Black maternal mortality and improving the pregnancy experience.”
Through a partnership with Emory Decatur Hospital, expectant parents are participating in a pilot in which they receive access to local providers of color through BabyLiveAdvice, a telehealth service that connects pregnant women to nurses, health educators and doulas in real time and provides virtual baby classes and support groups.
A second initiative by the Health of Women team is developing and testing a new app created by a team of Black female scientists and innovators. “More than 50% of deaths from complications related to pregnancy occur in the postpartum period,” Marini says. “The app aims to reduce morbidity and mortality by helping new mothers take charge of their own postpartum care through access to videos, podcasts and support groups. Healthcare providers are notified about any postpartum-related complications.”
Johnson & Johnson is collaborating on research protocols on the two tech platforms to design a three-pronged trial that includes measurement of health outcomes, racial equity outcomes and measures of health economics. Both clinical studies will begin in late 2021 and together will reach more than 1,000 pregnant women.
“In Georgia, 37% of counties are maternity-care deserts, which means that they have no obstetric providers or services,” Marini says. “These technology platforms will provide access and support for rural and at-risk women, provide respectful and equitable care and empower women with a better understanding of risks and self-care during pregnancy and after having a baby.”
On a national level, JJIV recently supported Health in Her Hue, a digital platform that helps Black women across the country find culturally competent doctors and healthcare practitioners and build community with one another.
Studies have shown that patients benefit from having doctors who look like them, but the healthcare workforce does not always reflect the diversity of the community that it serves.
“One of our affiliated providers recently told us that a patient drove three hours to get to an appointment,” says Health in Her Hue founder Ashlee Wisdom. “She was looking for a Black female gastroenterologist because her current doctor wasn’t taking her concerns seriously. But why should a woman have to drive three hours to find a provider who will take her concerns seriously?”
In 2020, Health in Her Hue was the overall winner of a new accelerator program in partnership with JJIV and Village Capital, which aims to support tech-enabled startups focused on providing culturally competent care to Black, Indigenous and People of Color (BIPOC), low-income or other underserved communities through grant funding, mentorship and networking opportunities. Many of the innovators taking part in the program are people of color who are bringing their own lived experiences to their work, which Lin Fabiano says is key, given that white male founders receive 57% of all investor funding.
“In the U.S., you imagine we have the best care in the world, but it doesn’t always feel that way and it can result in really different experiences and outcomes based on the color of your skin,” Lin Fabiano says. “On cultural, economic and logistical levels, our social systems make access to quality healthcare harder for people of color. At Johnson & Johnson, we’re trying to change that.”