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Many startup companies in healthcare are entrepreneurial or innovative, but true "disruptors" in the field are harder to come by. These are the companies that are actually shaking the pillars of an established system. 番茄社区app Editor-in-Chief Marty Makary, MD, MPH, of Johns Hopkins University in Baltimore, selected several companies that fit the profile of a real disruptor; we're profiling them in an ongoing series.

Telehealth has become so ubiquitous in the SARS-CoV-2 pandemic that it might not feel disruptive now months into widespread use. But one company's inpatient-to-primary care scope is unique, offering virtual care solutions at every step of the care pathway for patients and physicians: .

The company already accounted for a large share of telemedicine visits in the pre-pandemic world and grew with the stay-at-home orders. Televisits rose , and the company has projected compared with last year overall with some permanent uptick likely even after the pandemic ends.

"We have been providing a record number of visits across the spectrum of care from routine to complex care," said Lewis Levy, MD, the company's chief medical officer.

"We feel very much as though the horse is out of the barn, the genie is out of the bottle, and that the pandemic has changed both how consumers expect to get care as well as how physicians expect to deliver care," he added.

Right now, the rules have been relaxed for telehealth visits -- allowing them on open services such as Zoom -- but a dedicated platform like Teladoc's still holds advantages for physicians, Levy said.

"There have been many moves both at the state and federal level to try to get virtual care enabled as quickly as possible, everything from allowing providers to deliver care on platforms that are not HIPAA secure to regulatory changes that are enabling physicians to care for individuals with a relaxation of some state licensure regulations," he said.

"We do believe that going forward it is going to be most important that care is delivered through a HIPAA-secure platform and our technology was purposefully built to deliver telehealth care," he said, pointing to its number-one ranking among direct-to-consumer telehealth providers in the J.D. Power 2019 U.S. Telehealth Satisfaction Study.

But what's unique compared with the number of telehealth platforms that have sprung up in recent years, he added, is that it is "really the first and only end-to-end partner in virtual healthcare."

Early in July, the company acquired InTouch Health, which gave it the hardware and software tools to in complex medical environments virtually. Now the company has reach across home care, outpatient, and inpatient settings -- from chronic care management to acute visits and even neonatal and adult ICU, telestroke, and remote surgery.

One example of how this helps physicians is the long-standing relationship Teladoc and InTouch have had with , serving eastern Pennsylvania and New Jersey.

"In March, when COVID was beginning to really pick up on the East Coast, [leadership in those facilities] was foreseeing the need for virtual care to protect their own physicians," Levy said. In the subsequent months, Jefferson relied on Teladoc to connect the system's ambulatory care physicians to their patients and to make connections among its physicians, similar to hub-and-spoke stroke care.

"We are the single integrated partner for all of their virtual care needs, both inside and outside the four walls of the healthcare system," Levy said. "Their utilization increased threefold during COVID and they are going to continue to expand the use case and rely on virtual care as part of their strategic planning."

The pandemic has driven reconsideration of whether the right care at the right time in the right place really means that patients need to sit in a waiting room to see a physician in person. "In COVID times, increasingly the answer is no," Levy said. Teladoc is running a pilot with its own employees for virtual primary care of chronic conditions.

For patients, this kind of care can be transformative, too.

They can reach out for in-depth assessments of their case when, for example, considering third-line chemotherapy, entering a clinical trial, or joint replacement. "We have a physician team to thoroughly do an intake with the member," Levy said, from gathering all the imaging to repeating pathology. These in-depth virtual consultations change the diagnosis 40% of the time and the treatment in over 60% of cases, he said. Then the service navigates patients to providers in their geographic region for recommended procedures.

"We do find increasingly that virtual care can be the solution for your more minor acute medical situations as well as these more serious medical conditions," Levy said.

Other stories in the Disruptors series:

Healthcare Disruptors: What's Really in Your Meds?

Healthcare Disruptors: Bringing $0 Copays to Self-Insured Plans

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