COMMERCIALIZING eCONSULTS: THE TRUE PROMISE OF ACCESS

COMMERCIALIZING eCONSULTS: THE TRUE PROMISE OF ACCESS

The commercialization of eConsults brings the innovation from academic medical centers to communities across the country, ultimately transforming how patients can access their healthcare. 

We built a company around an interaction that already exists…freely…free of charge. And we hypothesized that by charging people for it, that more, not less, people would engage in it. I’ll admit, this seems to fly in the face of reason.

It’s far from uncommon for new ventures to charge for services once delivered as free. In fact, if the service already happens informally, the mountain to climb in order to change user behavior becomes slightly smaller. In the most overused examples from the “gig” economy, we all gave a friend a ride before Uber or Lyft allowed us to request one with the tap of a button and we let friends and family stay with us before AirBnB (in my case often overstaying my welcome). The challenge in building this more broadly is two-fold 1) building an efficient marketplace and 2) engendering the same trust that exists among family and friends, between strangers. 

In the same vein, the essence of eConsults - joint dialogue with a specialist over a patient case, is a fundamental tenant of the practice of medicine. Physicians in academic settings are frequently “curb-siding” their colleagues, so we claim no credit for the eConsult interaction. Quite the contrary! We tell our investors what we have built isn’t a clinical innovation. And while we think our algorithms are pretty impressive, it isn’t a technical innovation either. What we have built is a business model innovation. By adding efficiency and engendering trust among strangers we’ve been able to build a sustainable business model around an interaction previously conducted informally. Of course in commercializing eConsults, we did have structural tailwinds that are very different from the traditional gig economy: 1) medicine is a collegial and collaborative profession by nature and 2) clinicians are bound together by an oath to put patient care first.

“WE BELIEVE THE OUTGROWTH OF ECONSULTS FROM THE ACADEMIC NETWORK SETTING INTO THE BROADER COMMUNITY REPRESENTS THE MOST CRUCIAL INNOVATION IN ACCESS TO CARE IN OUR GENERATION.”

The power of a sustainable business model isn’t in the monetization of eConsults, The true power is in the ability to unlock an interaction previously trapped inside the academic health networks, and make it commercially available to communities all over the country. The implications for enhanced access are incredible.

Certainly the future of commercializing eConsults is not without its challenges. Successful models are still constrained by the growth in value-based care. And while eConsults are a natural part of the practice of medicine, they must now fit with the litany of other digital tools used by clinicians, not the least of which is the much maligned EHR.

Regardless of these considerations, we believe the outgrowth of eConsults from the academic network setting into the broader community represents the most crucial innovation in access to care in our generation. The future is bright.

Gil Addo is the CEO and Co-founder of RubiconMD. 

Gil drives RubiconMD's vision and strategy. He has seen firsthand the pain in getting a loved one to right specialist and believes there is a better way. Read more