In the wake of the covid-19 pandemic, virtual healthcare startups have flooded the US market. These companies promise consumers easy, speedy healthcare without the hassles of office visits. But such convenience comes with a price 鈥� namely an increased risk of misdiagnoses, overprescribing and privacy concerns.
Telehealth, or the ability to meet with doctors virtually, has existed for decades. But it wasn鈥檛 until the covid-19 pandemic that it hit the mainstream. Between March and October 2020, the number of telehealth services delivered in the US increased by compared with the same period the year prior. This was partly due to people seeking an alternative to in-person doctor appointments and partially because the government, in an effort to slow the spread of coronavirus, eased restrictions on the need for face-to-face consultations to obtain certain prescription medications.
As demand for telehealth ballooned and regulations loosened, companies such as Hims & Hers, Ro and Cerebral rushed to fill the gap. Unlike telehealth services offered by a doctor鈥檚 office, these direct-to-consumer start-ups typically act as middlemen, connecting people with doctors or therapists who work as contractors. They also advertise to consumers on social media and streaming platforms, using language that promises convenient solutions 鈥� primarily prescription drugs 鈥� for ailments such as erectile dysfunction, hair loss and depression.
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With just a few clicks, someone who signs up with one of these companies fills out a simple health questionnaire before scheduling an online appointment 鈥� via live video, for instance 鈥� with a licensed healthcare professional. These doctors can, and often do, prescribe medications, which are delivered directly to people鈥檚 doors, all without seeing them in-person.
This convenience certainly carries advantages. It increases treatment accessibility, especially in rural areas and for people without health insurance. For example, Betterhelp, a telehealth startup that offers virtual therapy, costs between per week. By comparison, most in-person therapists charge between and per session.
But direct-to-consumer telehealth can be disadvantageous for consumers too, particularly when it comes to privacy. Last year, a joint investigation into 50 direct-to-consumer telemedicine companies in the US by news websites Stat and The Markup found that .
While many of the telemedicine startups claim to have resolved these problems or are working to do so, the findings highlight a troubling issue: telemedicine isn鈥檛 always subject to formal regulation. In the US, the Health Insurance Portability and Accountability Act (HIPAA) protects people鈥檚 sensitive health information. Since telehealth startups merely connect consumers with providers, they aren鈥檛 necessarily regulated by such laws, as . This means some of the information provided by the consumer to the startup may not be protected 鈥� including their browsing history and potentially even the health assessment they initially complete.
Then there are privacy concerns around the settings in which patients and providers take appointments, says at the University of Alabama at Birmingham. She and her colleagues published a in the US. Six of the studies highlighted that a patient鈥檚 privacy is at risk during a telemedicine appointment if, for example, the patient or the healthcare provider takes the appointment where friends or family can overhear.
Furthermore, without physical exams, telemedicine cannot comprehensively assess people. 鈥淭he doctor is missing out on important information from an in-office visit 鈥� how is the patient walking? What is their pupil size? Do they smell of smoke or alcohol?鈥� says at Western Michigan University.
This is a problem with all telemedicine, but the rapid rise of direct-to-consumer companies has sometimes led to consumers being prescribed unnecessary medications. For instance, last year, the US Drug Enforcement Administration found that Truepill, a pharmacy for telemedicine start-ups including Cerebral, was . Cerebral no longer offers to provide consumers with controlled substances.
There is no doubt that telehealth plays a critical role in healthcare given its advantages. But, when startups are at the helm, prioritising profits and convenience can come at the expense of safe, quality care.
