COVID-19 accelerated the adoption of telehealth services. But what does the future hold? RISE West will explore innovative approaches to telehealth efforts during a panel discussion on Wednesday, Sept. 1, the first day of the main conference. We talked to Andy Ellner, M.D., one of the panelists ahead of the hybrid event, about Firefly Health, a virtual primary care practice established in 2016.

While many providers had to quickly pivot and embrace telehealth when COVID-19 prevented most in-person encounters, it was business as usual for Andy Ellner, M.D., and the virtual care team at Firefly Health.

Firefly Health, which Ellner cofounded in 2016, is a virtual primary care service based in Watertown, Mass. that provides members with a designated care team who offer continuous, evidence-based virtual coaching and support. The virtual team includes a physician, nurse practitioner, a health guide or coach, and a licensed therapist who are accessible 24/7. Their mission: to deliver health care at half the price but that is twice as good clinically and emotionally.

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How it works: Members download the Firefly app for free and can text with the team, make same-day appointments, set up regular video or chat check-ins, and obtain the help they need to meet their health goals. The technology platform helps support the team so they can respond within minutes to members who have issues or questions related to their health. If needed, the team can connect members to specialists virtually and coordinate their care to provide the fastest path to get an accurate diagnosis and appropriate treatment plan.

“That ongoing relationship affords us the opportunity to really be helpful and connected when someone gets really sick and that’s where cost in traditional models of care starts to accrue because people bounce around to different specialists, hospitals, and emergency rooms. We are able to stay connected to folks and pull specialists in when needed to ensure care is coordinated and everything is followed up on,” said Ellner, who will be a panelist at RISE West’s track session on current and future telehealth efforts.

Firefly’s results have been significant. “Right now, we are seeing in the range of 20 to 30 percent lower total expenditure on health care in the members we serve,” said Ellner. Members are also extremely satisfied. The organization boasts an average net promoter score in the 80s, a figure that surpasses Apple and Netflix. Most health care clinics and health plans’ net promoter scores are “in the zeros or 10s,” he said. In addition, the chronic condition outcomes of members with hypertension and diabetes being under control is about 20 percentage points higher than the commercial average, according to Ellner.

“Across a number of industries, we are seeing much better experience, much better outcomes, and significantly lower cost. It’s time for that type of innovation to quickly diffuse across health care. Ultimately [at Firefly] our goal is to get to half-priced care so we get to 50 percent of total costs but that is going to take some time,” he said.

 RISE West 2021 - August 30 - September 2 - Live in Colorado Springs and Streaming Online

During the first weeks of the COVID-19 pandemic, Ellner said the practice saw a huge surge in members who were experiencing anxiety, depression, and stress. But unlike a traditional primary care model where mental health services are fragmented, Firefly was able to meet those behavioral health challenges right away in an integrated and ongoing basis and help members cope, and in some cases thrive, during the epidemic.

In addition, the organization developed a service to employers to ensure employees could return to work safely when they wanted to reopen their office. Ellner said they served a few thousand people and there was no case of someone contracting COVID in the work environment. “This service and connection provides a lot of opportunity to support people in their day-to-day lives to keep them and others healthy. There is enormous opportunity, and we are just starting to scratch the surface,” he said.

As for the future of telehealth, Ellner said that COVID-19 accelerated people’s readiness to seek and deliver health care outside the walls of a physician’s office. But it will take more than adding a virtual feature to traditional models to drive necessary change, he said. Ellner believes it’s essential that the industry move to use a virtual platform to fundamentally change the structure of how we deliver services to dramatically reduce the cost of health care, improve the quality of care, and expand accessibility of services.

“We’ve had a several decades-long crises in this country around health care cost and access, and it keeps getting more and more acute, and that’s why I think virtual or digital approaches are so important right now. It’s less about taking a broken system and adding a digital layer. It’s about building a much better system that is much more accessible, lower cost, and higher quality,” he said. 

Ellner believes the future of health care is in primary care-driven models that have a holistic, integrated approach. “I’d really encourage investment in approaches built around primary care and serving patients and families in their communities, rather than a large hospital-dominated systems. I think that’s where the future is and investing in types of infrastructure such as payment models that support this kind of innovation is going to be critical for plans that want to stay on the cutting edge.”

RISE West 2021 will take place live in Colorado Springs and virtually via livestream August 30-September 2. To learn more, here are the links to the full agenda, list of speakers, and registration information.