With the administration signing the Consolidated Appropriations Act on February 3, 2026, extending Medicare telehealth flexibilities through December 2027, and patient demand driving unprecedented adoption, virtual care has moved from emergency response to fundamental transformation of clinical practice. Dr. Brandon Welch, founder and CEO of doxy.me, a platform facilitating 8 billion+ minutes of care across 1 million providers in 176 countries, examines how the proliferation of telehealth is reshaping medicine itself: clinical workflows, patient-provider relationships, access equity, and sustainable practice models. Drawing from his book Telehealth Success, Brandon delivers actionable strategies for healthcare leaders navigating the five pillars determining telehealth ROI: patient engagement, clinician efficiency, technology scalability, financial viability, and regulatory compliance in an era where patients expect care everywhere.
Brandon Welch, MS, PhD, Executive Director, Telehealth.org, Founder & CEO of Doxy.me
Megan Antonelli, Chief Executive Officer, HealthIMPACT
00:00:00 Intro: Welcome to Digital Health Talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Janae Sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
00:00:29 Megan Antonelli: Hi everyone, welcome to Digital Health Talks. This is Megan Antonelli and I'm excited to be here today with doctor Brandon Walsh. Telehealth is more than technology. It's about access, connection, quality care and sustainable practice. The proliferation of virtual care and patient demand for care everywhere is fundamentally transforming how medicine is practiced, not just where care is delivered. Healthcare stands at an inflection point where virtual care is reshaping clinical practice, expanding access, and redefining the patient provider relationship. The recent extension of Medicare telehealth flexibilities through December twenty twenty seven, including home based care, audio only capabilities and expanded provider participation, provides regulatory stability for this transformation already underway. Joining us today is Doctor Brandon Welch, founder and CEO of Doxy.me, which has facilitated over eight billion minutes of care across a million providers in one hundred and seventy six countries through Doxy.me acquisition of telehealth. And. And now excited to announce Health Impact Lives educational partner Brandon is addressing a critical gap healthcare leaders consistently raise, moving from technology adoption to effective utilization through clinician led, workflow aligned training that reduces burden, supports compliance, and improves care quality. He's an NIH funded associate professor at the Medical University of South Carolina and the author of Telehealth success. How to thrive in the new age of remote care. Hi, Brandon. Welcome to Digital Health Talks.
00:02:04 Brandon Welch: Hey, thank you so much. And slight correction. We've had twelve billion minutes of telehealth delivered.
00:02:09 Megan Antonelli: Oh, wow. Well, there you go. It's going fast. And you know, we always talk about and it was so great to meet you this week at Health Impact. And you know, having done this for so many years and talked about sort of the adoption of technology in healthcare, the speed at which adoption went happened during the pandemic is always, you know, sort of that, that silver lining, if you can find any. Um, you know, and that that speed of adoption, particularly of virtual health, um, I think is something that, you know, we continue to see and as the technology supports healthcare everywhere, it's kind of been an amazing thing to watch. But tell us a little bit about your journey and this, you know, I know you were a researcher working in, in biomedical informatics. Um, talk to us a little bit about your your founder's story.
00:02:57 Brandon Welch: Yeah. No. Um, my founder's story actually goes back to when I was a PhD student. So, um, I was a PhD student at the University of Utah in biomedical informatics, and, um, my my focus was actually around, uh, decision support for whole genome sequence information within the EHR. So as the doctors using the EHR, it automatically pulls, uh, whole genome sequence information with decision support and displays it to the patient, uh, in real time, the HR. That was my PhD thesis, and I have a master's degree in genetics. And so, um, that's that's kind of where I was focused. But one of the side projects I was working on was with some, um, obstetricians, and they were providing prenatal care to, uh, women in Utah and in Utah. They have a lot of kids, and a lot of people live far away from, you know, where the hospital is in Salt Lake City. Um, and a lot of them, they have other kids. And so it's like, we already know that they're low risk patients and they've already proven they can have kids. Do they really need to be coming, driving all the way in to have an in-person prenatal care visit? Um, especially when they've proven that they are low risk. And that was kind of the challenge that we were solving. And, um, I had previous experience working in telehealth for Genetic Counseling Company, where they did genetic counseling by telephone. And so I proposed, I said, why don't we do prenatal care by telehealth? Um, and especially to moms who've already delivered before and they're low risk. And they were very interested in that. And so, um, they said, okay, let's put together a study, prenatal care, telehealth study. Uh, and, Brandon, you're the technologist, so go figure out what telehealth technology to use. And so, uh, being young and dumb and naive, um, I was, uh, so sure I'll do it. And, you know, I knew that in order for this to work, pregnant moms had to work for pregnant moms. So in their homes, they're busy. They don't have a lot of, you know, time for tech because they got kids that are going to manage. And so I said, it's got to be as simple as FaceTime or Skype. And this is back in twenty thirteen. So Skype was still a thing. Um, and so we actually proposed that to do a prenatal care visits using FaceTime or Skype. Uh, and we went to propose this to the university. They said you can't use Skype or FaceTime. It's not HIPAA compliant. And that's where I was introduced. The whole concept of, you know, the HIPAA compliance for telehealth. And I said, okay, what are some HIPAA compliant telehealth solutions? And they said, well, and they pointed me over to these Polycom Cisco systems that cost thousands of dollars to set up and, uh, expensive and complicated to run. And I said, those are your options. And I said, there's no way we're going to be able to get a pregnant mom to set up one of these expensive Polycom systems in their home for one or two visits a month. It just doesn't make sense. Um, and so I went back to the drawing board and I went to Google and I typed in Simple and free. HIPAA compliant, simple and free telehealth solutions. Um. Expecting to find that and propose that. And I googled it and nothing came up. And I'm like it's twenty thirteen. How does simple and free telehealth software not exist online yet? Um, and so um, so it didn't exist. And I said, you know what? I'm familiar enough with the technology. Now, let me take, um, the new technology called WebRTC had just come out and said, let's build a simple telehealth solution that just is video only. It doesn't collect any data. We don't know who the patient is at all. It's just a connect the doctor to the patient by video. Click a link, nothing to download. And um, we put that together into a student business competition. We ended up winning an award. We use that money to build the first prototype. And then we wrote we gave that prototype to the, uh, study the clinicians, and they're like, oh my gosh, this is perfect. And so they use it for the study. And then as they were using it in the study, uh, both the clinicians and the patients are like, oh my gosh, this is great. So validated our idea. But then they're like, it'd be really nice if there's a waiting room or a patient queue or ability to share my screen or this and that, or like, those are great ideas. Let's do that. And so we kept getting more awards, and we kept using the money to build those features that they wanted, and to the point that, um, by the time I graduated, I had a fully built out telehealth platform, and it didn't really cost me anything to build other than competition and competition winnings in my time. Um, and I graduated with my PhD, and I became a professor at the medical university, the Medical University of South Carolina in Charleston, South Carolina. Um, but I had this fully built out product. So I said, well, just put it out there and let's see what happens. And, uh, so I went off doing my research. And on the side, this little telehealth app called Doxy.me is, uh, churning along. And more and more people are growing and growing, and over time, it just spread by word of mouth and people, more and more people started using it, and we made it available for free for providers to use. And apparently a lot of people had the same question I had. And they're looking for a simple and free, HIPAA compliant telehealth solution. And now we offered one.
00:08:01 Megan Antonelli: Wow. That's amazing. I hadn't realized that it really started, as, you know, when you were a student. And I mean, and it makes so much sense in terms of that need. I think, um, you know, being a mom myself and, um, having childbirth, understanding that, you know, how many times you go to the physician just to, you know, for, for, you know, the first time you feel like you need it and the second time around, it is, you know, that you're you're just kind of going through those appointments and it's just, you know, it's a lot of time especially, um, when you have kids and or working. Um, so, you know, and I think that's also so important is, you know, sort of these technologies born out of a need. And then this, you know, there's always been this hesitation around whether it's HIPAA compliance, how secure is it? And all of that. And I think, um, when that need is there. And we certainly saw that in the pandemic, you know, to some degree, some of that just sort of went to the wind. But I imagine during that time you had a huge uptick, um, that, you know, sort of that that need became, you know, sort of exponentially, uh, more, uh, you know, tell us a little bit about that in terms of particularly where, um, you know, where where you see the adoption, um, in terms of rural, uh, access and stuff. When you talk particularly about Utah, you know, not everybody can get to, to, to the cities for, for that. So talk a little bit about, you know, where you see the adoption and the need.
00:09:25 Brandon Welch: Yeah. So you know, what's interesting is um, in the early days we just rolled it out and said anybody's welcome to use it. And, you know, um, telehealth in the, in the mid twenty teens. So twenty fourteen uh, through before pre Covid. So essentially twenty fourteen to twenty twenty the only people really doing telehealth were the early adopters. If you're familiar with the adoption curve is early adopters, innovators, and they're the ones that were like, really thinking outside the box in terms of how to provide care. Um, and there's a lot of the, um, a lot of mental behavioral health folks, uh, providers were more comfortable with it because it's easier for them. There's a lot more resistance from, uh, more the medical physicians or they need they're more familiar with the hands on touch. Um, and so we saw a lot of early growth in mental and behavioral health pre-COVID, because that's where there's a little more familiarity. But again, it was very early adopters. Um, and when we try to talk to the most clinicians, they're just like, oh, is this this telehealth is valid is in-person care. You know, it was a lot more of like convincing people that telehealth was safe. Um, that changed overnight when Covid came because it wasn't a luxury. It wasn't something innovative anymore. It was, oh my gosh, in order for me to stay in business, I gotta adopt this thing. And it really thrust the rest of the market into, um, into telehealth. And so the conversations became completely different, where we were trying to convince people to health was safe pre-COVID, um, when Covid hit, it just everybody came over. The whole technology adoption curve went out the window, and everybody essentially adopted within a couple of weeks span. So in terms of doxy.me, you know, from twenty fourteen to twenty twenty, we had grown steadily. But, you know, we were kind of curving, exponential, curving upward, and to the point that at the beginning of twenty twenty, we had about eighty thousand users on our platform, and we were like, oh my gosh, we were doing awesome. We got eighty thousand providers using the platform and then Covid hits, and within two months we had eight hundred thousand providers using our platform. And um, and one of the days when Covid, one of our highest days, we had thirty two thousand providers sign up for Doxy.me in a single day. So we went from eighty thousand. Over six years in a single day. Had thirty two thousand people sign up in a single day. And it was nuts at that time. And so I, I kind of stepped away from at that time, I was my full time job was research professor at the Medical University of South Carolina. And so I had students and writing grants and papers and, and doing all that. And when Covid hit and doxy.me just kind of exploded, I had to kind of step away and focus on doxy.me. Uh, and, uh, being a professor became my side hustle. And so before that, it was the opposite. So it's really interesting. But, um, so essentially overnight, what I often describe is that we the, the trend was already heading towards adoption of telehealth that I mean, it was heading that way. Covid just, um, collapsed the time, the adoption time from like a decade down to like two months. And so overnight it was widespread adoption. We would have got there eventually. It would have taken ten years. Now it happened overnight. Everybody's there. Everybody has to use it. Um, and what was interesting is that when Covid first came out, if you remember, everybody was like, oh, we're going to shut down. Its all, we're only going to shut down for two to three weeks to let it pass, and then it's going to go back to normal. Okay. What that did was that set up that mentality and a lot of people's minds where they're like, okay, I'm only going to need a telehealth app for two to three weeks. So I don't want to invest a lot of time and money in it. So I just need something that's free that I will hold me over until, um, it, it passes by and two or three weeks. And so they all searched free telemedicine software. And guess who's number one in the search results? Doxy.me. And so that we got a lot of people coming and saying, you know, I'm only going to use you until Covid goes away and we'll go back to in-person. Well, two to three weeks turn into two to three months, which then turned into two to three years. And by that time providers became and providers and patients became very accustomed and used to and familiar and, um, very comfortable with telehealth and so that they didn't want to go back to in-person even when the restrictions lifted. They're just like, ah, well, why do we have to come in person? We just do it by video. We've been doing it for the past two years anyway. Why change it? And so, um, so what the adoption we saw was, you know, if you look at pre Covid, we saw this nice trend like this. Right. But the huge spike up in growth, it shot way up and it totally flattened the curve you know pre the years before. So when you look at the chart now it's like flat flat flat shoots up and then it drops down like this. Because I mean there was that spike when Covid first came out. And then that started dropping out after like two or three months, it started dropping, um, and but then it started flattening out. And then, um, for the last probably three years, our usage has been flat, which is fantastic because it didn't drop all the way down to pre-COVID levels. In fact, like it's like pre-COVID levels spike. And then where we're at now, it's like more than half of the Covid spike. So it's come down, but it's flat. And for me in the telehealth industry, I'm like, this is a huge victory. I mean, as Covid as, um, it was very impactful. Many people died and it's a very difficult time and businesses lost. But for the telehealth industry, it was actually very good. And it had a very lasting impact on telehealth. And and it really established telehealth as a normal, acceptable way of providing care and safe and effective and all the other benefits of health. It forced people to try it. They tried it, they got used to it. And now they're like, yeah, hey, you know what? Health is here. Let's use it. Um, and so that's really the dramatic change that's happened. And the other dramatic change is it's not just mental health providers anymore. A lot of physical health providers said, hey, you know what, I can do exams on this. And you know, it's not going to replace all my visits. But you know what? I'm just doing exam follow ups. Yeah. You don't have to come in person. I can just talk to you or some type of education. And so it's it's taught providers that telehealth is here, especially the physical health providers, the physicians that you can use telehealth in ways that make your practice efficient, more, uh, easy for your patients, um, without degrading your care. And you bring patients in when you got to do stuff in person, do shots or measure or whatever. Um, but stuff that's like follow up that doesn't need to be done in person. Yeah. Save yourself the hassle. Let's just do a video visit. And so that's one of the other big changes. Is that it? We see a lot more physical health providers using and comfortable with telehealth than accepting it.
00:16:12 Megan Antonelli: Yeah. No, I mean I think it's it's really amazing. And it is because it was really, you know, there was a battle to get adoption for so long. And I think, you know, going back to another another quote that Lisa shared at the at Health Impact last week. But change happens at the rate of trust. And what happened was ultimately I mean, telehealth was the safer option during the pandemic, so we had to trust it. We had to, you know, use it. And we did. And then it was, you know, it worked. I mean, I actually think of so many different, um, healthcare scenarios that I went through during that, you know, two to four year period. I mean, you know, two sons, husband, you know, very older parents or a lot of a lot of care that happened. And in some cases, the outcomes would have been better had we used telehealth. Right. So, um, that it was a it's a culture shift. It's a, it's a and it was ultimately that process shift and the technology, you know, platforms that were there. And then we tested them and then they became what we wanted to use. I think, um, in your you talk about in your book kind of like The Five Pillars of Success. Um, why don't we, you know, tell us a little bit about what what those five pillars are, and then we can kind of dig into what that looks like as we, you know, we're kind of over that adoption hurdle to almost. Now we're at this next evolution of what does it mean to provide care? Um, you know this that has continuity between both practice based medicine, hospital based medicine. And as we talk about kind of healthcare everywhere. But let's talk a little bit about those pillars first.
00:17:48 Brandon Welch: Yeah. So um, really quick in the backstory of this book. So, you know, as we're seeing this usage adopt and, you know, coming down and settling, um, to the new standard, one of the things that I um, did was I often talk to providers who use telehealth. And as a researcher, I'm always like asking questions and forming hypotheses and, and testing them and stuff like that. And one of the things, um, I often heard, um, providers fall into two camps as I've talked to them. The first is, oh my gosh, I use telemedicine and I love it. It's totally changed the way I provide care. It's it's it's simplified my life. It's so convenient. My patients love it. It's the greatest thing since sliced bread. Thank goodness we've got this. I'm going to keep doing it forever. It's amazing, I love it. Okay, that's the one camp. The other one is like the complete opposite, which is like, I cannot wait to get back to in-person care. And I don't want to do telehealth unless I've got a gun to my head. And, um, it was just I had a horrible experience with it. And, you know, as I look at that, I'm like, these are two extreme positions. Um, and you usually fall in one or the other. And, and I was like, what's interesting, they all got the same clinical training. Okay. There's no difference between age and or sex or training or background or, you know, whatever. Like I'm hearing there's some old physicians, young physicians, male, female, whatever. Like there was no clear dividing line. And I'm like, so there's no demographic similarities here. Um, there's or correlation. There's no, um, they got similar clinical training and background. You know what is what is the thing that divides what that leads somebody to go to this group or to this group. And as I started asking questions and interview them, and we started doing more research and asking these questions of like and asking people, why did you stop using telehealth? What was the biggest pain point? And then and then we also asked those who were successful and said, well, how did you set this up? How did you overcome these challenges and this and that? And we we asked these questions and the answers we got, we were able to distill down into five unique domains. And that is what formed the basis of the book that I wrote, Telehealth Success, like How to Be Successful telehealth is we looked at the two and we said, um, we identified these five domains and the five domains. One is, uh, patient success. So in order for the people to have a good experience with it, the providers have a good experience there. Patients had to have a good experience, you got to increase access to patients, make it easier for them. Um, they've got to want to do it. They've got to prefer it, um, that you do telehealth in a way that their patients want to do it, that increases their access, their access. And it's something that they desire and they ask for. And so patients have to be successful with it in order for the provider to be successful. The second is clinician success, meaning it's got to fit into their workflow. It can't add to their workflow. It's got to be harmonious with how they currently practice. It can add a burden. They've got to be able to do everything they want to do that in person, or at least most things they want to in person. And so they can't feel limited like, oh my gosh, I can't do this until health and those who are successful found ways to be able to do those things over telehealth that once were not successful couldn't um, it's it's possible to do it. Those were successful figured out, and those who weren't successful couldn't figure it out. Um, so it's clinician success. Um, and part of that is organizational success. It's got to work for the organization as well. Uh, the third one is technology success. And this is actually a big one, uh, where, um, providers who had a good experience pick the technology that best fit their use case. The ones who struggled with it often picked a technology that wasn't well suited for what they were trying to do. And so there's a lot of different telehealth technologies that serve different needs and very, sometimes very niche to the very specific need. And if you use a wrong technology for the wrong use case, you're not going to have as good of an, um, an experience which impacts provider success and patient success. And so it's very important you pick the right technology for the right use case. Um, the fourth one is financial success. So you've got to either make money or not at least lose money when you're doing telehealth. Uh, it can't cost you more to provide care over telehealth. Um, and, and those who are successful found ways of getting reimbursed for providing care or making money off of it, or make it work. Those who were not successful like this cost me a bunch of money, and it was a big headache. Well, yeah, of course you're not going to keep doing it if that's the case. But there are people who figured it out and so, you know, look at what they're doing. And then the fifth one is compliance success. And this is where you get into the privacy and security, um, laws like prescribing laws, medical licensure laws like practicing across state lines, different types of compliance, uh, consent type stuff you have to think about. And a lot of that was, uh, it can be if you don't have it figured out. Um, it can be a big burden and a big, uh, scary monster for those people who don't have it figured out. And they're just like, you know what? All this compliance stuff, the risks. I don't want to deal with it. I'm just going to not do telehealth at all, where those who figured out were successful were like, oh yeah, this is what you have to do to be compliant. And this is, you know, you just got to follow these rules. Um, and they weren't afraid of it. So we found that if providers were successful, if their patients were successful, the clinician, they use the right technology They're able to financially make it work and they were compliant. They had a really good experience and they want to keep doing it. Those who were not successful, they failed in one or more of those areas, and it was pretty consistent across the board. Very rarely do we see people who are successful fall in this category. They don't want to do it. Um, and, uh, but it's possible to be successful in all these areas and so that it's not a, it's not a like system issue. It's not because telehealth isn't effective, it's because it was implemented incorrectly or used or adopted incorrectly. And then at that point it's just like, well, that's not a system issue. It's not a technical issue. That's an education issue. And that's what prompted me to say, you know, let's put this together and how can we present this to the industry? And, you know, as a researcher, I'm like, well, let's write a book. And so, um, you know, we wrote that book put together. I partnered with a physician, Aditi Joshi, who's a emergency physician who did telehealth, and she's a a consultant in the field. Um, and so we kind of put our heads together and said, let's write a book. Two clinicians and, and health leaders on how to adopt and use telehealth so that they can be successful so they can keep doing it.
00:24:29 Megan Antonelli: Yeah. I mean, you know, and it strikes me almost you could replace telehealth with technology in some ways. I mean, there's, you know, in that the patient success, clinician success, technology success, financial compliance, these are the elements that if you don't get it right as any kind of digital health startup, any technology, you don't you don't, you can't, you know, you lose. And yeah, you know, and it's interesting in terms of with patient success, you know, when you think about telehealth and telemedicine and virtual health and kind of, you know, to me, you know, I feel like we're in this place where patients are demanding it. We need it. We want it for various things. But if you turn it around and it had been something that hospitals or physician offices were almost pushing on their patients to say, you know what? You can't come in until you've done this. I do wonder if there would have been a, you know, sort of a different, you know, feeling about it, right? Like, oh, God, I've got to do this. You know, it's almost like having to, you know, whereas because it's taken so long to get to that point where we actually do get it when we want it. And of course, not everybody does. But, you know, um, in, in places where it is available that that success comes from the fact that it's almost been withheld in some contexts. And then we want now on the flip side, the clinician success is different. And I think one thing I hadn't thought about until I heard, um, you and the folks at health talking about this is, you know, clinician success depends on the clinician. It depends on where they sit. And that's even true. I mean, it ties to this finance and compliance because sometimes we we talk a lot about whether or not health systems get reimbursed. And we talk a lot about how health system wants the patient in, you know, in their office or in, in the, in the building to get to get paid and have to have that. And now that those things have shifted a little in some places, in some, you know, for some, some things, you know, we're seeing the adoption go. But for providers, um, you know, behavioral health and otherwise that that need is different. And what they are able to do and how many patients are able to see does actually increase. But that distinction between, you know, sort of what financial success means for a provider versus a hospital, and then also what clinician success means in terms of the practice of care. So I would love to hear your thoughts and also a little bit more about telehealth and their role in educating the clinician. I think a lot of a lot of the focus has been around. You know what is financial success, compliance, success, technology. But as you get to that provider and what they need to know, not just about how to do it, but what what is going to change in terms of the questions they have to ask the patient, onboarding and even diagnostics. And I know some some specialties aren't there. Some specialties are further along. But I think it's really interesting as we begin to think about, you know, this as you know, the digital front door being, you know, where where medicine happens first. And, you know, as people want to age at age in place, you know, and, you know, back to that, that mom who doesn't want to have to come in, you know, pregnant woman who doesn't want to have to come in, you know, three times a month for for the appointments for natal care. What does it look like? And how does the practice of medicine change? And tell us a little bit about telehealth. Org and how they educate and what what that looks like.
00:28:09 Brandon Welch: Yeah. You know what's interesting is that with Covid, there was no opportunity for training on how to do this the right way. Everybody was thrust in and we just had to do it and survive. Like you're just surviving, you're just swimming and you're just grabbing onto whatever you can. And we didn't have the time to train and get systems set up and and do it the proper way. And we figured it out and it led to some successes, but also some failures along the way. Um, and it went from, you know, telehealth was a luxury before it became a requirement during Covid. But to some extent, telehealth has kind of gone back to it's a luxury where it's providers provide as an option to their patients, and patients can choose, I want to do it by telephone or in person. And providers will say, yeah, okay, you know, we can we can accommodate whatever you want. And, you know, and a lot of patients still choose to health. But as we go forward, I think there's going to become another critical inflection point where telehealth is not going to be no longer a luxury anymore. It's because of the the aging population, the demand in the healthcare system, the the limited number of providers. So more patients per number of providers you like doing inpatient um, visits is not going to be financially sustainable, um, or even be able to sustain the healthcare system in general. And in order to get care, they are going to have to look towards telehealth to, um, to lessen some of the demand on the healthcare system where, you know, patients are going to see a provider remotely at home first before you go into an in-person visit. And that's going to come, and that is coming, and there's no way around that. The the advantage we have this time, though, is that we do have time where we've tested it. We're more familiar with it. Um, and as we work towards that, um, telehealth first model where like see somebody by tele first before you get triaged and sent in person. Um, that that's going to be required. But we have time to build towards that and train people towards that and do it the right way so that we can be successful and not fail again. And that's where we see, um, that's where we see the future of healthcare going. It's there's no way that the current model is going to be sustainable. And we're going to have to, to, to relieve some of the pressure through these telehealth services. Um, and so let's, let's train the healthcare system on how to do it. Right. And, you know, following building on the book and the concept of the book, we say, okay, the book alone is the starting point, but it's really just a foundation. There's a lot of information that's coming. The technology changes. There's new policy updates. This book, I wrote it once, it's already out of date, but it's it's a good foundational text to understand the basics, but you have to keep building. We need something that's living that can that can live with and evolve with the changes. Like, I don't think I really talked much about AI in this book, but now it's dominating all of our conversations. We have to talk about it. So telehealth is kind of like the living version of my book that adapts to the changes in the environment. Um, and we also provide there's other than pure knowledge, there's not much incentive to read this book. Um, it's good to know it. It's good to have that knowledge, but you're not really getting much out of it. Besides that, with telehealth, we now have the ability to offer, uh, CME credits, which is something that every clinician needs to get. They have to get twenty to thirty whatever credits they need for their specialty. So they have something they have to do. They pay for it already. Um, let's just package this content, this education into a format they have to consume and, um, as a way to distribute this information. So we acquired um, and we provide news, analysis, opinion on different topics in telehealth as it come up. We keep providers up to date on policy changes, technology changes. So we're talking about these new things that come out. And then we also provide the CMS courses and webinars and latest updates. We just did a policy one for twenty twenty six. So it's a way to stay up to date. And the goal is to it's a living resource to provide the training and education information to to help the healthcare industry, um, understand how to do telehealth the right way so that when the time comes that they're like, we have to do telehealth, um, they're ready to do it the right way instead of being thrust into doing it the wrong way. So that's really the intention behind, uh, telehealth. Org.
00:32:38 Megan Antonelli: Yeah. Well, and I think that's I mean, it's so important. And as you said, it's like when we that fast adoption where it was almost, you know, it was a had to and and we did it and it, you know, we, we basically practiced the same medicine. We just did it virtually. And so what I think is going to be really interesting, and certainly as AI kind of factors into this is how how we can actually practice medicine better everywhere virtually than we did when when it's visit based. I mean, to some degree, I mean, as you get into remote patient monitoring and wearables and devices and, you know, all this sort of push and pull between, well, what are we going to do with all that data? Which is a completely understandable, uh, you know, uh, response from the clinician. But now as that technology to take that data and assess what's important and what's not, you know, gets better and better and cheaper. Although it's seemingly getting worse and more expensive at the moment, but I I'm forever an optimist and believe that it will get better. And it will, you know, I mean, I think we heard this week, you know, there will be a point where not using AI becomes the liability, not who does the liability land on. And it's the same as you get into, you know, after you release a patient and, and they, you know, you have an ability to monitor them. I mean, we talked on the podcast recently with, um, the folks from Iris. Iris telehealth. And, you know, they have capabilities of being able to listen to the voice and hear, you know, indications of predictive, um, you know, predictive outcomes for mental health. And so as those technologies get better and better, and care can be given better, because it can be because we can give, in fact, more of it more effectively. Um, the you know, the importance of this is just can't be understated. Um, and I think that that need to educate clinicians, knowing that, you know, just as you said, a book is a book and more often than not, a medical class and a, you know, education that happens, you know, those courses are set and this education and change is happening so fast that the importance of educating clinicians, you know, as this technology develops becomes so important. Um, you talked a little bit around, you know, kind of the policy side of things, right? And what does that mean? And I think as we step back and, and look at, you know, it's taken, you know, to some degree in healthcare, nothing happens until the government says this is the way it's going to be. And so you kind of, you know, they force the hand a little. Um, where do you think as we look at particularly like the rural health initiatives, um, you know, sort of fqhc participation and, you know, this, these telehealth flexibilities. Where do you see that? Um, from a strategic planning place for health or care organizations. Where should they be looking? So to sort of shift from the clinician to the healthcare organization. Now, what do you see as some of the things that they should be prioritizing, um, with respect to telehealth and virtual care?
00:35:58 Brandon Welch: Um, I, I often look at I don't know if you're familiar with, um, the theory of disruptive innovation or Clayton Christensen's disruptive innovation, where the small, simpler technologies disrupt the large incumbents and stuff like that. As I look at healthcare, um, system today, um, I view health systems very much as these large, slow moving organizations that do everything. And I see a lot of these, um, online telehealth companies that are providing not everything health system can do, but little narrow pieces as the disruptive innovations that are coming. So some like hims and hers and, you know, these large health systems, they do everything, um, but they're expensive and they're slow. And the results are compared to what you get for your money. But then I see these very fast and nimble startup up companies who are doing this one thing really, really well and efficient, um, at a fraction of the cost. And, you know, right now it's like it's a little, you know, mosquito or fly that these health systems are swatting right at. We don't have to worry about it. But what's it doing? It's eating away different lines of business. Um, you know, I think a mental healthcare is often, um, not done by health systems. Health systems kind of given up on that from a large extent. I mean, still providers, but they're missing out on huge opportunities there. Um, I think like men's health and women's health, um, you know, some of these drug weight loss drugs, they're losing that segment of the business now. And and over time, there's going to be these different telehealth companies that start up that take different parts of this, um, the health system and do it faster and cheaper, more efficiently, better outcomes and the health system and then the market patients and health insurers, payers are going to be like, yeah, why am I going to pay you X amount of dollars for the large health system? We get mediocre results. I'm going to go do that. So go to that. And you're already seeing payers do that already in certain areas like the GLP one and stuff. And so um, I see that I see this, um, disruptive innovation playing out, um, over the next decade or two. Um, and I imagine that there's going to be more like healthcare home companies that manage patients. They they get deals with the health insurer to manage patients in their home so patients can stay at home. They use technology. They use video devices to monitor patients, uh, and allow patients to stay at home rather than going off to some expensive, in-person, um, um, facility that costs a lot of money. I see the technology getting better. I see in, um, entrepreneurs, um, seeing the opportunity, jumping in and building successful businesses, and that eventually eats away at these large, um, large systems that are expensive and complicated to use. And so I see that's where the future is going. And so in terms of like how health systems prepare, like watch out for that. Either you got to think about how to redesign your systems to be more efficient, to offer systems at a cheaper cost. Otherwise companies are going to come in and disrupt you. And that's that's often my warning when I talk to health systems like you're going to get disrupted unless you can do it as bad as good as them.
00:39:19 Megan Antonelli: Yeah. No, I mean, it's gone from sort of virtual care as a, you know, as an access, you know, as a thing to serve access to, you know, sort of, you know, and to some degree build, build your, um, you know, customer base because you can give care more places to really, you know, the hospitals blockbuster moment. You know, I mean, if they don't, you know, if they don't, you know, it's it's going to be and I think your point about, um, you know, the other, you know, men's, men's and women's health and the care that hospitals have not been able to basically make money on. I mean, that's ultimately what missing out, right? I mean, you know, because because insurance hasn't covered some of the, you know, those those types of care, they haven't focused on it. And therefore all of these other, you know, smaller, more nimble companies are providing it. And, um, you know, and aggressively and, and well, you know, and, and people are getting what they want and then it's providing a model for why doesn't my regular care look like this? Right. I mean, that's ultimately what it comes down to.
00:40:24 Brandon Welch: So ultimately, what am I getting? I'm paying all this money and I'm not really getting anything. What's the point of it anymore? So and I think what's gonna happen, the health systems are going to continue to retreat to the areas that they are reimbursed for, and it's going to be a lot of the in-person emergency, expensive surgery stuff. And it's exactly the model that Clayton Christensen lays out in disruptive innovation. They retreat up market, and then the disruptors continue to eat away at that market until they are able to replace what those large systems do, and then they become disrupted. So they become a blockbuster, essentially.
00:40:58 Megan Antonelli: Yeah, yeah. No, it's it's and it is sort of you know, Clayton Christensen has been warning health care of it for so long. And then here we are. And it's really just happening. And then, um, you know, what I find amazing is the more health systems I talk to, the more buildings they're building. You know, this way. Yeah. Um, there's so much development in real estate.
00:41:22 Brandon Welch: Yeah, that's the problem. To stop building buildings and focus more on building low cost solutions. Because it's those those buildings are going to be empty one day. And, you know, in Clayton's Christensen's, um, theory, it requires, uh, these disruptions often come after a new enabling technology create an opportunity. And that enabling technology is the combination of telehealth and AI is going to, um, make it so much easier and cheaper for companies to replace most of what those large systems can do. And that that moment is now, and it's kind of like, um, you got to be aware of that.
00:41:59 Megan Antonelli: Mhm. One hundred percent. No question. Well and it, you know and well you know health systems and the system that is in you know, we're here, we want to educate them, prepare them and help them support. It is also you know it is sort of a patient driven you know that is what the patients are demanding. So you know, it's it's a scary thing. But at the same time it's, you know, it is a positive development and it is it's finding that balance. And I think what's great about what telehealth is doing is trying, is making sure that in that process, the clinicians as well, you know, the clinicians remain, you know, kind of educated on how to do this better and well as it develops. So, um, but, you know, as we always do, our, you know, our silver lining, um, you know, we always try to stay positive and talk about what's good. So in our last couple of minutes, why don't you talk a little bit about. And I think some of what we've already discussed is, is, you know, sort of the good things that are happening in healthcare. Um, you know, as you look at whether it's adoption rates or education or just virtual care delivery across, um, you know, across the spectrum of the specialties. Tell us what what you see as, um, you know, that you're most optimistic about the future of healthcare.
00:43:14 Brandon Welch: Usually when I get asked questions like this, I like to go back to like, first principles, thinking. I'm like, at the end of the day, what is the purpose of healthcare? And the purpose of healthcare is not to make some company bigger or to, you know, some market share and competition or whatever. It's it's that's all meaningless. What matters is a patient is sick and they want to get healthy. They want to get better, they want to get unsick. And and so I say, well, what is good about what's going on? And I, I'm really excited about a lot of the new technologies the digital health, telehealth, virtual health, also AI. These are all good things that, at the end of the day, are going to help patients get better, faster, for a cheaper cost. And healthcare is way too expensive, uh, both from our national economy and, uh, both at individual level as well. And it's way more than it needs to be. But what I'm really encouraged by is like, boy, there's a lot of potential this AI to do, a lot of questions to cut out, a lot of waste, to allow people at the end of the day to get better, which is what they're they're consuming healthcare to do is to get better or to stay healthy. And AI can do that much cheaper and more efficiently than the big expensive systems and ways of doing that now. And so I think what's good is that it's a very exciting, um, moment in healthcare with these new technologies, are our technologies that are really going to help people stay better and get better, uh, stay healthy at a cheaper cost. And, um, that's a really exciting thing. And, um, and I believe it's going to solve a lot of the systemic issues that exist in the healthcare industry with terms of access and coordination of care and, and travel between different people and get information and coordinating all that stuff, all that stuff, all those problems that exist go away. If you can allow a patient to get access directly from AI and answer their questions and get directed to exactly what they need no BS, no markups, and make things more efficient. So I'm excited where technology is going, what's possible now and what's coming. I think ultimately it's going to lead to, at the end of the day, better patients, healthier, um, patients that stay healthy, get better quicker for cheaper price. And so I think that's really good. And it's exciting.
00:45:31 Megan Antonelli: Yeah. No, I agree it's I mean, in fact it's the disruption that is good. It is what's delivering the care that's going to make it better. So tell our audience how they can, um, you know, learn more, go to telehealth. Org, um, get in touch with you all those things. Yeah.
00:45:49 Brandon Welch: I would say, uh, if you're interested in telehealth or staying up on the news, just go to tilt. Org and sign up for a newsletter we send out. I believe it's like a biweekly or monthly newsletter that goes out with the latest news and trends. Um, and that allows you to stay up to date on courses and webinars and the latest news analysis that we have. And that's the best place, um, to just stay up to date on that. Go to the website. Or you can also find my book there and it's free if you want the PDF, uh, e-book version or the audiobook, if you want the hard copy, you can just order it on Amazon and you'll get it. Um, and um, and then if you're interested in if you need telehealth software, simple and free health app. Uh doxy.me. Doxy.me is available for anybody to use. Yeah.
00:46:35 Megan Antonelli: Awesome. Well, and of course, as we, um, discuss and further our partnership. Um, you know, we'll be sharing our on our channel, some of the classes, the courses that are going to be available, um, to, to our audience as well. So. Well thank you, Brandon. It was great to chat. It was so good to meet you. I'm excited for everything that you guys are doing and how we're we're supporting it. And thank you to our audience. Very exciting times. Um, you know, and I think as Brandon said, the disruption that's happening is a good thing. And we're getting to a place in healthcare where, you know, that virtual care coupled with AI is going to provide the real time care where people want it, when they want it. So thank you, as always, for listening and joining us. This is Megan Antonelli signing off.
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