MedStar Health, Withings Bring Connected Devices to Concierge Medicine Program

As it scales up its concierge primary care medicine program, MedStar Health is partnering with digital health vendor Withings Health Solutions to provide patients connected devices such as cellular blood pressure monitors and cellular scales to stay connected to patients at home and identify potential health issues faster. Going beyond today’s partnership announcement, Withings executive Patrick Sheehan and MedStar clinical executive Ethan Booker, M.D., spoke with Healthcare Innovation about the value of delivering continuous real-world data to clinical teams and why concierge medicine is sometimes at the center of digital innovation.

Booker serves as chief medical officer of telehealth for MedStar Health, which has 10 hospitals in the Baltimore–Washington metropolitan area, and he is a MedStar Institute for Innovation leadership member. He heads up the enterprise telehealth activities with responsibility for vendor relationships, implementation and support as well as understanding the regulatory environment. He works with the MedStar Medical Group in deploying telehealth initiatives ranging from primary care visits to telestroke activity in the emergency departments. Last fiscal year, MedStar had 520,000 patient encounters via telehealth.

Concierge medicine charges annual fees for personalized services and is growing by 4% to 7% annually, with between 10,000 and 14,000 U.S. physicians now in such practices, according to Concierge Medicine Today. 

I asked Booker why MedStar created the Signature by MedStar Health concierge primary care program and why it wanted to include these connected devices from Withings as part of that offering?

He responded by saying there is a group of patients who have expressed interest in a very direct relationship with their provider. “From the very beginning, as we built out a concierge practice, we knew that we had the ability to differentiate in a number of ways,” he explained. “One of those is the world-class infrastructure of specialists and hospitals that backs this up. The other area of differentiation is that we already had this robust capability in telehealth and that connected experience.”

He said patients are often interested in the concierge experience because they're looking for not just how to take care of themselves when they're sick, but also because they are looking for opportunities for improvement in their health. “Generally speaking, that means an opportunity around data and connection. We knew that our concierge practice was going to have a digital and data-oriented lean from the very beginning. So as we built out that idea of gathering more physiologic data to be engaged in more continuity tracking and wellness, we knew that we were going to need some partners on how to gather that data. We  arrived at Withings with the idea that we wanted something that had a look and feel and the clinical quality that met that experience that we were trying to produce.”

Booker added that while MedStar wasn’t necessarily looking for deep integration into its EHR, its execs knew that having an accessible framework to be able to get and share that data was going to be important in how they move forward. “Having that combination of well-established clinical data collection and data sharing plus the look and feel and ease of use was why we ended up with Withings as the solution pretty quickly.”

Clinicians in the concierge program have to be ready to respond to this influx of patient data into their workflow. But Booker stressed that MedStar was actually well prepared for this, because it already had remote patient monitoring infrastructure. “We had that infrastructure built. We have a healthy blood pressure monitoring program in our primary care footprint. We have hundreds of patients that we're already doing remote patient monitoring for and infrastructure about workflow and processes to ingest and use that data,” he said. 

Innovating in concierge programs

Patrick Sheehan, vice president of value-based care at Withings, notes that innovations developed in concierge medicine tend to spread to other parts of the health ecosystem. 

“If you look at the rise of asynchronous care, that was a concierge medicine initiative, and telehealth was also concierge medicine. Now, not only are we seeing that across commercial and Medicare markets, but we're seeing asynchronous and telehealth care being core pillars in the Medicaid market,” he said. “We are believers that the same devices and the same services that we enable for a concierge medicine member, we also provide that to Medicaid members and FQHCs, and we still have a very strong ROI and business case there. So things that we do for a well-resourced membership community also apply to a member on Medicare or Medicaid.”

Booker agreed about concierge medicine being a place for innovation. 

“One of our primary care leaders has has made the analogy to the luxury car space. Twenty years ago, only luxury cars had backup cameras, and it's now essentially a standard feature of safety,” he said. “And as the safety features that used to be only in luxury cars are now democratized, I think it's a very similar circumstance in which some of these features that we're building into our concierge practice around data immersion, connectivity, availability — I would love to see those things democratized throughout our entire footprint.”

This collaboration with MedStar reflects a market shift to transforming concierge medicine into a scalable, data-driven approach to value-based care, Sheehan added. 

To give some background, Withings had a history as a consumer health tech company. It created the first connected body scale and blood pressure cuff, and was the first to embed medical ECG into a wearable, Sheehan said. It has developed innovations around the idea that you can have medical grade technology in the home environment. 

He said that around 2020, markets began to shift and Withings started working with health systems. “There was the remote monitoring market, mainly backed by the new fee-for-service codes at the time, and there was also the digital health market where employers and commercial health plans realized that their employees and their members would rather get care at home as opposed to going to a clinic,” Sheehan explained. “So we really started to serve those two emerging markets in healthcare. Fast forward to today, we've had over 300 partners and a million patients monitored in the medical setting. We're really a medical device company with consumer grade experience.”

Sheehan actually came to Withings Health Solutions with a background in tech-enabled services focused on complex care. He worked in downside risk arrangements, managing COPD and heart failure.

Because he has value-based care in his title, I asked Sheehan if there were new or existing alternative payment models that Withings’ health systems partners are participating in. 

“That's exactly why I joined Withings and to be very transparent, I’m a skeptic of the remote monitoring market,” he responded. “I think the remote monitoring codes, while well-intentioned, didn't really reward the right actions, and the real place of reward is around value-based alignment. Most of our health system partners are not billing RPM codes. They're actually working with us around hypertension, heart failure, weight management. Why? To improve quality and to avoid hospitalizations. In the case of MedStar, to have consumer willingness to participate and engage with the system. Where we see the puck going is away from the activity and more toward the outcomes that we can help generate.”

Booker spoke about the types of metrics he would be looking at in this program. 

“We're certainly looking at at patient satisfaction in the standard ways you do in a medical practice. But there's also a real opportunity here because of the size of this practice to have a pretty direct relationship with our patients and get feedback directly from them,” he said. “Survey tools are fantastic, but direct conversation is always useful if you can gather the data effectively.”

He added that they will look at utilization as well — not just that you try it once, but are you consistently engaged? “Withings has been a fantastic partner, but we have created a data infrastructure that if patients want to bring different consumer wearables to us, we've created an interface that allows us to do that, too.”

MedStar will also look at outcomes. If somebody's blood pressure is abnormal, is it getting better over time? “As this practice grows, and as our ability to ingest consumer wearables and other kinds of data grow, I think we'll probably get better at understanding how to trend it and how to understand it.”