A Healthcare Organization’s Planned Parenthood with Digitalization
Telehealth has changed the notion of how medical care can be delivered. How can an organization like Planned Parenthood compete in this climate and utilize telemedicine to its advantage?
The U.S. Healthcare System is one of the largest industries in America, comprising more than one-sixth of the nation’s gross domestic product and involving a massive supply chain that flows medical goods and services to patients. [1]. As patients demand for easily-accessible care has increased, healthcare organizations have grappled with the incorporation of digital medicine, such as virtual visits, secure messaging, and mobile health, into this supply chain to compete with new disruptive models of affordable care, like retail clinics, urgent care centers, and internet-based medical care companies [2]. Telehealth interventions provide one possible solution for healthcare organizations to meet demand of the growing aging population in the setting of fewer clinicians to provide goods and services [3]. As well, as reimbursement moves towards a value-based system, telemedicine allows for healthcare systems to match resources with value by expanding access to a cheaper supply chain to the healthier population while allocating the more expensive resources to the sicker pricier patients [4].
Planned Parenthood is one healthcare organization that has been working to incorporate telemedicine into its short-term and long-term strategy in order to address the pressures of increased patient demand, competition from other models of care delivery, and payers changing its reimbursement systems. Planned Parenthood is an organization that serves a diverse population across the United States with comprehensive reproductive, primary care, and educational services. In the short term (the next two years), Planned Parenthood has been focusing on expanding the routes of telehealth interventions to reach its core diverse patient population and expand access to care. The organization launched a mobile texting platform for patients to receive sexual and reproductive health information and questions from their providers [5]; created a mobile application for patients to have virtual visits with direct-to-consumer testing for sexually transmitted diseases [6]; launched an mobile application to track one’s birth control and period to improve upon family planning initiatives [7]; and offered prescriptions for birth control and urinary tract infections through its telehealth platform “Planned Parenthood Care™” [8]. In the medium term (three to ten years), Planned Parenthood hopes to focus on virtual reality and other technology to transform how health education and information is provided to its patient base and how the organization uses the vast information it is receiving through telemedicine [9]. As well, Planned Parenthood hopes to be able to use telehealth to provide family planning resources such as legal medical abortion to low-resource poor rural areas; though successful in several States, this telehealth resource has been met with lawsuits and court-interventions to strike down this capability [10,11].
There are additional steps that Planned Parenthood needs to make in order to address the growing concerns of changing reimbursement, increased demand, and competition. In the short-term, the organization needs a better overall structure and presentation of the telehealth capabilities to its patients. There have been too many platforms of telehealth across multiple avenues that makes it difficult for a patient to understand the scope of what Planned Parenthood has to offer. Its competitors have a single website and mobile application that offer similar services that allow for patients to understand the breadth of the digital capabilities [12,13]. In addition, in the short term, Planned Parenthood should consider how to expand upon its direct-to-consumer capabilities for educational, reproductive, and general primary care services as the organization has scale to be able to distribute these medical goods and services. In the medium term, Planned Parenthood needs to consider how it will face the political climate while addressing its core mission for sexual and reproductive health. Currently, they only provide telehealth services in six states and should focus on how to expand their telehealth capabilities across the large national network of Planned Parenthood.
Thinking about how telemedicine has impacted Planned Parenthood thus far and how the organization could consider moving in the future, I ask my peers the following questions:
- Should Planned Parenthood expand its telehealth and direct-to-consumer medical program in the setting of a political and cultural climate that stigmatizes sexual and reproductive health? How can it compete with smaller telehealth firms without the Planned Parenthood reputation?
- What are the advantages or disadvantages for Planned Parenthood to have a telehealth program that focuses on sexual health across all populations?
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Citations
[1] “National Health Expenditures 2015 Highlights,” Centers for Medicare & Medicaid Services https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf accessed November 2017.
[2] Beck, M., “ How Telemedicine is Transforming HealthCare,” The Wall Street Journal (June 26, 2016), https://www.wsj.com/articles/how-telemedicine-is-transforming-health-care-1466993402 accessed November 2017.
[3] Kvedar, J.C., “Telemedicine is Vital to Reforming Healthcare,” Harvard Business Review, (October 7, 2015), https://hbr.org/2015/10/telemedicine-is-vital-to-reforming-health-care-delivery accessed November 2017.
[4] Kvedar, https://hbr.org/2015/10/telemedicine-is-vital-to-reforming-health-care-delivery.
[5] “Planned Parenthood’s New Mobile App Brings Confidential and Convenient STD Testing and Treatment to Your Doorstep” Planned Parenthood, June 16, 2015. https://www.plannedparenthood.org/about-us/newsroom/press-releases/planned-parenthoods-new-mobile-app-brings-confidential-and-convenient-std-testing-and-treatment-to-your-doorstep accessed November 2017.
[6] Giorgio, M, Kantor, L, Levine, D, Arons, W, “Using Chat and Text Technologies to Answer Sexual and Reproductive Health Questions: Planned Parenthood Pilot Study” Journal of Medical Internet Research. September 20th, 2013. http://www.jmir.org/2013/9/e203/ accessed November 2017.
[7] “Spot On” Planned Parenthood. https://www.plannedparenthood.org/get-care/spotontracker accessed November 2017.
[8] Roy, J, “You can get birth control from an app- should you?” Los Angeles Times. June 21 2016. http://www.latimes.com/health/la-he-birth-control-app-telehealth-20160621-snap-story.html accessed November 2017.
[9] “Planned Parenthood Highlights the Power of Technology for Health Care and Education at ‘VR for Good’ Summit” Planned Parenthood, August 2, 2017 https://www.plannedparenthood.org/about-us/newsroom/press-releases/planned-parenthood-highlights-the-power-of-technology-for-health-care-and-education-at-vr-for-good-summit accessed November 2017.
[10] Sifferlin, A, “Planned Parenthood Appeals Ban on Telehealth Medication Abortions” Time Magazine, August 28, 2014. http://time.com/3207170/planned-parenthood-telehealth-abortions/ accessed November 2017.
[11] Mack, H “Planned Parenthood settles Idaho lawsuit that banned telemedicine for abortion-inducing medication”. Mobile Health News. January 24, 2017. http://www.mobihealthnews.com/content/planned-parenthood-settles-idaho-lawsuit-banned-telemedicine-abortion-inducing-medication accessed November 2017.
[12] https://www.lemonaidhealth.com, accessed November 2017.
[13] https://www.mavenclinic.com, accessed November 2017.
Generally speaking, I think the healthcare field is ripe for disruption, including digitalization. I often groan in frustration when my doctor’s office tells me that a document can only be sent via fax, for example.
The only concern I have with telemedicine is privacy. I am worried that a teenager might want to have a private conversation about a sensitive issue with a doctor, and a family member or a classmate may overhear what is being said.
If that issue can be resolved, then I fully support telemedicine, including in this context of sexual health. Access is a big problem in health care and this will make it easier for most people to speak with a doctor. In addition, a lot of people don’t get their annual physicals because they claim they don’t have the time or that it is a hassle. Making it easier for patients and doctors to interact will lead to better outcomes.
I agree with Zach – I think all in all telemedicine is a fantastic idea, especially for Planned Parenthood users. In addition to the concern of privacy, I worry that depending on the quality of the telemedicine and the honesty of the patient, there could be issues around inaccurate diagnosis or prescriptions as noted in the MedPro Group article cited below. If not implemented properly and closely monitored, a major dependence on telehealth could increase malpractice issues. My questions back to you are what is the right way to gradually but effectively role this approach out, and how do you manage quality control on an ongoing basis?
Cascella, Laura. “Virtual Risk: An Overview of Telehealth From a Risk Management Perspective,” MedPro Group, https://www.medpro.com/documents/10502/2820774/Virtual+Risk+-+An+Overview+of+Telehealth.pdf, accessed November 26, 2017.
Fantastic read and fascinating article. Thank you for sharing this piece on such an important issue.
I think this is an excellent strategy for Planned Parenthood both in terms of achieving its mission to empower and educate women on fertility without prejudice as well as navigate the current political climate. I think the Planned Parenthood brand is part of its competitive advantage as it looks to compete with smaller telemedicine organizations. Not only is the name widely recognized, it has also built credibility among a prospective user base as an organization that advocates on behalf of woman’s health, prioritizing their fundamental rights before politics or criticism.
I am less concerned about the issues around privacy from the vantage point that Zach raised. I actually think this digital strategy over comes a huge barrier to entry – ie. the stigma of potentially being seen entering a facility. I am however worried about hippa. Hipaa regulation in the age of technology is largely undefined and continues to be a grey era that healthcare startups grapple with. As such, for Planned Parenthood, there is regulatory risk associated with this strategy. Moreover, the investment in technology required to secure patient data could be extensive.
Yet, to me, the potential upside significantly outweighs the risk/costs associated by this strategy. The ability to reach a broader population, to allow women to make more educated decisions about their body, and to reduce the stigma around sexual/reproductive health, is not only the right thing to do but is also the right business thing to do. In an era where FemTech is attracting significant capital investment, Planned Parenthood is well positioned to ride this funding wave.
I absolutely agree with Zach, Sonia and Isabel that this article is so interesting and relevant in the current climate.
When I started reflecting on the questions that you raised at the end of your essay, I envisioned a very optimistic future for Planned Parenthood as they expand their telehealth outreach. As you briefly touched upon the stigmatization of reproductive health in a lot of places, I feel their digitization will be an important tool to empower people to have access to it without having to deal with “judgement” or “backlash”. I don’t see competition from other telehealth platforms as a threat to “Planned Parenthood” because their digital platform will still come with their brand recognition.
One of the concerns that I have, outside of what you mentioned in the essay, is how to establish a greater degree of trust between the patients and doctors. One thing that works in their favor is that platforms that frontline patient contact is handled by knowledgeable, patient and empathetic individuals will achieve the greatest success [1]. Since the philosophy of Planned Parenthood aligns with this, it would be a good platform for them to build on.
[1] Judson B., 2017, “How Telehealth Platforms Will Reshape U.S. Healthcare Delivery”, Huffington Post.
I echo my peers above that this is such a relevant topic in today’s healthcare space. I think telehealth applications and programs is a no-brainer for Planned Parenthood because of Isabel’s three points on the ability to reach a broader population, to allow women to make more educated decisions about their body, and to reduce the stigma around sexual/reproductive health.
However, I think there is one issue that must be overcome for telehealth to be successful for Planned Parenthood. Given that 80% of Planned Parenthood’s patient population has incomes at or below 150% of the federal poverty line, I question whether these patients have the means and access to smartphones to be able to use telehealth. My question would be how does Planned Parenthood resolve this issue and ensure that its patients have the infrastructure to access telehealth programs.
Source: http://www.cnn.com/2015/08/04/health/planned-parenthood-by-the-numbers/index.html
Great topic!
I completely agree about the need to sort of streamline Planned Parenthood as it seems to be all over the place at the moment, but it has done a fantastic job so far in building a brand name that resonates with its consumers. I am not too worried about the privacy aspect and would like to echo Isabel’s point. If anything, I think that the digital space allows for more privacy, but might take away the human element (comfort, counseling etc.) that we tend to get from one-on-one visits. An issue I’d worry about is perhaps the vulnerability of the digital world (hacking etc.) as that could be a major problem down the line if any ‘attacks’ take place.
I also think Planned Parenthood should expand its reach, despite the current political and cultural climate. I feel that momentum played a key part in changing the game here, and any slowdown in momentum may enable adversaries to destroy all the value that Planned Parenthood has brought to the table.
I see plenty of advantages that far outweigh the disadvantages of entering the telehealth space. We’re seeing far greater accessibility, speed of access, anonymity/privacy (somewhat), as well as reduced costs in the long run (and perhaps even in the short-to-medium term).
Thanks for writing about this!
I definitely agree with a number of comments that have already been posted. However, contrary to Matt’s comment, I believe a digital health platform would be beneficial to individuals who’s incomes are at or below the poverty line. I think, for the most part, smartphones are ubiquitous – in my mind, the true challenge for these individuals is finding the time to go to a doctor’s office, while juggling a number of responsibilities with limited resources. Especially in a climate that has politicized the topic of women’s health and caused a number of women’s clinics to shut down (increasing the travel time to the nearest clinic for individuals) to prevent women from receiving abortions without regard to the other services that they offer.