Throughout the history of modern medicine, there are three common themes among the innovations and technologies developed to improve the practice.
First, they’re typically born from a need. The stethoscope, for instance, was invented in 1815 by a French physician who couldn’t hear his patient’s heartbeat using the typical practice of placing his ear on the chest.
Second, new technologies are typically developed by the physicians themselves. In a list of 40 of the most well-known, impactful medical inventions, only a handful were invented by non-physicians.
And finally, the purpose of the inventions—from the stethoscope to the CT scanner—is to increase the physician’s ability to care for patients and produce positive health outcomes.
It’s this long-standing tradition of innovation in the medical field that RelyMD, a new Raleigh-based telehealth company, seeks to continue.
At its core, RelyMD is a way for Emergency Room physicians to communicate with patients in need of expert medical evaluations, prescriptions and advice via a secure, HIPAA compliant, live video platform.
But RelyMD is more than just the technology and platform that enables the communication between patient and doctor. It’s the execution of a long-standing theory that effective medicine can be practiced virtually—through telehealth—without losing any of the benefits of in-person care. Many experts theorize that when executed well, telehealth can simplify healthcare and increase positive health outcomes by making quality healthcare more affordable, accessible and efficient.
Though these technologies aren’t yet widely prevalent or pervasive throughout the US healthcare system, RelyMD co-founder Dr. Bobby Park and his team are betting they will be and that RelyMD will be one of the companies leading the charge.
In just over a year since its founding, the Raleigh startup has acquired big local clients like Rex UNC Hospitals and Capitol Broadcasting Company (ExitEvent’s parent organization) and early adopters like HQ Raleigh. It has the big vision of making telehealth ubiquitous in North Carolina, and then beyond.
And as Park describes it, “it’s only a matter of time before telemedicine and virtual health are a normal thing. Who wants to drive across town when we can see anyone with a phone line or smartphone within 10 minutes for $10 a visit?”
Founded by brainstorming physicians
RelyMD was founded in 2015 by Wake Emergency Physicians, PA (WEPPA), an independent group of roughly 100 emergency room physicians who staff nine emergency departments in Wake, Johnston and Granville counties. They collectively saw over 300,000 patients in 2015. The group began discussing the ideas behind RelyMD in 2012 to solve what they saw as a gap in the healthcare system—a lack of affordable and efficient methods of receiving emergency care for non-acute needs.
At that first meeting on the topic, Dr. Park, an Emergency Room physician, recalled a recent incident in which his sister called him as she was heading to the ER with her daughter, who had cut her hand. Using FaceTime, he was able to see that stitches weren’t necessary and all the cut needed to quickly heal was a good cleaning and bandage. His colleagues cited similar stories. They realized they were onto something.
Their early plans for RelyMD happened to also coincide with health insurers’ switch from paying for the number of healthcare services providers deliver (or a “fee-for-service” model) to paying for the quality of care (or a “value-based care” model). In addition to this shift within the healthcare industry, the Affordable Care Act and other regulations also began to incentivize providers to move toward value-based care models. Experts had identified telehealth technology as a tool to better serve patients and integrate the new care models into their healthcare systems more seamlessly.
Funding to those companies began to spike in 2014, with large rounds going to Doctors on Demand, Specialists on Call and MDLive. In 2015, funding to telehealth companies hit $400 million according to CB Insights.
It’s for these reasons and because they “felt very strongly that healthcare needs to be simplified,” that Park and his colleagues felt best suited to build the startup. It only helped that they had extensive experience in practicing emergency medicine and access to 100 potential on-call doctors.
Shortening wait times, diagnosing illness more efficiently
It took three years for the WEPPA doctors to develop the platform’s protocol and technology, and ready it for launch in January 2015. WEPPA co-developed the RelyMD platform with TCS (now Comtech Telecommunications Corporation) a telecommunications firm based in Maryland. WEPPA also relied heavily upon member physician Dr. David Kammer, a former Apple and Microsoft software developer. Kammer now serves as the company's director of technology.
In addition to Kammer, RelyMD employs roughly six full and part-time non-clinical employees who maintain the product, business and sales side of the business. The roughly 100 WEPPA physicians are the businesses’ founders, investors and co-owners and they also staff the clinical side of the business.
WEPPA treats RelyMD as if it was a 10th ER, contracting its services to RelyMD just as it does the other ERs. Park, who was recently named one of Triangle Business Journal’s 2016 “Health Care Heroes”, serves as co-founder and director. As RelyMD was Park’s brainchild, he was the natural pick to lead it—the other WEPPA doctors confirmed his position through a vote. He continues to practice medicine and see patients through RelyMD.
The platform enables an interaction between patient and doctor that is as seamless and simple as using FaceTime, but more secure, HIPAA compliant and able to transfer documents and prescriptions. It’s intended for “unscheduled care” or when a person is unexpectedly sick or injured but is unwilling or unable to travel to an ER. Park is careful to note that RelyMD is not a substitute for primary care or other specialized care appointments.
To use the platform, the patient logs into the platform on a computer, tablet or phone, pays for the service (on average between $10-$50) and submits information like medical history, allergies and the purpose for the “visit” as well as photos of the injury or issue, if available. He or she then waits in a virtual waiting room for the on-call physician.
Like a typical ER, RelyMD keeps one physician on call 24 hours a day, 365 days a year, and that doctor is never simultaneously on duty at another hospital. As such, the average wait time to see a RelyMD physician is eight minutes—30 minutes less than the state average of 38 minutes. The doctor and patient then interact via video or through a traditional phone call if the patient prefers.
The rest of the visit mirrors a typical doctor’s visit—the doctor examines the patient, asks questions, and if possible, makes a diagnosis and submits an e-prescription to the patient’s preferred pharmacy if needed. So far, RelyMD doctors resolve 92 percent of their patients’ medical issues in their first visit. For the typical patient, the doctor will send discharge notes with instructions via the portal. The notes can also be sent to any traditional provider at any point by the doctor or patient.
In cases like a heart attack or stroke where in-person care is required, the physicians immediately refer the patient to a specialist at the closest, most convenient healthcare facility. On-call doctors will even coordinate the care for the patient, calling the hospital or doctor to which they’re referring a patient, much like a doctor in a traditional practice would if confronted with a situation outside their scope of expertise.
RelyMD operates outside of all Insurance networks, and any individual (in NC) can use the service. Payment can come from health or flexible spending accounts or debit or credit cards.
But individuals are not RelyMD’s target customer base. RelyMD acquires the bulk of its patients through partnerships with corporations. So far it has over 30 corporate clients, including the nearly 10,000 employees that work for recently-announced partners UNC Rex and Capital Broadcasting.
According to Matthew Cox, RelyMD’s head of sales and business development, when the startup partners with an organization, it structures a deal that “makes sense for both parties,” then the company offers RelyMD’s services alongside traditional benefits like paid leave and health insurance to their employees. Employees can then access RelyMD at a heavily discounted rate.
Penetrating North Carolina, then considering what's next
Bootstrapped thus far with funding from individual WEPPA physicians, the team is not actively raising capital but is open to considering partnerships with funders whose goals align with their own. They intend to broaden their customer base and reach more North Carolinians outside the Triangle through corporate partnerships. For now, the company is “very focused” on the state because of its connections locally, but for the future, Cox says “everything is on the table.”
Eventually, Park would also like to expand and provide high-quality care through RelyMD to vulnerable populations like the elderly, rural and low-income households. He notes RelyMD could even be a solution for K-12 schools struggling to fill or fund school nurse positions.
For now, RelyMD is content focusing on WEPPA’s specialty, emergency medicine. But Park notes that the same principles used to build RelyMD could be applied to a number of different medical specialties—from post-operation care to dermatology.
As for the future, both Cox and Park believe it’s only a matter of time before telehealth is the norm. Park says he envisions a not-too-distant future when a sick child’s first request is, “Hey mom, dad, I’m sick. Can you give me the iPad to see Dr. Park?”