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Many modern concepts of primary care build on the pioneering work of Dr. Barbara Starfield, who studied primary care systems around the world and defined the four Cs of effective primary care: first contact, comprehensive, coordinated, and continuous. In the U.S. healthcare system, most people do not have affordable access to these four Cs today.
The COVID-19 pandemic exacerbated inequities and forced many patients and providers to adapt out of necessity — for instance, to use telemedicine for the first time to triage and provide care at home. Since then, there has been a Cambrian explosion of telemedicine and virtual care offerings in the market.
Stepping back from the recent hype around virtual care, the fact is that the scope of care a Zoom-style video visit or phone call can accomplish will always be limited and insufficient to close the healthcare loop for most people; in some ways, it’s like going to a nice restaurant and being able to order only appetizers. In reality, telemedicine should be just a single feature of a more comprehensive primary care experience, rather than the full menu.
That said, there is tremendous value in being able to deliver care virtually to a patient in the comfort of their home, and the upside of a more accessible, home-based care model is the opportunity to create entirely new clinical workflows that alter the longer-term economics of healthcare.
What is different today that could dramatically enhance home-based care?
In short, it’s hardware that has become more personal and wearable, higher-quality and medical-grade, and internet-enabled. Devices like the Apple Watch and continuous glucose monitors (CGMs) are digitizing the body in ways that have never been possible before and giving people new insights about their health. These devices and the data that they generate could be a bridge between patients and primary care providers, allowing them to take healthcare beyond the four walls of a traditional clinic and an episodic encounter.
This bridge has until now been missing in healthcare. While patients have begun to adopt these technologies, many providers have been reticent for a number of reasons — such as not enough time to look at data, no economic incentives, administrative overload, and lack of EMR (electronic medical record) integration. Despite the tens of millions of people who are now wearing an Apple Watch with ECG capabilities, very few patients are actively exchanging HealthKit data with their doctors and receiving proactive and real-time clinical guidance.
This is why the Steady Health experience is magical for diabetes patients — and why we’re so thrilled to be bringing Steady Health into the Carbon Health fold. With the integration of CGM data into the virtual diabetes clinic, Steady Health endocrinologists are interacting with patients and their data continuously, providing guidance, educating their patients, and making treatment decisions. This is a journey that people with diabetes no longer need to walk alone.
In today’s broken, disjointed healthcare market, it’s too easy for patients to get lost. Handoffs between primary care providers and specialists are not always well coordinated. Pharmacy prescriptions are sometimes not picked up by patients. Follow-up care gets forgotten. Devices are just another shard in this fragmented mirror of healthcare, too often overlooked. Carbon Health has an ambitious answer to these challenges: a full-stack omnichannel primary care ecosystem that can do it all — running physical clinics, offering virtual care, and integrating hardware to meet patients where they are and where they need us. And by doing so, we can create a seamless healthcare experience for both patients and providers, and bring modern healthcare back to the four Cs:
• First-contact care: Physical clinics mean that Carbon Health can handle the full range of new health problems in ways that virtual-only providers will not be able to.
• Comprehensive care: Carbon Health will be able to look at a patient as a whole person rather than as a single condition.
• Coordinated care: With new programs like Steady Health (and more programs to come in the future) offered in-house, there will be fewer broken handoffs between primary care and specialists.
• Continuous care: Connected devices that are fully integrated into a Carbon Health–built EMR mean that the entire workflow of the care team can be optimized to deliver a more dynamic and continuous experience in the home.
What this means for the Steady Health team as they join Carbon Health is that they can put the entirety of their efforts into providing the highest-quality care for the thousands of Carbon Health patients who will benefit from that care.
I joined Carbon because of the amazing company and culture that co-founder and CEO Eren Bali and the team have already built — and the excitement that everyone at the company has for this vision of omnichannel primary care that we are just getting started on. If you are inspired by this vision like I am, come join us!
