Comparing VSee, Zoom, GoToMeeting for Virtual Doctor Visits

VSee Zoom GoToMeeting telemedicine

VSee, Zoom, GoToMeeting — with all the options out there for doing telehealth and telemedicine, how do you know what works best for your telemedicine needs? It’s been awhile since we’ve looked at Zoom and Citrix’s GoToMeeting (GTM) products, so we decided to check them out again and see how VSee is stacking up.Continue Reading…

Teledoc and American Well Fight Over Telemedicine Software Patent

american well vs teledoc

American Well has filed a lawsuit against TeleDoc. The suit claims that TeleDoc violated American Well’s intellectual property rights . The news comes right on the heels of TeleDoc’s recent tangle with the Texas Medical Board.

According to FierceHealthIT, the issue is over American Well’s patent called “connecting consumers with service providers.” It concerns the backend system by which American Well matches care requests with available providers.  American Well says that “Teladoc is well aware that it has been engaging in and continues to engage in the unauthorized practice of American Well’s patented inventions.” They go on to claim that TeleDoc applied for a license to use American Well’s patents, but that American Well denied their request.

TeleDoc however is fighting back. It’s CEO Jason Gorevic told MobiHealthNews, “We very strongly believe that those patents are invalid. For one, American Well’s claims of being ‘first-to-market’ are demonstrably false due to the fact that Teladoc and others were providing telehealth long before American Well was even formed as a company. Second, the patents in question are impermissibly broad and cover matters that are too obvious to be patented.”

There’s no question that TeleDoc’s business model is not original or unique. The technology for telemedicine has been around for over a decade. But it’s hard to see how American Well could win this fight in court. After all, “connecting consumers with service providers” is something than many companies have done for years. Their claims sound a lot like patent trolling, that is, suing someone for “stealing” an idea that was already widely known. Whoever wins this fight, neither party can legitimately claim to be the world’s number-one telemedicine provider.

Not long ago TeleDoc had the largest market share in telemedicine. But they were late to adopt video, and they slipped from their #1 rank this year.

American Well started out building patient portals for hospitals. But their video solution, licensed from Vidyo, was expensive and complicated. They recently pivoted in order to offer their own online doctor service, to copy the successful MDLIVE and TelaDoc and business model.

Lonely Nights for Vidyo at ATA 2015 Exhibition

VSee had a great exhibition at this year’s ATA 2015.  As you can see, even at the exhibit closing time, interested participants are swarming our booth, learning about VSee waiting rooms and ultra-light home care kits.  Meanwhile, the Vidyo booth right across from us is cold and empty, and their staff have taken off early.

Thanks to everyone who came to see us this year and helped make this year telemedicine’s coming out year!

VSee booth ATA 2015

end of Day 1

VSee booth ATA 2015

VSee booth ATA 2015

end of Day 2

 

Running out of time to find a Google Helpouts alternative

need helpouts alternativeJust one more week and Google will be shutting down Helpouts, their expert-advice platform and marketplace. Health providers who use Google Helpouts will need a new solution so that they can continue offering telemedicine. The good news is that with the growing number of telemedicine services offering video doctor visits, there are plenty of Helpouts alternatives out there.

While the idea behind Google Helpouts was worthy, it never really caught on. Google itself  says, “unfortunately, [Helpouts] hasn’t grown at the pace we had expected.” Part of the problem is that there is so much free expertise available online, from blogs to iTunes University to Howcast on YouTube. It’s no wonder that Helpouts got buried all that great information.

Another problem was the user experience. Writing for VentureBeat, Mark Sullivan tells the story of a mental health provider disappointed with Google Helpouts:

Lewisville, Texas-based counselor Will Singleton was excited about Helpouts when he heard it had launched. But it soon became clear to Singleton that Helpouts wasn’t going to fit into his practice like he hoped it would. The people who called the service didn’t have just a few questions that could be handled in a short amount of time. In Singleton’s case, the people who he talked to online came to the service with problems that were best treated with long-term, regular sessions. ‘These were just people who were trying to get free therapy.’

google helpouts health

While the Helpouts marketplace may have been an easy way to get some Google juice, it seems to have lacked the design and credibility needed for a healthcare delivery platform. It required patients to get a Google+ social media account as well as use Google Wallet to pay for sessions. It lists free pet health advice alongside safe dieting training sessions and $150/hour radiologist consults. Furthermore, there has always been a question of how Google was going  to charge providers for using Helpouts since their 20% per visit fee for other Helpouts users is illegal for healthcare visits.

VSee provides a simple waiting room experience that fits easily into medical workflows, whether it’s a walk-in or scheduled visit. It allows physicians to use a platform that can be trusted to protect patient privacy.

As a health provider, your expertise is valuable. And time is money. If you’ve been using Helpouts, write to sales@vsee.com and we’ll help you make the switch.

Google Helpouts Shutting Down in April

Google Helpouts shutting downGoogle has announced they are shutting down Helpouts, their platform for experts to offer advice by video, on April 20. With Google Helpouts shutting down, health providers who use the service to consult with clients will have to find an alternative to Helpouts.

In the Guardian Liberty Voice, Alley Hines writes:

There were hopes of taking it into the medical community where people could consult with their doctor, nurse, or even the veterinarian. Offering the search for medical information at no charge was one way that Google promoted Helpouts.

But apparently even the lure of “free” for providers wasn’t enough get Google Helpouts off the ground. And at one point Google was even giving away free video doctor visits. The search giant’s response as to why it’s shutting down Helpouts: “unfortunately, it hasn’t grown at the pace we had expected.”

Of course, it was always a big question mark whether Helpouts would succeed among the medical community. While it got promising reviews, let’s just say Google isn’t exactly your go-to man when it comes to matters of privacy and the healthcare community is pretty strict when it comes to things like that. Google also hasn’t had a great track record when it comes to understanding the health industry – consider Google Health, its other failed attempt to get into the consumer health door.

In full disclosure, during last year’s ATA trade show, VSee even had people from the Google Helpouts team coming over to get a demo of the VSee virtual waiting room in order to understand how we structured our simple telemedicine workflow.

As a health expert, you need a video solution that matches your unique requirements. Helpouts may have been a great way to get found online, but it’s definitely not the best way to show that you’re serious about a patient’s privacy. In any case, don’t rely on a generic product built for the masses. Choose VSee – it’s 100 percent HIPAA-secure and specifically designed for telemedicine.

How NOT to Run Your Online Practice

Writing for the Atlantic Online, Joseph Burgo describes his experience providing psychotherapy sessions over video as a mental health provider.

Burgo has some interesting things to say about expatriates and the psychological problems they confront. But his article suffers a major flaw: he doesn’t realize that his online practice is unethical.

That’s because he uses Skype for his patient sessions. It is well documented that Skype does not comply with HIPAA. Furthermore, Skype has always been in the hot seat for leaving a backdoor access to encrypted user data. Therefore, the private information that Burgo’s patients share with him may not be secure.

Mental-health providers should do their research before choosing a video conference solution. While Skype may be a household name, it has a poor reputation for being secure, and just doesn’t come across as a very professional video chat tool. Besides, there are more than a few alternatives. VSee’s Cloud Medical Office, for example, is 100 percent HIPAA-compliant, and we offer a complete workflow solution that allows psychologists to send prescriptions, schedule appointments, and keep their records secure.

Read more of VSee’s advantages over Skype.

TouchCare: a Hot Addition to Telemedicine

VSee is happy to welcome TouchCare to an already buzzing telemedicine market, where they join such big-hitters as MDLIVE, TelaDoc, American Well, Health Tap, and Doctor on Demand.

Here are two pieces of good news. Last month, TouchCare secured $4 million in venture capital. And at the same time, they introduced their new app in beta, which allows physicians to connect with patients through their smartphone or tablet.

TouchCare’s senior management is made up of former investment stars like Damian Gilbert. Their arrival in telemedicine is just more proof that, now that it’s becoming almost ubiquitous, smart investors see the opportunity for a gold rush.

TouchCare

And it’s not just venture capitalists getting in on the action. Insurance companies, too, see the need to provide their customers with better service through telemedicine. For nearly two years, Wellpoint has paid its member physicians to conduct video consultations with patients. And Anthem Blue Cross and Blue Shield is promoting an app for tablets and smartphones so that their members can access a doctor by video. In fact, you don’t even have to join Blue Cross / Blue Shield – you can sign up for LiveHealth Online and pay $49 for a virtual visit with a doctor. The service is already available in most states, and with Anthem having added the service to health plans in at least seven more states this year, you could be fully covered for all your video doctor consultations.

Yes, telemedicine is definitely the hot ticket right now. And this growth will only continue as people realize how telemedicine makes patients’ lives better.

RingMD: A New Telehealth App from Singapore

This very moment, several new applications and devices are entering the market. And the telehealth market is truly global. In Singapore, an app called RingMD launched this month. It promises to connect patients to doctors via smartphone. But for now, it appears limited to Southeast Asia. And it’s only available for Android devices (since it is using webRTC). RingMD has been around for a few years and has a dozen people.

ring md logo

You can read more about RingMD here. But it’s not clear from this article whether RingMD offers anything more than video chat. Most doctors need additional tools to schedule appointments and store records. But it appears that RingMD doesn’t offer any of that. Here is a review of virtual doctor evisit services for more information.

Which offers a nice segue to some exciting news. Next month VSee will launch a new product we call Cloud Medical Office. This brand-new service provides health care providers a complete practice of their own – including scheduling, file storage, and record archives – so that they never have to worry about putting together the right tools, but can run their entire office virtually and on-the-go.

Our CEO Milton Chen will debut Cloud Medical Office at the mHealth Summit in December.

Do-It-Yourself Telemedicine Solution for an Ebola Isolation Unit

CDC Ebola unit suit

Being on the front lines of Ebola containment is a frightening job. Protective measures include setting up check-in stations outside of the hospital, wearing heavy duty face shields and decontamination suits, duct-taping layers of gloves to sleeves, and using telemedicine technology. In fact, Nebraska Medical in the lonely Midwest has taken Ebola treatment and prevention to a new level with its use of HD video telemedicine and hands free medical technology. Using technology like digital stethoscopes, X-rays with wireless transfer, and real-time video allows it to keep Ebola treatment safe yet personal. It has successfully saved all two of its Ebola patients and has made Nebraska Medical a CDC model of care for fighting Ebola. It was also recently awarded a 10M telehealth grant by CMS.

VSee Lets You Do Telemedicine On the Cheap

However, you don’t need a 10M telehealth grant to set up a telemedicine isolation unit like Nebraska Medical – which uses Vidyo, a very expensive and complex system.  VSee simple, secure telehealth lets you set up interactive HD video telemedicine for your isolation unit in just about 2 hours. Unlike Vidyo and similar systems. VSee’s peer-to-peer platform does not require any complicated server setup or maintenance. Furthermore, VSee’s simple design allows you to easily integrate telemedicine devices without any additional equipment or complicated configurations. VSee even allows you to send up to 4 device images simultaneously so you can see both the patient’s face and the device images without toggling or doing special video mixing.

To start using telemedicine in your isolation unit, all you need is a few pieces of easily obtainable equipment:

Setting Up Ebola Telemedicine in Less Than 3 Hours

To set up your system, download VSee to your computers. For the isolation unit PC, configure VSee to auto answer mode: Go to the VSee address book, click Settings–>Preferences–>Automatically accept calls. VSee allows you to add only selected VSee accounts to auto accept calls to ensure security.

VSee auto call accept

To set up your PTZ HD camera: Go to the VSee address book, click Settings–>Audio and Camera Setup. Select your PTZ camera from the camera pull down menu.

VSee Camera Setup

And if you’re not ready to “do-it-yourself”, VSee offers a pre-configured isolation unit to get you started.  Please contact sales@vsee.com and join Dr. Gavin MacGregor-Skinner and other VSee users in fighting Ebola with telemedicine today.

 photo courtesy: CDC Global via Flickr

Zoom Is Not HIPAA Compliant (updated on Feb 1, 2015 – Zoom will now sign BAA)

zoom hipaa compliant

Please see VSee CEO Milton Chen’s comment below for update on Feb. 1, 2015 .

Zoom, an online web meeting provider, has been marketing as itself as a telehealth solution. However, if you’ve done your HIPAA homework, it’s clear that Zoom isn’t ready for telemedicine. First, Zoom copied its HIPAA faq’s almost directly from VSee’s old HIPAA page. Second, it hasn’t bothered to keep up with discussions of the HIPAA rules since then. This leads to the problem that unlike VSee and Vidyo, Zoom does not sign Business Associate Agreements (BAA) required for HIPAA compliancy.

In a PDF downloaded from their website, it claims that “Zoom never has access to any information, health or otherwise, that you may observe, transmit, or receive by using Zoom, and therefore is not a business associate under HIPAA rules.” Thus, it is saying that signing a BAA is not necessary for it to be compliant with HIPAA.

It’s true that early on when the HIPAA Final Rule (or Omnibus Rule) first went into effect on January 23, 2013 (covered entities had another 6 months to actually get their papers and policies in line), there was a lot of confusion about whether video calling services — Skype, Vidyo, VSee, WebEx, Zoom, etc.– were exempt from being a Business Associate (BA) under HIPAA’s “conduit exception.” (HIPAA only mentions the post office and telecommunication carriers as specific examples of the conduit exception).  For example, according to Dr. Ofer Zur, author of The HIPAA Compliance Kit:

The Final Rule seems to state that in order to be exempt from serving as a BA, the software must only be transmitting the data (as Skype does) and must have no access to that information. The conduit rule is a rule that exempt a company from being a HIPAA Business Associate only if it:

1) Only transmits the encrypted PHI and
2) Never has access to the encryption key.
According to some experts the fact that Skype can give information to law enforcement (as it has been known to do) means they have access to the encryption key, which means they must serve as a BA. However, Skype neither provides a BA Agreement nor claims to be HIPAA Compliant.

The issue, however, was cleared up by HIPAA’s enforcing agency, the Office of Civil Rights (OCR) at the Department of Health and Human Services, by the end of 2013. In fact, VSee was able to make direct contact with an OCR representative to find out whether the “conduit exception” applied to VSee and other videoconference vendors.

Yip Fong, the OCR representative we talked with confirmed that a BAA would be required for its healthcare customers. She noted that even though patient health information (PHI) isn’t “stored” or “maintained”, it is “transmitted” over the Internet which is always susceptible to a breach despite strong security measures. Therefore providers must enter into a BAA with such vendors.

Would Zoom Take Responsibility for a HIPAA Privacy Breach?

In the end, the question is who is going to take responsibility in case of a personal health information (PHI) leak. Consider, even if you apply Dr. Ofer’s understanding of the HIPAA “conduit rule” Zoom still wouldn’t be exempt from being a BA. While Zoom encrypts the data they transmit, the encrypted video is in fact first transmitted to its servers which have full access to the raw video. In other words, Zoom has access to the encryption key, and this is a major architecture hole for leaking patient confidential information.

Furthermore, HIPAA is also clear that even something as simple as saying patient X had a call with doctor Y is considered PHI.  Leaking such personal health data can mean fines of up to $1.5M per patient. Conducting a telemedicine session with Zoom makes a provider that much more vulnerable to such leaks.

For example, suppose you are a therapist specializing in depression and you use Zoom to make an appointment with me.  Zoom knows that I talked with a depression therapist, and people can infer that I am depressed.  If Zoom accidentally leaks this information out – who is responsible? Clearly, Zoom should be responsible since it is the one that revealed a patient condition. Thus, Zoom should be signing BAAs if it wants to be HIPAA-compliant.

Moral of the story: if you’re looking into telemedicine video, do your homework and make sure you’re working with a HIPAA-compliant video provider who knows the rules.

Vidyo No-Show — Are They Giving up on Telemedicine?

This year’s ATA Fall Forum in Palm Desert, CA was a huge show of strength for telemedicine. All the big names were there, from Global Med to AMD Telemedicine to MedWeb to VSee, even non-HIPAA compliant Zoom was there. The theme was “Managing Chronic Conditions via Telemedicine,” and the VSee team was proud to participate and see our old and new customers.

Notably absent from the exhibition floor was Vidyo, the nemesis of VSee.

Almost all VSee customers are former Vidyo or webRTC (OpenTok, AddLive) users who were dissatisfied with the video quality or customer service of these video providers. Given the explosive growth of telemedicine, is Vidyo giving up the telemedicine space and leaving the field to VSee and Zoom? Exhibiting at ATA’s telemedicine tradeshows show commitment to serving that market segment. It shows a company’s intent to support and focus on telemedicine users. Can you trust a company who doesn’t even bother to show up?

Perhaps this absence signals a shift in Vidyo’s strategy? Maybe they’re spreading themselves too thin with their new injection of venture funding. Perhaps they’ve realised their solution is less competitive, so they’re moving away from the healthcare industry. We would not be surprised if they give up on telemedicine to focus exclusively on video games.

HealthTap Taps Doctors for Virtual Video Visits

HealthTap doctor

photo credit: HealthTap

HealthTap, best known for its online health question and answer knowledge base curated by real doctors, is looking to join the ranks of real-time virtual doctor visit platforms such as MDLIVE, American Well, Teladoc, and Doctor on Demand. Actually, it’s looking to outrank these virtual health platforms to become the Amazon of virtual health care. It already offers physician-reviewed health news and health/wellness app recommendations, as well as creates a snapshot of your health profile based on your HealthTap use. Last week HealthTap announced a new Prime service that gives subscribers unlimited access to live videoconferences with doctors for $99 a month, plus $10 for every additional family member. HealthTap Prime could be great for some patients, especially those suffering from chronic conditions. But is HealthTap Prime good for doctors?

Should You Become a HealthTap Virtual Doctor?

If you’re a physician licensed to practice in two or more states, HealthTap wants to recruit you. But it’s not clear whether they expect you to close your practice and go completely online with them. Photos on their website’s homepage show doctors skydiving and playing with their children, presumably because they’re now liberated from having to keep office hours.

Like most employers, HealthTap doesn’t advertise how much they pay, except that it depends on the number of patients you see and how well you rate.  But in order to enjoy that kind of lifestyle, HealthTap doctors must be compensated very well. Otherwise, you would need to spend many long hours consulting patients by video before you could begin to earn nearly as much as a typical doctor’s income.

Before you rush to enlist in HealthTap’s army, consider what the job entails. You’ll be doing more than just consulting with patients online.The job description on HealthTap’s website calls for doctors who are willing to:

  • Identify and engage licensed, board certified physicians to join the Prime network (read: recruit your fellow physicians for HealthTap)
  • Partner with the Community and Social teams to drive enthusiastic word-of-mouth advocacy among our Prime and Network Experts (read: do some marketing for HealthTap)
  • Act as a resource for new Prime physicians (read: training new hires)

So in addition to working as a consulting physician, you will also be responsible for marketing, recruiting, and training.

Given what HealthTap has to offer, why would any doctor sign up with them?

HealthTap Alternatives

You might be better off working with Doctor on Demand, which charges patients only $40 for a 15-minute consultation. You would get to keep $30 of that, which adds up to $120 per hour.

Even better, consider working with AskMD, an online consultation service of ShareCare health and wellness social platform co-founded by Dr. Oz.  AskMD provides you with an online presence that you control. And rather than replace your practice, AskMD improves it by giving you a way to “meet” your patients before they arrive at your door.

Vidyo Gets Another $20M Investment to Explore the Wild West of Video Conferencing

Vidyo, VSee competitor, just raised another $20M to bring their total funding to $139M — well ahead of the typical $40M needed to reach IPO stage.  With 300 employees and a monthly burn rate of probably ~$4M, Vidyo’s $20M fundraising at this stage of the game is rather unconventional – companies positioning for IPO normally raise huge rounds. It’s highly likely that Vidyo’s current revenue can cover its expenses, but it needs extra cash to explore new markets.

An expansion into new markets isn’t too surprising considering that video conference companies valuations have been poor cousins to Instant Messaging companies, e.g. Instagram and WhatsApp.  It’s likely that Facebook’s acquisition of WhatsApp for $19B earlier this year has jolted Vidyo investors, pushing Vidyo to explore new markets.  According to Vidyo CEO Ofer Shapiro, Vidyo has its sight set on more than the enterprise video conferencing space – it’s going after consumer markets, and it wants to go big.

This includes going after the booming healthcare space to bring video chats to hospital beds or patients in their homes as well as to the online banking space. But even beyond that, it means taking video conferencing into the “Internet of Things.” We’re not talking smartphones but everyday technology from wearable devices to gaming consoles to household appliances — with the end goal of putting Vidyo technology directly into the hands of consumers.

Vidyo has already gotten a head start on this with Google+ Hangouts video chat which used a Vidyo plugin until recently.  Even now with Google Hangouts moved onto the VP8 video codec and getting ever closer to a completely WebRTC implementation, the Vidyo and Google partnership continues with deals such as Vidyo’s work to add its scalable video codec (SVC) into VP9 (which will eventually be used by Hangouts and all WebRTC platforms) and the VidyoH2O video conferencing bridge for Google Hangouts.

VSee, on the other hand, has taken the strategy of focusing exclusively on healthcare and developing workflows to make healthcare customers happy. The question is: Will VSee’s strategy will knock Vidyo out of healthcare market.  Is Vidyo spreading itself too thin to make you happy?

In any case, congratulations to Vidyo on the another round of successful fundraising!

Google Helpouts Review – Google Hangouts for Health Providers

Google Helpouts health

Video chat visits with your doctor are no longer a thing of the future. A growing number of telehealth platforms like MDLIVE, American Well, Teladoc, and Doctor on Demand are offering online video consultations with a doctor anytime. As a health provider wanting to get a start on telehealth in your own practice, you may be considering video options such as Vidyo, American Well, VSee, and more recently, Google Helpouts–think “Google Hangout HIPAA compliant.” Hope you find this Google Helpouts review helpful.

Google Helpouts is yet another new Google product experiment. Based on Google’s popular Hangouts video chat tool, Helpouts is a way for experts to offer their services via live video consultation. (You may want to check out this general Helpouts review.) Healthcare Helpouts, in particular,  allow health providers meet specific HIPAA regulations for connecting to consumers over real-time video. Whether you’re a nutritionist, a midwife, speech therapist, or a physician, you can now provide your expertise online with Google Helpouts.

Unlike Skype and Google Hangouts, which have security issues, Healthcare Helpouts is a bit more conscious of HIPAA privacy concerns and requirements. Helpouts offers you a Business Associate Agreement (BAA) with Google, email and text notifications cleaned of personal information. It also automatically records video chat sessions and sends the recording to both you and your patient for any required record-keeping (which you also have the option to disable).

Google Helpouts also fits well into a clinical workflow. It includes patient scheduling, provider calendar, email and text notifications, and online payment all in one package. Of course, all these features have to be enabled through a Google account, and require using Google’s Calendar and Wallet products. However, this may not be a big deal, since most of us are already part of the Google mafia in some way. The bigger problem you’ll face is whether this Google service will stick around.

Google Helpouts healthcare

Google Helpouts scheduling

You should also know that Helpouts comes with a few limitations. First, you’re out of luck if you need to do a group call – Helpouts is strictly for one-on-one video calls. Compare that to VSee OneClick, which allows you to add multiple users into a video call and also for a user to leave the video call at will.

It’s also good to know that while Google is willing to sign a HIPAA BAA with you, it does store and retain rights to access to your data including recorded video chat sessions. VSee video chat sessions, on the other hand, are just between you and your patient. VSee does not store or have access to any data passed during your video chat.

On the up side, probably the biggest draw of Helpouts for health providers at the moment is the pricing. While other Helpouts users are charged a 20% commission fee from each of their Helpouts sessions, healthcare providers currently get to use Helpouts for free. (Apparently it’s against the law to charge a percent commission from healthcare services.) But don’t be fooled. Google is out there to make some money, and it will either come up with a profitable pricing model or the Helpouts product may fold as with the failed Google Health portal and many other promising Google products.

In short, Helpouts could be a great way to test the video telehealth and telemedicine waters, but make sure to keep your other options open.  Helpouts is most definitely a work in progress, and it’s still very much up in the air whether it will survive the wilds of virtual care.

MDLIVE – Favorite Telehealth Product at Innovation HealthJam

MDLIVE reviewMDLIVE’s virtual doctor visit platform received some great reviews at the recent Innovation HealthJam, a 3-day virtual brainstorming session on hot healthcare issues.  Hosted by Panasonic, HealthJam topics ranged from genomic mapping, connected aging, patient engagement to telemedicine and telehealth. MDLIVE along with other virtual doctor visit services Zipnosis and American Well showed up several times in a “My Favorite Telehealth Products” forum. I was a little surprised at how popular online doctor services like MDLIVE have become.  Here are some MDLIVE reviews that were posted:

“I’m a fan of MDLive. I’ve used this telemedicine service twice with great success. I even used it from Dublin!” – John Nosta, Jam host

“I also like MDLive (http://bit.ly/1n9GgCt) and, for simple conditions (you know the ones Gramma used to treat), I like Zipnosis (http://bit.ly/1p69BSL) – its Minute Clinic on Your Mobile.” – Patricia Salba, Jam host

“I have found MDLive to be an excellent solution for simple stuff. It is FAST (10-15 min), immediate, and cheap $35. Customer service was excellent, much better than traditional care models.” – Christopher Wasden, academia

There was also a plug for MDLIVE competitor American Well:

“I tried out American Well at a conference. The MD was terrific, I received a recording of the visit, and it was affordable -less than my urgicare co-pay.. I’m looking forward to their nutritional services, launching in July. This saved me a trek to an urgicare center. The recommendation was also appropriate –no prescription was supplied.” – Ellen Cohn, academia

Looks like the next time I have a sinus infection I’ll have to try out MDLIVE’s telemedicine service – definitely cheaper than trying to meet my deductible!

What has been your experience with online virtual care?

AddLive WebRTC Video Chat Stealth Acquisition by SnapChat Leaves Citrix and Big Guys in the Dust

addlive snapchat acquisitionAddLive, a small WebRTC voice and video chat company early this week announced its secret acquisition by popular private photo messaging app, SnapChat.  Its blog post notes that while there are “no immediate plans to add new customers to the platform, we intend to continue providing our ongoing video chat services.” This includes telehealth video doctor visit app Doctor on Demand and social health management platform WellTok as well as big boy Citrix (one of the losers in the bidding war for AddLive along with LogMeIn and Cisco.)  While the amount for the acquisition remains undisclosed, blogger Chris Kranky notes that an 8 digit figure wouldn’t be out of the ballpark.

While Snapchat holds a fairly small share of the instant messaging market among popular applications such as WhatsApp, BBM Chat and Facebook Messenger, it has managed to raise over $120 million in funding.  It also had the balls to turn down a $3B acquisition offer from Facebook last October.  The Verge reports that the AddLive acquisition occurred several months ago, which makes sense considering Snapchat’s newly released “serendipitous” video chat which its CEO Evan Spiegel said is designed to capture the “essence of conversation.”  The app is available in both Google’s PlayStore and Apple’s AppStore.

AddLive also gets kudos from WebRTC blogger Tsahi Levent-Levi for being an excellent product and proving that WebRTC is a working reality on the market today. (AddLive has won the WebRTC Conference & Expo 2013 “Best WebRTC Tool” Award and also offers screen-sharing, multi-party conferencing, and support for browser-based video chat via WebRTC.) However, his concern is that current clients will eventually lose AddLive as their WebRTC API provider once its contracts are up.  Furthermore, this will cause companies looking to use WebRTC API in their products will be cautious of contracting with small WebRTC vendors such as Weemo, Layer, vLine, TenHands, and the likes.  Of course, there is always OpenTok and Twilio.

Doctors on Demand – Telehealth Services to Video Call Your Doctor Now

doctor on demand Times magazine

excerpted from Time magazine

Online virtual doctor visits are a growing breed of telehealth services beginning to dot the healthcare landscape.  Companies such as MDLIVEAmerican WellTeleDocGoogle Helpouts, and Doctor on Demand offer virtual care services that are designed to give you immediate access to a doctor so getting medical attention is more convenient and accessible for everybody. This means no more sitting around urgent care waiting rooms full of germs and sick people just to get seen for a minor cold.  It also means you don’t have to take a big chunk of time out of work or haul a sick child down to an office to see a doctor.  Instead, you can get on your laptop or mobile device and easily have a doctor see you virtually from the comfort of your home or office.  Depending on your needs, there are a range of telehealth and telemedicine options out there these days for online doctor consultations.

More Ways to Get Health Care Online

For a quick diagnoses and prescription for something like a cold or yeast infection, Zipnosis offers 5 minute online doctor diagnoses at $25 per illness.  You can also get fast answers for your health condition using popular smartphone health apps like AskMD and HealthTap which give you free access to instant doctor answers.  Full-fledged live doctor video consultations with primary care physicians, specialists, and therapists are also now available.  Virtual care platforms that have these services include MDLIVE ($45/consultation for doctor or therapist), American Well ($49/consultation), TeleDoc ($38/consultation + $150 annual membership fee), Google Helpouts for Health (price set by individual health providers), and celebrity newcomer, Doctor on Demand ($40/consultation).  You can check out our list of virtual consultation service reviews here.

Dr. Phil Showcases Online Doctor Video Visits

Doctor on Demand Dr. PhilEven TV health personalities like Dr. Phil are getting into the game. Dr. Phil recently featured the Doctor on Demand telehealth app on his own TV show as well as on The Doctors. In addition, he is one of the funders of Doctor On Demand (along with an impressive list of investors including Venrock, Andreessen Horowitz, Google Ventures, and Athena Health CEO Jonathan Bush). He also sits on its advisory board and happens to be the father of one of the co-founders, Jay McGraw.

Doctor on Demand allows you to see a doctor without being a part of a health plan or employer group.  It charges based on time (like lawyers) rather than a per visit fee at a $40 per 15 minutes rate.  It also employs doctors to work scheduled shifts rather than having doctors subscribe to the service to see patients whenever they have down time.  Its pay model allows physicians get to take home $30, while Doctor on Demand gets a $10 cut.  Doctor on Demand consultations are currently available in 31 states, including California, Florida, Georgia, Illinois, Indiana, Michigan, Mississippi, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia and Washington.

Video Visits With Your Doctor A Growing Frontier

Even without media hype from Dr. Phil, Dr. Stork, and Dr. Oz, virtual doctor visits are a clearly growing healthcare option. Long touted as a solution to healthcare accessibility for patients in underserved and rural areas, telehealth is also seen as a way to help lower healthcare costs and improve effectiveness, cover doctor shortages anticipated with the Affordable Care Act, and to make healthcare more convenient overall.   Furthermore, video doctor visits are also benefiting doctors.  According to a recent study, 80% of doctors are using mobile devices in their day-to-day practice, and MedCity reports that “many are choosing to work remotely and consult with patients on video chat services

Are you ready for video chat visits with a doctor?

More Telemedicine Articles…

Business Insider breezy read – “There’s A New App That Will Let You Have A Real Doctor’s Appointment Using Video Chat On Your Smartphone

Modern Healthcare reports TeleDoc study – “RAND study cites telemedicine benefits: lowers costs, expands access

Fast Company on Google Helpouts, Google’s new marketplace for healthcare experts – “The Doctor, Veterinarian, and Lactation Specialist Will See You Now—On Video Chat”

Is WebRTC Video Conference Ready for Market?

webrtc video

WebRTC and the promise of video calls right from your web browser has captivated the media and businesses over the past few years. So it’s not unusual for us to get questions about how VSee compares with WebRTC video.  Recently, we got this interesting question from a customer:

From your expertise, how much dev time would VSee save me over building my own VC system utilizing Web-RTC with other supporting open-source technology?  I have a development team with 4 engineers.

Building your own video conferencing system using WebRTC with just 4 engineers is an impossible task – if you’re trying to go to market fast and if you want to achieve high performance.  With that many engineers, you can touch up the interface of WebRTC video, but you can’t improve its performance. When Google open sourced WebRTC technology, it opened up an exciting new world of possibilities for developers.  However, it’s also worth noting that Google also held back a number of WebRTC components when it purchased On2 (the source of WebRTC video) and GIPS (the source of WebRTC audio).  So the truth is that while WebRTC performs better than Flash, its raw open source performance still isn’t that great. This is why even Google uses Vidyo to run Google Hangouts instead of fully employing its own WebRTC technology.

The Road to Great Video Performance

To develop great video performance, you have to do deep video work, and there are only a few companies out there who have successfully done this – VidyoLifeSizeZoom, VSee and of course, the big guys such as PolycomMicrosoftCisco / Tandberg…. Every one of these companies have two things in common 1) they have spent years working on video, and 2) they have large engineering teams devoted to video work. Working on video is like an arms race – either you commit a lot of engineers to constantly upgrade or you quickly fall behind on the performance curve.

Furthermore, developing great raw video performance isn’t going to be your only issue.  Keeping your servers operational 24×7 under a heavy load will be another big chunk of engineering time that is more than enough work to keep your developers busy. People expect video to work like the phone—when you need to use it, it works. Since everybody starts with SIP or XMPP server open source stack, you will need to do a lot of hands-on engineering to fix and improve what’s needed.  We have 4 engineers alone dedicated just to improving our server performance.

To Use or Not To Use WebRTC Video?

So your choices are:

  1. Stay on the WebRTC video performance curve. In that case, using 1 engineer to keep up with its interfaces would be more than enough.  You could also use OpenTok video API, which gives you a nice wrapper over WebRTC.

  2. Go native yourself. This would require investing in a large team of engineers and years of work – as VSee and our competitors have done.

  3. License video conference from VSee or one of our competitors and get the highest video quality out there.

WebRTC is a fantastic technology, and is definitely the direction to go.  In fact, VSee uses the WebRTC audio echo cancellation code in our audio pipeline.  However, at this point in time, WebRTC video is still immature, and companies betting on WebRTC will probably still have to wait 2-3 years before it is ready…or at least wait until Google starts uses WebRTC in its own products.

Milton, VSee CEO

OpenTok Drops Free 1-on-1 Video Calls

OpenTok by Tokbox
It may be time to give VSee group video chat a whirl now that OpenTok (WebRTC version) 1-on-1 calls are no longer free.  Not only are VSee 1-on-1 calls always free, even group video calls are always free.
OpenTok is now requiring everyone to pay at least 50 bucks a month for their service. This does get you unlimited 1-1 minutes, but only if you always make a direct peer-to-peer connection, according to a recent Quora answer post by TokBox Developer Evangelist Ankur Oberoi.
The caveat, he notes is
“You should also be aware that for ~8% of connections around the world, peer-to-peer is not possible because of symmetric NATs and firewalls. If you want to support everyone, even in a 1:1 scenario, you will need to rely on using minutes. You get 10K minutes a month at the minimum $50 level.”  If you think you’ll need more minutes, you might want to check out all the other OpenTok price tiers here. Note that for group video calls, you do get charged for the minutes used on each video stream (i.e. each caller) during the call.
So why not give VSee free videoconference a try – after all, it’s no money out of your pocket 🙂

Finding the SBR Health and VSee Link

SBR Health video solutions

Just for the record, while SBR Health (secure video-based solutions for the creation of virtual healthcare delivery networks) did come out of VSee (secure video conference + screen share for telehealth), they are two separate companies without any business ties.  I get asked about the relationship between SBR Health and VSee all the time – so I wanted to write this blog to clarify – because there is a small story behind it 🙂

SBR Health and VSee – What’s the Link?

When VSee was started, telemedicine and telehealth weren’t anywhere on our horizon.  We were purely focused on building a video collaboration tool that would provide an awesome user experience. However, as the VSee product matured, we started seeing numerous medical and healthcare-related sales leads, so I asked Chris Herot, our then Chief Product Officer, to focus on VSee healthcare customers.

Chris, as you may know, is now the CEO of SBR Health.  When I first met Chris, he had just ended his previous venture, Convoq (a WebEx alternative platform for web conferencing) and had written an insightful article on his experience.  I was a struggling first time entrepreneur, so I took the initiative to reach out to him and ended up hiring him for VSee.  It’s a decision I will never regret – Chris is one of the smartest and most talented people I know, and I learned a lot from him about running a startup, for which I’m extremely grateful.

But getting back to how SBR Health was born – we were getting so many healthcare-related leads that the SBR Health idea was formed to allow VSee to have a better product-market fit for these leads.  The initial idea was to help hospitals manage their video calls more effectively.  For example, if Stanford Hospital required a Spanish translator, the system would route the VSee video call to a translator matching the requirement. Unfortunately, at that time, VSee didn’t have the engineering resources to serve SBR Health and its general medical requirements, so today SBR Health and VSee are two separate entities, each on its own business trajectory.

Differences Between SBR Health and VSee Telehealth

So how does SBR Health differ from the VSee telemedicine / telehealth eVisit offering? SBR Health aims to simplify the work flow of major hospitals – specifically – through skill-based video call routing, as described in the Stanford Hospital medical interpreter example. These skills were later expanded beyond just languages and  interpretation services. Other companies that aim to optimize complex medical work flows include a booming Eceptionist, which is doing quite well. It offers a platform that “supports scheduling, telemedicine, e-referral and triage management, wait list and wait time management, case management, care pathways, protocols and reporting” for hospitals and healthcare facilities.

VSee telemedicine eVisit takes a holistic approach to providing our telehealth platform as a service. We have developed the entire stack from low level video and medical device sharing to calendaring, virtual waiting room, doctor dashboard, etc. to HIPAA-compliant data hosting. By developing the entire software stack and modules – VSee is able to customize design and provide a simpler virtual visit experience for both patients and doctors.

You can learn more about VSee telemedicine eVisit at

Thanks!

Milton, CEO

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