Can This Start-Up Change the Way We See Primary Care in the US?

DECEMBER 07, 2017
Check in, wait 20 minutes, sit in a room for another 15 minutes, have a 10-minute conversation with the doctor, and then, hopefully, walk out with a solution. This describes a typical visit to a primary-care physician's office. But despite our overburdened health care system, trying to make the process more patient-focused and relevant has become a big discussion point recently. So, will things change?
 
Some attempted solutions have included walk-in clinics, which are aimed at cutting down the wait and allowing patients to avoid having to set up appointments. Another idea is an increase in the number of mid-level practitioners (eg, nurse practitioners and physician assistants) to help ease the burden on physicians for low-risk issues. 
 
Meanwhile, the rise of telemedicine is providing a potentially new way to get patients in contact with their care team from the comfort of their own homes, but one start-up based in San Francisco, California, is seeking to take this to a whole new level. Forward is a start-up that wants to make patients the focus of multiple health endeavors, with care teams catering to their needs, and combining a futuristic-looking clinic with teleservices, all for a flat membership fee, 

What sets Forward apart is its embrace of multiple parts of the digital health field, including:
  • Genetic testing: Focused on detecting hereditary cancer genes to then counsel patients on management strategies
  • Onsite blood testing: Forward plays up the fact that patients can get their blood work done at the clinic without having to go anywhere else.
  • Personalized plans: Pushing a holistic approach, Forward seeks to engage users in factors related to wellness, including diet, exercise, and sleep. The company wants to use wearables and other applications to help monitor and give feedback to patients.
  • Vaccinations (travel medicine): Patients can get their workups done before traveling overseas and all the required vaccinations and medications, as well.
  • Onsite pharmacy: After patients finish their appointments, they can stop by the pharmacy to get medications. Interestingly, the website states that "most common" medications are available and at no additional cost. I imagine this excludes most specialty medications and niche drugs because of costs.
So, what is the big deal? Forward is leaning on its ability to tie together all the data that can be collected from patients using smartphone apps and wearable devices to build a more objective view of their health and take the time to make a more meaningful impact on their health. Recently, Forward has expanded its offices to Los Angeles, California, and it looks poised to keep growing. 

The only issue I see with Forward is whether the available technology can meet the data aspect to drive therapeutic interventions. In many ways, Forward is taking a semi-science fiction approach to revitalizing health care that I can get behind. But for a flat fee of $149 a month for such services, I am having a hard time envisioning this rolling out to everyone. It looks instead like a more niche platform for certain patient demographics.


Timothy Aungst, PharmD
Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an associate professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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