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Jay Parkinson: Tele Vision for Health Care

Dr. Jay Parkinson and his virtual health platform Sherpaa are quietly bringing telemedicine to the forefront of employers’ minds by providing meaningful health care with measurable results.
a doctor is an exercise in narrowing. Doctors’ undergraduate science degrees are honed in on health care during medical school and then on specific patient populations or areas of the body during residency. The ultimate goal is to successfully treat a patient one-on-one. 
Dr. Jay Parkinson took that path, but he doesn’t fit that mold
ecoming a doctor is an exercise in narrowing. Doctors’ undergraduate science degrees are honed in on health care during medical school and then on specific patient populations or areas of the body during residency. The ultimate goal is to successfully treat a patient one-on-one. 
Dr. Jay Parkinson took that path, but he doesn’t fit that mold. 
“I’ve always been a big-picture thinker,” Parkinson said. “I knew that I didn’t want to be part of a broken system. Trying something out has always been my passion, and sometimes it leads to bigger and better things.”
In Parkinson’s case, thinking big also meant thinking back. His online health care company, SherpaaHealth Inc., builds upon the practice of telemedicine — virtual care delivered in real time — that was first conceptualized in 1967 by Dr. Kenneth Bird. Since then, the practice has seen success in niche markets, including the prison system, but is slowly gaining mainstream acceptance among employers, patients, the medical community and, perhaps most importantly, venture capitalists. 
By integrating the latest technologies, Parkinson is helping employers reduce rising health insurance costs while still providing quality care to their employees. 
After receiving his bachelor’s degree in biology from Washington University in St. Louis and his medical degree from Penn State University, he began to question the effect he would be able to have on the population’s health while completing a pediatric residency at the now-shuttered St. Vincent’s Hospital in New York’s West Village neighborhood. 
“When I was in residency, I saw the life of doctors and that it was really one-on-one,” said Parkinson, 39. “I thought that was really cool, but when you want to make an impact in the world, you really have to make a systems change, a process change and a big-picture change. I realized that I had all these really great ideas about what health care can and should be, but that you can’t really do that when you’re seeing patients one-on-one.” 
In 2006, while completing his second residency for preventive medicine at Johns Hopkins University in Baltimore, Parkinson stumbled upon a solution capable of changing the way that health care is delivered in the United States.
Photography was an outlet for Parkinson at this time, one that led him to form friendships with other photographers and members of the “creative class,” many of whom did not have health insurance. 
“I was sort of their connection to health care,” Parkinson said. “They would hit me up all the time with emails and pictures of what was going on with them, and I would do my best to help them out. Doing that made me realize there was something to that approach. People are absolutely willing to communicate online with doctors.” 
He wasn’t wrong. 
In its 2014 survey of telemedicine, international law firm Foley & Lardner found that 84 percent of executives feel that telemedicine services are either “important” or “very important” to their organization. Furthermore, in its 2014 Health Care Changes Ahead Survey of U.S. employers with at least 1,000 employees Towers Watson & Co. found that 75 percent of employers anticipate offering telemedicine services by 2018 at a potential health care cost savings of $6 billion a year.
With a secure messaging system that allows patients to text and email with Sherpaa staff physicians, Parkinson is using telemedicine to both keep patients out of the traditional health care system and drive down the rising cost of health insurance for employers.  
TV Doctors 
The concept of telemedicine is not hip or young. It is not the brainchild of a Silicon Valley tech wizard. It was developed five decades ago because a doctor got tired of sitting in traffic. 
In the 1960s doctors made about $8,000 a year, said Dr. Jay Sanders, professor adjunct at the Johns Hopkins School of Medicine and CEO of the Global Telemedicine Group. As a result, many of his colleagues moonlighted at outside practices. Sanders’ professor, the aforementioned Bird, served as the medical director at Logan Airport Medical Station in Boston. Though the airport was only 3½ miles from Massachusetts General Hospital where they both worked, the commute sometimes took him an hour each way.
“One day he was so upset about the commute that he came up to me, grabbed my arm and told me he had an idea,” Sanders said. “He wanted to buy two cameras and put one at Logan Airport and one in the ER and examine patients over TV.”
Though Bird, who died in 1991, came up with the concept, Sanders is widely considered the father of telemedicine. 
“I thought it was the stupidest idea I had ever heard in my life,” Sanders said. “And I’ve been working on his stupid idea ever since.”
Sanders’ opinion has since changed. The process of asking questions to assess a diagnosis can be completed just as effectively over phone or email, Sanders said, which makes slow acceptance rates more frustrating. 
“All of the technology is growing up in parallel,” Sanders said. “The fundamental reality is that most service industries figured out how to bring their services to the consumer a long time ago. We go online to do our shopping. We have our entertainment brought to us. We do our banking online. People make a big to-do over technology that we are using in other phases of our lives, but when we apply it to medicine, we think it’s strange.”
Towers Watson found telemedicine usage rates to be 10 percent or less at most U.S. companies. 
The underlying problem is patient confusion over just what telemedicine can be used to treat, said Dr. Allan Khoury, senior health management consultant at Towers Watson. According to the consultancy’s 2014 Health Care Changes Ahead Survey, 15 percent of primary-care visits, 15 percent of emergency room visits and 37 percent of urgent-care visits could have been solved effectively and at a lower cost via telemedicine. 
Sanders is quick to clarify that telemedicine is not a substitute for medical care. It is an additional capability that employees should be aware of. 
“I don’t think employees understood where telemedicine fits in the midst of all the other services they have available,” Khoury said. “Employers used to just purchase the service and assume employees would use it because it was so convenient. It turns out you have to be more aggressive in order to generate substantial uptake.”
Fortunately or unfortunately, the cost of health care has risen to a point where the opportunity to save money is motivation enough for employers to try a new approach. 
Right Space, Right Time
Health care costs have employers over a barrel. According to Nathaniel Lacktman, a partner and head of the telehealth and telemedicine practice at Foley & Lardner, an international law firm headquartered in Milwaukee, the health care industry has reached a point where employers must consider outside solutions in order to keep health care costs down. 
“We’re at a tipping point,” Lacktman said. “The tenor of health economics has changed. Employers are looking more toward risk-based contracting rather than paying a flat rate for unlimited services that an employee may or may not use. Employers want to know exactly what they are spending and what they are getting for their money.”
Annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, with workers on average paying $4,823 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust 2014 Employer Health Benefits Survey.
Affordable Care Act regulations add another sense of urgency. Frustrated employees who have had the rising cost of health care shifted onto them through high-deductible health plans are looking to their employees for solutions to keep them healthy and not triggering copayments, Lacktman said. 
According to the Foley survey, 50 percent of employers responded that telemedicine’ s ability to keep employees healthy was their No. 1 rationale for implementing the practice as part of their benefits plan.  
Thankfully, technology is catching up to the point where it can provide a solution.
“The user experience is better,” said Skip Fleshman, a partner at venture capital firm Asset Management Ventures, which focuses on the growth of the digital health industry. “Technology has improved to the point where it is possible to have an integrated flow from booking appointments to having a consultation to being reimbursed all in a seamless manner. Core infrastructure, faster download speed and low latency makes a solution like this actually possible.” 
The ability to communicate instantly also improves upon the traditional health care system. Typical doctor’s visits involve about 15 minutes of interaction with a physician, and direct follow-up, especially in the case of emergency situations, is difficult to achieve, Sanders said. 
“From a physician standpoint, telemedicine provides a way to continuously engage patients and ensure better quality care,” Fleshman said. 
As a result, the industry is crowded with competitors. Investment in telemedicine technologies has grown significantly in recent years, including a $50 million funding round by Teladoc Inc. in September 2014, while Doctor on Demand raised $21 million in August 2014.
Sherpaa raised $4 million in initial funding. 
“That’s not to say that our next round is going to be small, but in the beginning we had to focus,” Parkinson said. “You don’t want to be reckless with the amount of money you raise.” 
Speak Soft and Deliver Results 
Sherpaa partners directly with companies to provide access to doctors via the Web, phone or app for a $30 monthly per-employee fee. Unlike other platforms, Sherpaa uses only messaging systems to streamline the diagnostic process and increase the likelihood that employees will remain engaged with the platform. 
“I think it’s the safest practice of medicine because you have a direct connection to patients at all times,” Parkinson said.  
Though the ability to connect with a physician at any time is comforting and likely to help drive engagement, the ability to drive health insurance costs down is what employers really want. According to the Kaiser Foundation 2014 Employee Benefits Survey, health care premiums increase an average of 5 percent annually for employers.
This is where Sherpaa appears to deliver. In 2014, on average the companies enrolled with Sherpaa saw a 6.5 percent decrease in the cost of insurance compared with the 5 percent increase in cost experienced by those companies that did not use telemedicine, according to Towers Watson. 
“Instead of going to the emergency room and triggering a $700 copay or an urgent-care center and triggering a $150 copay, telemedicine solutions can solve common health problems for around $40,” Towers Watson’s Khoury said.
Sherpaa’s secure messaging system distinguishes itself, though. In addition to being a convenient way to connect with doctors, it also automatically records patient data, Parkinson explained. This means that Sherpaa has a record of what employers are paying for treatment. Knowing exactly how employees are using health care in real life allows Sherpaa to provide clients with demographic data that helps them choose the correct insurance plan for their workforce. 
“We help them understand the best options for the employees,” Parkinson said. “Most people just accept the deal that the insurance company offers them. We provide the information to help them spend better.” 
Regardless of the telemedicine solution they choose, employers should know that their investment in the technology will help drive down costs. 
“Telemedicine is where you can get a hard ROI,” Khoury said. “It’s easy to put in. It’s not intrusive. The employees who use it like it, and it pays for itself very, very quicklyBecoming a doctor is an exercise in narrowing. Doctors’ undergraduate science degrees are honed in on health care during medical school and then on specific patient populations or areas of the body during residency. The ultimate goal is to successfully treat a patient one-on-Dr. Jay Parkinson took that path, but he doesn’t fit that mold. 
 
Dr. Jay Parkinson photo by David Lubarsky Photography
 
 Becoming a doctor is an excercise in narrowing. Doctor's undergraduate science degrees are honed in on health care during medical school and then on specific patient populations or areas of the body during residency. The ultimate goal is to successfully treat a patient one-on-one.
 
Dr. Jay Parkinson took that path, but he doesn't fit that mold. 
 
"I've always been a big-picture thinker,” Parkinson said. “I knew that I didn’t want to be part of a broken system. Trying something out has always been my passion, and sometimes it leads to bigger and better things.”
 
In Parkinson’s case, thinking big also meant thinking back. His online health care company, SherpaaHealth Inc., builds upon the practice of telemedicine — virtual care delivered in real time — that was first conceptualized in 1967 by Dr. Kenneth Bird. Since then, the practice has seen success in niche markets, including the prison system, but is slowly gaining mainstream acceptance among employers, patients, the medical community and, perhaps most importantly, venture capitalists. 
 
By integrating the latest technologies, Parkinson is helping employers reduce rising health insurance costs while still providing quality care to their employees. 
After receiving his bachelor’s degree in biology from Washington University in St. Louis and his medical degree from Penn State University, he began to question the effect he would be able to have on the population’s health while completing a pediatric residency at the now-shuttered St. Vincent’s Hospital in New York’s West Village neighborhood.
 
“When I was in residency, I saw the life of doctors and that it was really one-on-one,” said Parkinson, 39. “I thought that was really cool, but when you want to make an impact in the world, you really have to make a systems change, a process change and a big-picture change. I realized that I had all these really great ideas about what health care can and should be, but that you can’t really do that when you’re seeing patients one-on-one.” 
 
In 2006, while completing his second residency for preventive medicine at Johns Hopkins University in Baltimore, Parkinson stumbled upon a solution capable of changing the way that health care is delivered in the United States.
 
Photography was an outlet for Parkinson at this time, one that led him to form friendships with other photographers and members of the “creative class,” many of whom did not have health insurance. 
 
“I was sort of their connection to health care,” Parkinson said. “They would hit me up all the time with emails and pictures of what was going on with them, and I would do my best to help them out. Doing that made me realize there was something to that approach. People are absolutely willing to communicate online with doctors.” 
 
He wasn’t wrong. 
 
In its 2014 survey of telemedicine, international law firm Foley & Lardner found that 84 percent of executives feel that telemedicine services are either “important” or “very important” to their organization. Furthermore, in its 2014 Health Care Changes Ahead Survey of U.S. employers with at least 1,000 employees Towers Watson & Co. found that 75 percent of employers anticipate offering telemedicine services by 2018 at a potential health care cost savings of $6 billion a year.
 
With a secure messaging system that allows patients to text and email with Sherpaa staff physicians, Parkinson is using telemedicine to both keep patients out of the traditional health care system and drive down the rising cost of health insurance for employers.  
 
TV Doctors 
 
The concept of telemedicine is not hip or young. It is not the brainchild of a Silicon Valley tech wizard. It was developed five decades ago because a doctor got tired of sitting in traffic. 
 
In the 1960s doctors made about $8,000 a year, said Dr. Jay Sanders, professor adjunct at the Johns Hopkins School of Medicine and CEO of the Global Telemedicine Group. As a result, many of his colleagues moonlighted at outside practices. Sanders’ professor, the aforementioned Bird, served as the medical director at Logan Airport Medical Station in Boston. Though the airport was only 3½ miles from Massachusetts General Hospital where they both worked, the commute sometimes took him an hour each way.
 
“One day he was so upset about the commute that he came up to me, grabbed my arm and told me he had an idea,” Sanders said. “He wanted to buy two cameras and put one at Logan Airport and one in the ER and examine patients over TV.”
 
Though Bird, who died in 1991, came up with the concept, Sanders is widely considered the father of telemedicine. 
 
“I thought it was the stupidest idea I had ever heard in my life,” Sanders s