The financial world was buzzing in August when Teladoc (TDOC -1.52%) purchased Livongo Health for an eye-popping $18.5 billion. While both companies were thriving -- Livongo was more than doubling sales every year, and Teladoc was also growing fast and increasing its network of members and providers -- some investors worried that this was far too high a price for an acquisition at the height of a once-in-a-century pandemic. To many, it seemed that neither company should have wanted to do the deal at the time. The next month, Amwell (AMWL 5.54%) went public with a $100 million injection from Alphabet (GOOG -1.10%) (GOOGL -1.23%), and remote health was back on everyone's mind.
Through all of this, one company that's been overlooked in this space has been signaling its intention to be a leader in telemedicine. If history is any indication, Zoom Technology (ZM -0.82%) will be the stock to own in virtual care.
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Integrating with existing platforms
Zoom has become well known for facilitating business meetings, school classes, and more in the time of coronavirus, but like Teladoc and Amwell, the company also offers an app for electronic health records (EHR) systems. The leader in the EHR space -- Epic, with a 29% market share --allows physicians to launch Zoom from within the interface and document the visit directly in the patient's record. Patients, meanwhile, are able to launch Zoom from within Epic's patient system, called MyChart, on their computers or mobile devices.
Although Amwell is the preferred telehealth partner for Epic's chief rival, Cerner (CERN), even health systems that use Cerner began using Zoom's telehealth solution during the pandemic to meet the increasing demand. This industrywide shift to Zoom was captured in a survey conducted during April and May in which the 1,300 providers who responded noted that the telehealth solutions they had used the most were doxy.me -- which is free -- and Zoom.
Ease of use for providers and patients
Teladoc, Amwell, and Zoom all have easily downloadable apps for consumers. However, it's the user experience within the EHRs that matters to the providers and administrators, and that will be key to determining which one becomes the industry standard. While each company offers features that improve information flow, security, and remote camera control for physicians, there are a few differentiating features between them.
Amwell, for instance, has its own line of branded telemedicine carts -- systems that include cameras and displays to allow remote physicians optimum access to patients. There are advantages and disadvantages to this. By owning the hardware, the company can ensure a seamless experience for clinicians and prioritize technological advances that enhance its software. On the other hand, health systems looking for telemedicine solutions may balk at replacing expensive hardware to get the most out of a company's software offerings.
Customers do seem to like Amwell. The company won the MedTech Breakthrough Award for best telehealth solution in May, and it has a Net Promoter Score (NPS) of 56, according to its S-1 filing. (NPS is a measure of customer satisfaction calculated by subtracting the percentage of users who are negative about a company, service, or product from the percentage who are very positive about it. The scores range from -100 to 100, with higher being better.)
While Teladoc was named the company that provided the best consumer telehealth experience by J.D. Power in 2019, its management does not report overall NPS in its filings. Zoom, on the other hand, reported a remarkable NPS of 70. J.D. Power might like Teladoc, but users love Zoom.
What will separate Zoom from the pack
In 2017, Zoom CEO Eric Yuan estimated that healthcare represented 10% to 15% of the company's user base. Management has organized the business into verticals focusing on specific industries so that it can more effectively solve problems for users. In healthcare, the company has highlighted several use cases from customers that demonstrate its ability to address needs beyond the traditional doctor's office visit. While they didn't share specifics, management did note that healthcare was one of its fastest-growing verticals.
One underappreciated aspect of Zoom's solution is how well it handles low-bandwidth environments. Because it automatically adjusts to bandwidth constraints, participants are able to maintain a connection even when connectivity is low. This is no trivial issue -- because of building layouts and budget constraints, it can be difficult for hospitals to provide enough access points for consistent, high-quality wireless internet connectivity everywhere in their facilities.
On its blog, management has highlighted several healthcare providers that have successfully leveraged the Zoom platform. Stratus Video, a remote language-interpretation company, has used the technology to serve patients in thousands of hospitals, and several groups -- including the largest mental health care provider in California -- have used the platform for psychiatric and behavioral health visits.
The conferencing features allowing doctor-to-doctor collaboration are another plus; at the Phoenix Children's Hospital, pathology teams use them to stay virtually engaged with surgeons in the operating room, allowing those experts to be "present" when their input is needed most. The hospital recently reported a threefold increase in the number of clinicians using Zoom, because it suffered fewer technical glitches and required less setup time.
While many solutions in telemedicine were already benefiting from the growth in demand for remote care, the pandemic has driven their adoption rates to previously unthinkable levels. The consumerization of healthcare has been transforming patient choices and health system investments over the past decade. User experience and ease of access will continue to be key differentiators in both the consumer technology world and the healthcare industry. Patients expect technology on par with what they experience in other aspects of life, and clinicians comfortable with the latest tech in their personal lives are keenly aware when the solutions at work don't measure up.
Zoom has grown by identifying and solving individual use cases -- many of which the company didn't originally imagine -- and has rapidly gained market share precisely because its offerings are so easy to use. The number of Zoom users grew by more than 30 times in just the months between December 2019 and April 2020. Those new users will come to expect the simple launch, easy-to-understand interface, and robust features the platform offers. The telemedicine space is growing and will have room for more than one winner, but a culture of creating happy customers and easier-to-use technology makes Zoom the telehealth stock to buy.
