Glen Tullman: The State of Healthcare and Telehealth Trends

Glen Tullman has emerged as one of the foremost experts on telehealth. He is the CEO of Transcarent, the first comprehensive, consumer-directed health and care platform. Before that, he founded and ran Livongo Health, the first at-scale consumer digital health company for people with chronic conditions.

At our telehealth summit, Optimizing Virtual Care in 2024, Tullman offered his insights on the state of healthcare and trends for the future.

Glen Tullman on the state of American healthcare

Tullman points out that American healthcare is confusing all around, especially when it comes to costs.

“Despite all of our efforts across the board, what people tell us—whether they’re Republicans or Democrats, men or women, younger people or old people—they tell us that we’re failing at health care today,” Tullman says.

Healthcare costs are eating us alive

Americans find healthcare “more confusing, more complex, and more costly than ever before,” Tullman says.

“And if we look at what’s happening in our economy, healthcare costs are stifling both investment and innovation for business and government,” Tullman says. A prime example is Starbucks spending more on healthcare for employees than on coffee.

“​​Healthcare is the number one cause of bankruptcy in the United States because people don’t understand what healthcare will cost them,” Tullman says.

Tullman explains that healthcare costs are through the roof in part because the system is overly complex and impossible to understand.

American healthcare leaves consumers feeling lost

Putting aside the fear of a bad diagnosis or urgent medical issue, Tullman points out that knowing where to start is often overwhelming. He gives the example of hurting your knee or hip and all the questions that come to mind. He says patients typically ask these three questions:

1. Is it covered?
   • And how much will it cost them?
2. What should you do?
   • Do you get surgery? Should you opt for physical therapy?
3. Where should you have it done?
   • A major medical center or hospital? What about an ambulatory surgical center? Should you see a specialist locally, or would it be better to travel across the country?

It’s not just confusing for patients; it’s also confusing for doctors. This can lead to doctors performing administrative tasks that detract from actual care.

“Doctors today, on average, spend more time figuring out what pharmacy you should go to than they do your diagnosis,” Tullman says.

The lack of straightforward paths and clear information compounds the financial and emotional strain on individuals and families, exacerbating an already stressful situation.

The Experience Era: Glen’s predictions for the future

Tulman is optimistic that digital tools and generative AI can help patients and providers overcome these difficulties. The system may still be complex, but we can use machines to process the labyrinth for us.

He emphasized the dawn of what he calls the “experience era” in healthcare, a paradigm shift that prioritizes the patient experience above all else by focusing on simplicity and humanity. “It will be an experience that uses technology to create something that puts us back in charge of our care,” Tullman says.

As an example, he talked about how technology has changed our transportation experience. Tullman said he recognized how much the experience had changed when he had to explain the process of hailing a cab to a student when teaching a seminar.

“I said, ‘Well, you just wave to your cab when standing outside on the street.’ And he said, ‘And you just hope one comes? What kind of strategy is that? Why don’t you just Uber?’”

A few years ago, hailing a cab was an everyday experience, but digital tools like Uber quickly made it seem archaic. Tullman foresees the same transformation in healthcare.

“We’ve seen that in every other industry. We’ve seen that in travel, we’ve seen that in hotels, we’ve seen that in music, in everything we do. Except for the most important thing: Our healthcare,” Tullman says.

Here’s a summary of Tullman’s predictions:

Home-based healthcare solutions

“Health and care will move closer to your home,” Tullman predicts, and telehealth is only the beginning.

“In five years, just like we don’t talk about digital banking, we won’t talk about digital healthcare. We’ll just talk about healthcare,” Tullman says.

“Telehealth penetration before the pandemic was about 3%. During the pandemic, it went up to 100%. We couldn’t go into any office space. Now it’s settling in about 10x what it was—about 30%,” Tullman says.

But, patients and providers increasingly realize that telehealth doesn’t mean spending time on a Zoom call. For example, there are a number of specialty telehealth services that let you quickly request prescriptions and refills with a survey and a few text messages with a provider.

Another example of how home-cased care will expand is laboratory testing inside your home through “mini-labs” that will provide a comprehensive battery of medical testing without the need to drive to a medical facility.

“We educated the whole country on how to do home testing during COVID. Now we’re going to provide more and more of that testing into a mini lab in your home through new companies being devised every day,” Tullman says.

However, Tullman says it will take more to expand healthcare choices for consumers.

AI as a fundamental component

“Think about actually taking your phone and having everything you need available [for your health]. And very specifically, think about accessing care in 60 seconds, 24 hours a day,” Tullman says.

“All this will be fueled by something you’ve heard a lot about: Generative AI,” Tullman says. 

Tullman predicts that AI will make accessing medical care as simple as a Google search. Today, many use ChatGPT as if it were a search engine, but Tullman says it’s not yet ready for the medical major leagues. Despite that, Tullman referenced a study that ​​found patients had as much confidence in an AI chatbot as a live physician.

However, he stands firm in his belief that AI won’t actually replace the doctors; it will merely be an intermediary for them.

“What AI is really going to do is empower our doctors,” Tullman says, “When a patient wants to talk to a human, they’ll ask to talk to a human,” he adds.

Tullman gave an example from his company, Transcarent, explaining how it uses AI to take on administrative burdens. Transcarent can evaluate your health plan to determine if something is covered, connect you with the right doctor, and handle routine paperwork, saving you time and helping your doctors focus on actual care.

Market consolidation and new models

Tullman predicts that increasing market consolidation will provide a more consistent healthcare experience. Alongside that, new business models  will transform care, like the aforementioned home labs.

Tullman gave the example of the rise of pharmacy benefit management (PBM) models. Five years ago, there were three major players: Express Scripts, CVS Caremark, and Optum Rx. Then, they were consolidated by major players, which paved the way for new startups, like Mark Cuban’s Cost Plus Drugs.

“Again, all that happened in a five-year span, think of how quickly other aspects of healthcare can change,” Tullman says.

Consumer-directed healthcare

As consumers are increasingly empowered by access to healthcare and information about their healthcare, they will wield more power in the market. In our current system, patients are often at the mercy of an overly complex and opaque system, but these technological advances allow them to become true market forces.

“We always tend to overestimate the impact of technology in the short term and underestimate it in the long term,” Tullman says.

Tullman demonstrated how Amazon transformed retail commerce. Years ago, if you wanted a specific product, like a pair of sneakers, you may have visited multiple stores to see if they were in stock. Then Amazon made it possible to order the exact sneakers you wanted and have them shipped to your door. Now, many Americans can get the exact sneakers they want delivered to their door in two hours or less—even quicker than if they had got in their car and visited the store themselves.

Tullman predicts the same sort of transformation for the medical space.

“It’s realizing that the consumer is now in charge. That’s a big switch from the old days, where the caregiver, administrator, or insurance broker was in control. No one has any misconception of who’s in charge when you go on Amazon. And that’s how it will be for healthcare in the future,” Tullman says.

How to prepare for a consumer-directed era in healthcare

For some providers, living at the whim of patients might seem scary, but adapting is as simple as listening and developing empathy.

“The beauty of healthcare is all of us are health consumers. So all you need to do is go home and ask your family, parents, kids, or spouse what kind of experience they want. Then you can go to your own practice and see how to match that experience,” Tullman says.

We’ve all been stuck in a waiting room and understand how frustrating the experience can be. What if you texted all of your patients to tell them that you’re running 30 minutes behind? Tullman says small changes like that can make all the difference.

How to prepare for the AI era

“Often people say to me, ‘Will AI take my job?’ and I say to them, ‘AI will not be taking your job. But, someone using AI could take your job unless you adopt the new technologies,” Tullman says.

Tullman likens AI to a calculator. These days, you’d be seen as inefficient if you refused to use a calculator and instead did all your math by hand. AI is no different.

Tullman encourages practitioners to embrace these new technologies by signing up for a personal ChatGPT account and becoming familiar with it.

“ChatGPT is not for use in your practice, this very important, because it doesn’t meet the quality or confidentiality requirements for patient care. However, it will give you a sense of what capabilities are coming.” Tullman says.

“On a professional level, find tech partners that are incorporating more AI and efficiency tools into their products. That should be one of the questions you ask when you bring on new vendors or talk to existing ones,” Tullman says.

Conclusion

Glen Tullman sees a future where technology levels the playing field for patients—what he calls “healthcare consumers”—giving them the tools they need to negotiate the care they need and receive instead of being at the mercy of insurers and healthcare administrators. Tullman sees that being accomplished in large due to generative AI’s capability to parse long, complex globs of text alongside new market players in healthcare who can find efficiencies in working with patients.

“We [Transcarent] are a big user of TextExpander. We use it as a part of our patient communication process. It makes our entire transaction much more efficient,” Tullman says. “The efficiency that it can add is dramatic. Once you use it, you say, “What did I do before?”

Not everyone will agree with Tullman’s vision, but we can all agree that healthcare is ready for a change.

“Today, we do not have a healthcare system, but a sick care system. We treat people when they get sick instead of keeping them healthy as the first priority. And then when we fail at that, [we also fail at] getting them world-class, high quality, affordable care,” Tullman says.