San Francisco, California-based telemedicine company Doctor on Demand has launched Synapse, a major platform update meant to round out the company’s capabilities as a virtual primary care provider.

Synapse is meant to better serve Doctor on Demand’s range of payer and employer customers by plugging into their existing healthcare offerings with cheaper, deeper and more efficient virtual care options.

Using Synapse, the company’s customers can more easily link their existing provider networks with Doctor on Demand’s personal medical group which is being expanded to include nurse practitioners, pharmacists, dietitians and care coordinators.

The new clinical staff is meant to push the past the company’s current services in urgent care and behavioral health to meet needs in areas like preventive health and chronic disease management.

“Our doctors have been asking us to enable them to do more things,” Doctor on Demand CEO Hill Ferguson said. “On the patient side we’re seeing more and more patients without a primary care doctor coming to use once every couple of months for a hypertension treatment.”

While customer demand goes part of the way to explaining the launch of Synapse, there are also larger industry trends at work. According to a survey from the Kaiser Health Foundation, 26 percent of adult patients said they don’t have a primary care provider. That number nearly doubled among millennials.

There’s also a squeeze in the supply of primary care physicians, with the Association of American Medical Colleges estimating a shortage of up to 49,300 clinicians by 2030.

Doctor on Demand isn’t alone touting its product as a solution to this widening gap in the larger continuum of care and competitors include Seattle-based 98point6, New York-based K Health and Chicago based First Stop Health.

Ferguson said that new clinical staff will use the full range of the company’s communication methods which include asynchronous messaging, voice calls and video visits to do regular check-ins, fill prescriptions and provide other care management services for patients suffering from chronic illness.

A new program helping to enable these expanded services is what the company is calling its digital medical home, a singular patient profile informed by the company’s clinical touchpoints and linked to connected devices and wearables through Apple Healthkit and Google Fit.

This patient profile builds on the company’s existing EMR system and can be shared with outside clinicians and linked to health information exchanges.

Especially as employer-based and Medicare Advantage plans turn toward narrow network systems to control costs and improve care coordination, Doctor on Demand claims its Synapse platform can guide referrals to ensure that specialists, lab services, imaging and prescriptions stay in network.

Doctor on Demand initially launched in 2013 to provide on-demand urgent care visits directly to consumers. Since then, the company has shifted its core customer base to self-funded employers and health plans looking to plug into the potential cost savings of telemedicine visits.

The company has raised more than $160 million in funding since its founding, including a $74 million Series C round last year led by Princeville Global and Goldman Sachs Investment Partners.

Ferguson said he sees more Doctor on Demand patients evolving toward continuing relationships and repeat visits with clinicians and defined care teams as the company moves past core urgent care functions.

He added that Synapse is designed to be flexible and plug into the specific needs of employers and health plan customers who may want to unlock additional capabilities past Doctor on Demand’s initial telemedicine offerings.

“A big part of our mindset when it comes to Synapse is putting virtual care at the center of your health,” Ferguson said. “The other players in the space don’t manage their own practice and there’s no formal clinical guidelines they’re managed by. You’re not going to do primary care successfully that way.”

Ultimately, Ferguson said the hope is to develop new plan types designed around the idea of a virtual primary care system as an initial triage and touchpoint for the healthcare system.

“As we move toward the future, most primary care will have to look like this in order to be accessible to everyone,” Ferguson said. “If you’re trying to take care of the 300 million-plus people in the United States you’ve got to use a virtual front door to get there.”

Picture: Andrey Suslov, Getty Imgaes

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