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Last month PocketHealth raised US$16m in a Series A funding round that will be used to increase the medical imaging sharing specialist’s presence in the US. The start-up is focused on developing tools that integrate with EHRs in a bid to make it easier for patients to access and understand their medical images and radiology reports.
The tool, which is available for a yearly $49 subscription fee, enables patients to download, share and transport their medical images. This allows access to their images as well as the ability to share images with other physicians and providers, via PocketHealth itself, or via fax or CD.
PocketHealth says it will use the funding to hire more staff and build more clinical partnerships in Canada, its domestic market, and the US.
The Signify View
When it comes to stakeholders in healthcare, patients have, sometimes literally, more skin in the game than anyone else. It is, therefore, a natural assumption that these patients should want to be as involved as possible in their care. This is one of the fundamental tenets upon which PocketHealth’s plans are based.
PocketHealth indulges this sensibility, banking on the belief that patients will want to feel a sense of ownership over their own medical images, that they should want to be able to look at these images themselves, easily share them with whomever they wish, and even scrutinise their radiology reports using the company’s simple language glossary. Should patients seek such accessibility, some of the Canadian company’s tools could prove attractive. The appetite for outpatient imaging is growing, particularly in the US. PocketHealth’s software will make it easy for patients to be more flexible with their care and take advantage of this growing range of providers available to them.
However, there are some limitations to this opportunity. PocketHealth boasts that it already has more than 500 imaging providers across North America signed up to the service, but this is an agreement which will be approached by providers with some reluctance, or at best, caution. While individual outpatient centres may benefit from making it more straightforward to bring customers across from competitors, by the same token, it is also easier to lose them. At least providers don’t necessarily have to pay for this privilege, with the most basic provider plan available at no cost.
Poking a Bear
Another longer-term challenge for PocketHealth is that much of its functionality is already possible, or relatively straightforward to implement via a provider’s existing EHR or medical imaging IT vendor. PocketHealth may be successful in the short term but will need to quickly consolidate its position, lest it risk other larger and more established vendors sensing an opportunity and rushing to fill it. Together the top three image exchange vendors in the US (Life Image, Ambra and Nuance) represent 86% of the market. Although these are primarily focused on provider-to-provider exchange, if any one of those vendors decided to extend functionality to support patients’ ability to share images, it could immediately reach a significant portion of US patients.
PocketHealth will face other challenges too. While it is no doubt true that increasing patient engagement can, in some circumstances have a positive impact, how universally these benefits can be applied is likely overstated. This is borne out by a study published in the American Journal of Roentgenology of a comparable initiative by imaging IT vendor Visage, which saw radiologists at NYU Langone record video reports in plain English, to keep patients better informed about their health. While anecdotal feedback of the video reports was positive, uptake was, on the whole underwhelming. This was not only true for radiologists, of which just 105 out of 227 included in the study made video reports, but also patients. In total 3,763 video reports were produced during the study period, but of these, just 864 (23%) were viewed.
Patients Care?
One finding highlighted by the study is the fact that, even when more patient-friendly reports are freely given, actual demand among patients is very low. This apparent lack of interest will only be exacerbated when patients are required to pay, as PocketHealth requires if it is to make any money. Further, it undermines the product’s central premise that patients really will value having constant, direct access to their scans.
Even the product’s plain-English glossary should be treated with caution, suggested as such by PocketHealth’s claim that the company worked with doctors to ensure it is “comprehensive and accurate”. The risk is that many of the findings that can be seen on medical images are complex and detailed. Plain English will, in many instances fail to convey this nuance – there is after all a reason specific medical and technical language is required. While not an immediate threat given physicians will still have access to the original reports, it does introduce a degree of vagary that will not sit comfortably with many physicians, allowing patients to understand the subtleties of their diagnoses.
Fundamental Frailty
These are not trivial issues with the product that can be overcome with software updates, or tweaks to UI. These are fundamental barriers that, on the face of it, could limit the long-term feasibility of the product unless significant changes are made, or additional opportunities are identified. As the value of patient data increases, such an opportunity could be in the commoditisation of deidentified patient imaging data, for example.
Without such prospects, on the other hand, PocketHealth’s longevity looks limited. The vendor may well enjoy some short-term success, utilising its novel approach to capitalise on the growing outpatient imaging sector, and riding the Covid 19-induced interest in digitisation and remote technologies. However, longer-term, PocketHealth is at risk of succumbing to one of two outcomes. If the product is very successful in the short term, large EHR and imaging IT vendors will see the opportunity, and quickly look to offer a patient-facing integrated image exchange themselves, either by developing one internally or picking a company in the space, such as PocketHealth.
Alternately, the vendor’s image-sharing capability will be assumed by large EHR and imaging IT vendors, while the ability for patients to view their own images and read their own reports will be underutilised. It may transpire that most patients who want additional detail about their diagnosis, do so through their doctor, and not an app, resulting in a service that isn’t used.
In either scenario, unless PocketHealth does hold an ace up its sleeve in its product pipeline, the long-term opportunity looks slight. The Canadian vendor therefore needs to capitalise on its current momentum and the novelty of its product to capture as many patients and providers as possible. It should seek to invest in establishing its brand and credibility, while getting customers to use its service. This still might not be enough to grant the vendor the long-term market leadership position it seeks, but it should at least help bolster its valuation and make a buyout more likely than a battle. When all things are considered, that’s a commercial, if not necessarily clinical, win.
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This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. This content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify Research. To view other recent Premium Insights that are part of the service please click here