Globally, millions of people suffer from some form of skin disease, including a variety of cancers. Teledermatology is transforming the model of care by enabling access to specialist dermatologists, consequently speeding up diagnosis and tailored treatments, in addition to easier management of follow-up visits. The first-class affordable care is delivered within a few hours, which creates pleasant patient experience and positively affects one’s health outcomes. Together with Dr. Philipp Wustrow, Co-Founder of OnlineDoctor, the foremost provider of teledermatology in Europe with over 70.000 patients, we dive into their business model and unique value proposition to more than 600 dermatologists and 40+ statutory health insurers, A.S.S.I.S.T.‘s acquisition and the vision to bring the world’s first AI-supported medical product in teledermatology to market maturity, as well as key market trends and the role of Pharma in this space.
Almost 900 million people world-wide have some skin / dermatological disease. Teledermatology can play an important role in these patient journeys. The store-and-forward teledermatology, in which patients can send images and text to a dermatologist for review is a cost-effective way to deliver high-end quality secure care to a larger number of patients. Being diagnosed and receiving a personalized reliable treatment from a specialist in just a few hours, not months, empowers patients to take control over their health and helps them manage their conditions more effectively daily.
Teledermatology assists dermatologists to streamline the care of their service and helps them also in their workload. It brings their specialist care closer to other healthcare stakeholders, such as primary physicians, pharmacists, nurses at elderly homes or hospitals, etc.
With chronic dermatological diseases representing a burden for healthcare systems, digital solutions are taking up the challenge for disease prevention, management and earlier diagnosis and treatment. These novel services are becoming key vehicles for improving one’s quality of life, in some cases saving lives and significantly lowering the cost of skin care.
Today, various payer organizations revamp or expand their digital service offerings via partnerships with digital health innovators, who have under their arsenal a large number of specialized dermatologists that can offer increased access to dermatologic care. Building a digital health ecosystem unlocks value for insurers and presents them with an opportunity to improve their members’ experience and drive healthcare value, while reducing costs. Today, most of the processes to build ecosystems have little impact. Find out how to build a successful digital health ecosystem here.
Recently, in a candid conversation with Dr. Philipp Wustrow, Co-Founder of OnlineDoctor, we learned how their partnership with over 40 statutory health insurers leads to 25 million people being able to use their service free of charge, the role the company plays in the teledermatology space and their vision to transform the doctor’s visit through a digital first approach and to enable specialists to offer timely, affordable and high-quality digital skin care to their patients, their way to empower patients by giving them a chance to choose a preferred dermatologist and even if necessarily see the same doctor in-person within 5 days.
Enjoy the interview!
Research2Guidance: Can you please introduce OnlineDoctor briefly and what unique footprint you are leaving in the teledermatology space.
Dr. Philipp Wustrow: OnlineDoctor is the leading teledermatology provider in Europe. Patients with skin problems receive a specialist diagnosis and recommendation for action within a few hours. Patients can freely select their preferred specialist via our platform, regardless of their location.
The company was founded in 2016 as a spin-off from the University of St.Gallen in Switzerland. Today, roughly 25% of all the dermatologists in Switzerland use our platform daily. In 2019, we expanded to Germany and in 2020, we entered the Austrian market. In total, we have already been able to treat over 70,000 patients via our platform and over 600 dermatologists use our platform every day.
What makes us unique and stand out in the market:
Our platform is characterised by various unique selling points.
First, purely from the perspective of our positioning and our philosophy: Our goal is to take dermatologists with us on our journey into the digital age and to further develop our product in line with their interests. In contrast to other providers, we do not try to monopolise the economic opportunity to a few heads, but to provide all dermatologists with access to teledermatology through technology. This is a fundamental difference in our positioning, as we see ourselves as partners of dermatologists in the interest of patient welfare. Derived from this, we entered an exclusive partnership agreement with the Professional Association of German Dermatologists (“Berufsverband der Deutschen Dermatologen”). This means that the association markets OnlineDoctor as the platform recommended by specialists to its approximately 3500 members in Germany.
Our network now consists of over 600 experienced specialists who use OnlineDoctor daily. Accordingly, we can offer our patients a much wider range of more experienced and specialised dermatologists. We are also the only provider that allows the patient to choose his or her preferred dermatologist. Due to our many hundreds of specialists, we can scale and answer very large numbers of patient enquiries. It would already be possible for us to treat over a million patients digitally via our platform per year.
In addition to our focus on the needs of dermatologists, we are very patient-centred regarding the patient journey. We work with over 50 statutory health insurers who make our service available to their customers. Hence, more than 25 million patients can already use OnlineDoctor free of charge.
Moreover, we have very professional structures with our team of almost 40 people. We have our own growing unit of software developers and experts in the areas of UX and legal questions. Accordingly, we are the only teledermatology provider classified as a medical device and follow corresponding quality standards.
Research2Guidance: These are some very remarkable facts. What is your service offering?
Dr. Philipp Wustrow: In telemedicine, a distinction is made between synchronous and asynchronous approaches. At OnlineDoctor, we rely on the “store and forward” technology meaning on the asynchronous approach, as we connect specialists with patients in a time-shifted manner.
If we take a deeper look into the patient journey and assume that one has a skin problem, the patient can use our web app onlinedoctor.de, if we talk about the German market, and start right away by choosing his health insurance company and a preferred dermatologist. The opportunity to choose a doctor creates enormous trust and legitimacy from the perspective of the patient.
Next, the patient describes his symptoms and answers other relevant questions about the affected skin problem with the help of our interactive chatbot. The underlying idea is to recreate the physical doctor-patient conversation in a digital way. Afterwards, the patient can upload three pictures of the skin problem, which he has previously taken with his smartphone. The request only takes about 5-7 minutes.
The diagnosis and recommendation from the chosen dermatologist are transmitted in 7 hours on average. We guarantee a response within 48 hours.
Research2Guidance: It’s fantastic that one can choose the doctor and that the request is free in most cases because you have many partnerships. What are some of the similarities and differences in the countries you work in?
Dr. Philipp Wustrow: There are some notable similarities. In all three countries, patients have difficulty getting an appointment with a dermatologist. Getting a specialist opinion can be very time-consuming. The waiting time is often weeks or months, and it is obvious that the waiting time does not contribute to the improvement of the skin problems and that diseases are often postponed.
Dermatologists are often booked up for months and completely overworked. Usually, the urgency of an appointment from a medical perspective cannot be sufficiently considered when scheduling. With our technology, we try to solve these challenges for both dermatologists and patients.
But there are also differences between the markets. For instance, regarding the existing legal and regulatory frameworks as well as in the context of the health insurance systems. When we went online with our solution in Switzerland back in 2017, there was still a general ban on remote treatment in Germany. We had to hope that the German market would open up to our business model and concept, which it fortunately did.
The Swiss market has been familiar with the concept of telemedicine for over 20 years. The idea that access to digital care supports and empowers patients is much more deeply embedded in the Swiss system than elsewhere. This helped us to build on the existing structure and gain traction, as no major shift in mindset was necessary in Switzerland. But of course there are still many areas that need to be developed further in Switzerland in this context.
In the last few years, the digital health market in Germany has improved greatly in terms of structure and regulation, which has accelerated the introduction of telemedicine, and of course the pandemic has also acted as a catalyst in this context. In some areas, Germany is even taking on a leading role throughout Europe. This process will hopefully continue.
Research2Guidance: Yes, indeed, Germany is leading the digital health reimbursement process in the EU.
How a company profitably scales its solution is a key to success. What is your business model? How do you ensure your commercial success?
Dr. Philipp Wustrow: We have three main revenue streams. Our B2B2C stream is the largest one. Our partnerships with different health insurance companies allow us to offer our service to their customers free of charge.
The B2C revenue stream covers all the patients, who are not members of our health insurance partners. To use our service, they need to pay out of pocket.
We also have a B2B revenue stream, where we partner with health professionals. Under this heading we subsume for example pharmacies, hospitals, elderly homes, and general practitioners. They provide access to our dermatologists by doing the request for their patients. For this purpose, we have developed a special app that is tailor-made for health professionals and their needs.
For example, over 300 Pharmacies in Switzerland provide our online skin check service on site. If you have a skin problem, and you enter one of these Pharmacies, the Pharmacist will educate you about our partnership and service. Via our app the pharmacist makes the request to one of our specialists. Usually in under an hour a personalized diagnosis and recommendation for action will be received.
Research2Guidance: It is impressive how many health insurance partnerships you have. What is your value proposition to health insurers that has led you to this success?
Dr. Philipp Wustrow: We were able to position ourselves as an attractive partner for health insurance companies based on various unique selling points.
Our positioning as a partner of dermatologists is certainly an advantage, as the health insurance companies also have an interest in supporting offers that meet the interests of dermatologists and those of the association representing the dermatologists.
The possibility to choose the dermatologist also has the advantage that if a physical appointment is necessary, e.g. due to necessary further examinations, this can normally be offered in an average of 5 days. Our service therefore does not end after the digital diagnosis. This is only possible because we collaborate with local dermatologists. The fact that we can connect local doctors with local patients is something health insurance companies are looking at.
Compliance with central certifications is also elementary. We are the only provider of asynchronous teledermatology classified as a medical device. Our internal software development competence is also key. This enables us to ensure appropriate interoperability with the technical systems and platforms of the health insurance companies.
In summary, the service must be patient-centred. This ultimately leads to the fact that it is frequently used by the patients.
Research2Guidance: When it comes to health and in cases of chronic illnesses, this also includes some skin conditions, having an ecosystem could be a great way to offer a holistic treatment that will lead to better outcomes. Have you built your digital health ecosystem or are you part of one?
Dr. Philipp Wustrow: It is key to provide patients with the best care possible. At OnlineDoctor, we have a wide range of specialized and experienced dermatologists that have their own networks with other doctors and institutions they partner with.
Specialised ecosystems can bring great benefits. Patients receive the best possible treatment when companies from different areas of the healthcare sector join forces and develop joint innovative solutions. This includes, for example, coordinated access to a network of outpatient and inpatient healthcare facilities.
Research2Guidance: What are the trends that you see in the teledermatology space?
Dr. Philipp Wustrow: I think the future is bright and I am happy to share some of the trends that, for me, stand out.
First, the era of one size fits all is over. Individual needs must be addressed in digital health, and I think our specialized network of dermatologists plays an important role in this. To give you an example, we can provide parents and their children direct access to paediatric dermatologists. Patient centric telemedicine is the future.
Secondly, customer experience is playing an increasingly important role in the use of digital health applications and teledermatology. At OnlineDoctor, we use an interactive chatbot rather than a simple questionnaire to make the whole experience more engaging.
Thirdly, I think there will be a stronger focus on chronic care management. The treatment of patients with chronic conditions is becoming increasingly important for us, and we are committed to providing an optimal treatment option for this rapidly growing community of patients with e.g. psoriasis or atopic dermatitis. Currently about 20% of our patients are multiple users and often have chronic conditions. They are given the opportunity to continuously document the change in their skin problem and symptoms. In this context, we speak of telemonitoring.
Finally, artificial intelligence will become a standard of care. I see AI applications as very valuable to improve the precision and speed of the diagnoses made.
Research2Guidance: You have mentioned different healthcare stakeholders, what is the role of Pharma in the teledermatology space? Are you partnering with Pharma?
Dr. Philipp Wustrow: Pharmaceutical companies can also benefit from cooperation in the field of teledermatology. Many of them are trying to offer patients and doctors added value that goes beyond the pure therapy. Corresponding telemedical services can play a key role in this context. Joint research efforts can also be interesting and help the field of teledermatology to develop.
We cooperate with selected pharmaceutical and dermocosmetic companies and try to transfer the added value they provide in the physical world to the digital world for the benefit of our dermatologists and patients. To name a few partners, in Germany and Switzerland we work with L’Oréal, Galderma, AbbVie and Sanofi. The well-being of the patient is always at the centre of every partnership. This is our guiding principle.
Research2Guidance: Last month you have acquired A.S.S.I.S.T., a leading developer for AI in the field of dermatology. Congratulations. What is ahead of OnlineDoctor?
Dr. Philipp Wustrow: The pioneering acquisition is part of our vision to bring the world’s first AI-supported medical product in teledermatology to market maturity. That will be a milestone in the digitization of healthcare and a revolution in teledermatology. With the technology, we can now bundle the knowledge and experience of our specialist network in an AI and make it available to each of the 600 dermatologists who work with us. This symbiosis of medical expertise and state-of-the-art technology supports medical work and increases diagnostic quality.
However, we do not only want to grow on a technological level regarding artificial intelligence or deploying an e-prescription solution. Our team sees great potential to enter other markets to expand our leading position beyond the DACH region. Our concept has proven to be successful, and we are confident that we can transfer our model to other markets. We are also looking beyond the European continent in this respect.
To be able to cope with this growth in terms of resources, we will continuously expand our team and bring additional international investors on board.
Research2Guidance: Dr. Wustrow, thank you very much for this great conversation, for sharing with us OnlineDoctor’s journey and your vision of the market. We wish you and your team to stay healthy and have a lot of success.
OnlineDoctor is the leading provider of teledermatology in Europe with over 70.000 patients. People with a skin condition use the service to receive a diagnosis and therapy recommendation from a dermatologist of their choice nearby within a maximum of 48 hours. Only in 15 percent of the cases a personal visit to the practice is necessary after a consultation via OnlineDoctor. In that case the patient will get an appointment at the practice usually within five days compared to regular waiting times of around 35 days. OnlineDoctor currently works with around 600 dermatologists. The vision is to transform the doctor’s visit through a digital first approach and to enable specialists to offer timely, affordable and high-quality digital skin care to their patients. In Germany, the company operates as an exclusive partner of the Professional Association of German Dermatologists (BVDD) and cooperates with more than 40 health insurance companies. In addition, over 300 pharmacies and hospitals in Switzerland use the OnlineDoctor pro app for advice on skin problems.