Teladoc election headwinds?

Not the election story everyone is talking about but surprising to me: During Evercore ISI's second quarter earnings results preview presentation earlier this week, analysts highlighted that Teladoc could face pressure from increasing advertising costs as a result of campaign spending. Teladoc relies on advertising to drive new users to its direct-to-consumer mental health company BetterHelp, the cost of which is a constant source of questions from investors. Analyst Sameer Patel was careful to hedge that campaign spending can be region and channel specific, but still said that any uptick in pricing is broadly unfavorable for Teladoc. It could prove an untimely headwind given that BetterHelp recently reported decreasing revenue, and that Teladoc is trying to cut costs and improve its profit margins.

Conversely, Patel noted that physician networking service Doximity, which sells advertising to pharmaceutical companies, could see a boost as marketers look for channels that aren't all gummed up with political spending.

policy

Study: Mental health facilities scale back on telehealth

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In a new study published in JAMA Network Open, researchers from RAND Corporation document a slight decline in the number of outpatient mental health treatment facilities that offered telehealth after the end of the official public health emergency in May 2023. The researchers called 1,000 outpatient mental health treatment facilities posing as potential clients before and after the end of the PHE. Before, 799 offered some telehealth, compared to 765 after. The sample included public and private facilities from a SAMHSA database but did not include private practices or the mental health startups we write about frequently. The findings highlight how policy decisions can affect access to telehealth, though, things may have changed since researchers last gathered data in November 2023.

artifical intelligence

A provocative call for real-world testing of health algorithms

The Coalition for Health AI is facing a lot of questions about its proposed framework for evaluating artificial intelligence models used in health care. Now some of the calls for reform are coming from inside the house. On Wednesday, CHAI members Christopher Longhurst and Karandeep Singh of UCSD, along with other health IT colleagues, proposed a new way to evaluate health AI that differs from CHAI's.

STAT's Brittany Trang writes that whereas CHAI's agenda is largely based on using a nationwide network of health AI "assurance laboratories" that would validate AI models for all of health care, Longhurst and colleagues instead proposed a "network of health care delivery organizations to function as AI implementation science centers focused on the clinical effectiveness of AI models in real-world implementations." Longhurst et. al criticized CHAI's main proposal of validating algorithms through computer simulation, calling it "helpful" but "insufficient for demonstrating improved patient outcomes, which will require real-world evaluations similar to clinical trials for a new drug."

The call for evaluating the patient outcomes moves closer to other proposed models of using local validation instead of assurance labs and shows the wide differences in opinion that CHAI will have to navigate as a 2,500-member organization.

Wearables

Samsung Ring, Oura AI, and Apple speculations

Samsung yesterday announced a new smart ring that will allow users to track sleep, elements of heart health, menstrual cycles, and something called an "energy score," which like similar metrics from other manufacturers combines several readings, like sleep and heart rate variability, to give users "enhanced awareness of your current state." The company also announced a new version of its Galaxy Watch that offers features like sleep apnea detection.

The biggest news here is that Samsung's ring becomes a very big, very powerful competitor to Oura, which for years has been developing lots of health-focused features for its own line of smart rings. Not to be outdone, the company this week announced Oura Advisor, an experimental coaching feature that gives users personalized advice. Users will also be able to chat with their AI coach. (If this sounds familiar, OpenAI's Sam Altman and Arianna Huffington were just previewing their plans to develop an AI health coach.)

Also of note: Bloomberg's Mark Gurman provided an update on what he's heard about the next Apple Watch — rumored features like blood glucose and blood pressure monitoring and sleep apnea detection may not be ready for this fall's launch.

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What we're reading

Not another AI health coach: Why healthcare is human, and always will be, Hospitalogy
Acceptability of hospital-at-home care and capacity for caregiver burden, JAMA
The Quad Gods level the esports playing field, The Verge
How Elmo and his friends are helping little kids with their 'big feelings' amid a mental health crisis, STAT