Remote patient monitoring and telehealth have seen an unprecedented boom throughout most of 2020 and even the early part of 2021. As the pandemic’s grip on the globe eases and patients return to in-person visits, the future hangs in the balance for many companies that landed huge chunks of capital for their remote platforms.

Babylon Health is one such company. In this Hot Take, senior analyst Alex Lennox-Miller explores the challenges that their offering will face upon entry into a tough U.S. market, as well as concerns that their patient population in the U.K. will not be representative of their potential stateside consumers.

Chilmark’s upcoming Market Trends Report on Virtual Care will explore these issues and more in greater depth; you can sign up here if you’d like to be added to our mailing list to receive updates on the research.

Transcript of the video below:

Alex Lennox-Miller: [00:00:00] Babylon Health made its reputation with an immensely cherry-picked population. Moving into the U.S. market? They can’t. We need to know, can Babylon really provide the kind of results that they’re promising? And underlying their technology might be some really worrying biases and problems.

[00:00:22] Welcome back to the Chilmark Research Channel. I’m Alex Lennox-Miller, a senior analyst here at Chilmark Research. While you’re watching the video, make sure to like, subscribe to our channel to stay up to date on all of our content and leave a comment below. We love to hear from you and we love to continue the conversation.

[00:00:41] Babylon Health has finally gone public in the U.S. with a $4.2 billion valuation. There are still a couple of really big questions as they transition into the U.S. market. In the U.K., Babylon was funded essentially by the NHS. They were paid an amount per patient, but the patients that they got had to meet certain requirements. The result was a very specific population, one that was overwhelmingly young, almost exclusively centered in affluent, healthy neighborhoods with very distinct health challenges from the population at large.

[00:01:25] They were essentially the worried well. They were people who didn’t have serious health challenges, didn’t have serious chronic conditions, wanted to be able to access their primary care provider or GP on demand.

[00:01:40] And for them, Babylon was perfect. They loved it. Providers with Babylon were very happy. But Babylon did not have to provide the kind of challenging, complex care management that’s really needed when you have a population facing serious chronic illness. As they move into the U.S., the population that they’re addressing can’t be selected that way. When you look at the practices that they’ve acquired and the populations that they’re trying to address, they’re frequently sicker than the norm, not healthier. These are people with really serious needs, and it’s a level of need Babylon has never had to address with their technology platform before.

[00:02:30] When you look at the technology Babylon offers, it’s essentially their A.I.-driven symptom and triage checker, which is impressive. Don’t get me wrong, I love technology and I love these things. But when you look at what they have, it’s not enough. Remote appointments, a patient front-facing triage checker, but a serious lack of the supporting elements, the supporting resources, the remote monitoring, the ongoing coaching and health management that a company like Livongo provides to their patients. It really makes you wonder how good the care Babylon provides can be, and if they’ll be able to prevent the kinds of really costly hospitalizations, E.D. visits, and intensifications of symptoms that they need to meet the revenue targets of their value-based contracts.

[00:03:25] The other big issue, and this is one that faces the industry as a whole, not just Babylon, is rooted in some of the fundamental elements of algorithmic A.I. We know that bias can propagate in these algorithms. Sometimes it comes from the algorithm itself. Sometimes it’s rooted in the best medical practices that the algorithm is based on. Some of those come from decades of practice but are still rooted in research and investigations that were biased in and of themselves. When you look at some of the results that people have published–about the Babylon platform diagnosing women who have heart attack symptoms with panic attacks, for example, when they diagnose men with much more serious conditions and advise them to visit an E.R.–it really makes you wonder.

[00:04:21] It’s possible to address these issues. I hope Babylon has. But we don’t know. And when you talk about an algorithm that’s intended to be the first and central experience of somebody’s primary care, not knowing isn’t acceptable.