So what? Since April, the remote monitoring space has seen a steady stream of VC funding, acquisitions, regulatory approvals, CPT code and reimbursement expansions. While these solutions primarily focus on monitoring chronic disease patients, they continue to set the stage for upstream use of digital biomarker surveillance for screening and diagnostic applications. Furthermore, digital biomarkers provide speed, continuity, and cost benefits that instrument-and-reagent solutions cannot accomplish, providing improved overall diagnostic value. However, repurposing these solutions as long-term epidemiological or public health surveillance tools is less certain. One could easily envision smartphone manufacturers adding a “Public Health Alert” feature, similar to the Public Safety and AMBER Alert notifications, that could be used to issue heightened vigilance notices or health recommendations for at a sub-local level for budding outbreak clusters for seasonal pathogens like influenza, future epidemics (e.g., SARS, H1N1, MERS, Zika, Ebola), or even pandemics. Digital surveillance tools could also be leveraged for basic epidemiological research to better estimate disease incidence and prevalence, characterize transmission rates and patterns, and refine disease models. While we’re likely to see fluctuations in reported accuracy and public acceptance of digital surveillance tools in the near-term, we strongly believe they hold long-term potential for transforming preventive care.   

TLDR: Ro is a telehealth company that began as a digital pharmacy called Roman (now a subsidiary) focused on expanding access to men’s health treatments (e.g., ED, hair loss). Ro has since expanded to offer wraparound teleconsultation services and solutions for women’s health (Rory), smoking cessation (Zero), and weight loss (Plenity), as well as a subscription-based digital pharmacy for generics. Ro’s acquisition of Workpath, a technology platform for coordinating at-home phlebotomy visits, marks a milestone in its strategy to create a vertically integrated telehealth platform.  

So what? COVID’s acceleration of telehealth adoption by patients, providers, and payors has made for a record-breaking year of 24 telehealth deals for a total of $1.5B (compare to 2019’s 12 deals at $384M). Amid a landscape of telehealth giants making big moves (e.g., Teladoc’s $18.8B acquisition of Livongo, Amwell’s IPO [now valued at $6.8B], Hims & Hers SPAC merger [valued at $1.6B]), Ro’s CEO, Zachariah Reitano, has said the company is setting its own sights on a public offering. Ro’s angling toward vertical integration is not unlike Teladoc’s strategy with Livongo, which augmented the company’s virtual visit platform with an AI platform with at-home diagnostic and therapeutic applications. We maintain that the rapidly maturing telehealth space continues to be ripe for consolidation, particularly via vertical integration plays that shift perception from telehealth being substitutive for in-person care to telehealth expanding the scope and possibilities of care (e.g., through a feedback loop of real-time, continuous data collection, AI or physician-based interpretation, and digital therapeutics).