Coronavirus and the Future of Telemedicine

On Friday, WIRED’s editor in chief Nicholas Thompson hosted a Facebook Live with ER doctor-turned-cofounder Caesar Djavaherian, who now serves as the Chief Medical Officer of his telehealth companionship, Carbon Health. This was the first in a series of four conferences in which WIRED will explore what the coronavirus pandemic will mean for the future of business, education, engineering, and health. Hundreds of books tuned in, and we took questions from observers in real epoch. The discussion has been lightly edited for clarity.

Nicholas Thompson: Hello, I’m Nicholas Thompson. I’m the editor in chief of WIRED. Thank you ever so much for connecting us on this Facebook Live. We’re going to be talking about the future of telemedicine. Thank you to Caesar Djavaherian for participating us.

Caesar is an emergency room physician, “ve been here for” numerous, many years. He’s also one of the founders of Carbon Health, which is building one of the first at-home coronavirus exams. He’s been at the front lines of combating the coronavirus since the very beginning in the Bay Area. He’s on the front lines of helping to build the technology to fight it. He’s on the front lines of figuring out the future of telemedicine.

So, Caesar, good morning.

Caesar Djavaherian: Good morning. Thanks for having me.

NT: Let’s start with a little bit about you.

You started as an emergency room physician. And at some object a marry years ago, you made the decision that the most important thing you could do is try to stimulate prescription guys more efficient, particularly through telemedicine. Tell me about that alternative and a little about that transition.

CD: I started off as an ER doctor. I actually trained in New York City, where the pandemic is hitting hardest. And just like numerous physicians who practice medicine, I became a little bit disenchanted with all of the administrative loadings that physicians must be addressed in their daily lives. And I wasn’t satisfied with the answers to my questions about why we do things this behavior. And I was told, “Well, we always get it on this lane, ” or “This is the way we’ve traditionally approached X type of healthcare.” And I imagined, you know, in 2013, 2014, 2015, with incredible technology developing in every other industry, why couldn’t we take a step back on how healthcare was being delivered? And genuinely expect ourselves, if we were to create a brand new healthcare system today, what would that definitely sounds like?

And part of it is that you can do so much in person. But there’s a lot you can do actually online, outside of the clinics. And given the opportunity to take a step back from it, and asking that question, and genuinely trying to strip down healthcare to its bare bones, almost like, you know, how Elon Musk talks about first principles. So what are the first principles in healthcare? It’s really a provider and a patient and some work that has to happen around that interaction. And formerly you can break it down to those bare bones you can then start to build technology that can enable that experience to be much better from the patient perspective, and, frankly, much better from the doctor perspective.

NT: So, you’re trying to beat Elon Musk without the tweet blizzards, right?

CD: Well I’m not very good at tweeting.

NT: We have a quick first question, which is’ What is telemedicine? ’

Got a coronavirus-related news tip? Send it to us at covidtips @wired. com.

CD: Ah. So, you know, the definition of telemedicine is fairly broad. So it’s anything from, you know, taking care of a patient’s needs through the telephone–so exactly the old fashioned way–to having video interactions with your patients, to actually having video interactions with your patients assisted with maneuvers. So whether it’s loading intelligence from your Apple Watch, or exercising a remote stethoscope like ECHO Health has built or some of the at-home products like blood pressure cuffs, connected proportions, that sort of thing. And there are lots of companies that have gone into this field under the umbrella of telemedicine. But frankly, it entails different things to different people.