3 June, 2024
In the Know and Not Alone
5 minute read
How rural individuals are making sense of their health with AI
Prologue
The day of the long-awaited discharge from the hospital finally arrives and I cheerfully enter my patient’s room, only to find her solemnly gazing into the distance.
“I don't know what I'll do when I go home. At home I just spend most of my time managing, worrying, and learning about my medical conditions. It's just so… scary.”
What do I say? What can I say? In this moment, I feel powerless. The uncomfortable reality is that even though our multidisciplinary medical team had done so much, it was but a small piece in the grand arc of our patient's life.
And I think to myself, once again, how much I wish I could always be available to be by my patients' side. I want to understand their needs and advocate for them so they can achieve the best outcomes possible, know what's going on, and never be alone in their health journey.
In the know and not alone
Across the United States, there are many who suffer in silence, invisible to mainstream healthcare. 42% of Americans live with 2 or more chronic conditions and as many as 30 million live with an undiagnosed rare disease. In rural settings especially, many don't make it to the hospital until it's too late.
We believe it's time for a change. MDandMe exists to help people make sense of their health. Our goal is to provide a doctor best friend whom anyone can turn to for guidance, comfort, and support. To do this, we leverage leading AI models combined with longitudinal data to provide a hyper-personalized experience.
Our technology is designed to be used at any and all points during your healthcare journey: from a conversational symptom checker when you first feel unwell (see earlier blog post), to a community where you are matched to others with near-identical medical histories, to follow-up conversations where you can have diagnostic reports, lab values, and doctors notes explained in plain language. By helping before and after care, agnostic to which provider you choose to see, our system serves as a base camp for any journey in the healthcare landscape.
Who we serve and how we do so
“It's crazy to say but I feel like your AI has compassion for me. It believed me and didn't call me dramatic or dismiss my concerns.”
Since our launch in January 2024, we have helped over 40,000 people, and our users have created over 7,000 unique posts documenting their health journey with MDandMe Community. Currently, around 10% of our daily traffic comes from return users. Among those who post to Community, over 40% return to use our service again.
Oftentimes our users' first thought is not to go to the doctor. 58% of users for whom we have self-reported ZIP code information live in rural communities with population density <500 people per square mile, which is 4-fold higher than would be expected from population data alone. On a per capita basis, our users are more likely to reside in states with fewer major medical centers and within these states, the bulk of the users live 10+ miles away from the nearest hospital.
The realistic comparison for most of our users is not between MDandMe and a real doctor, but between MDandMe or being alone in their struggles. We are proud to reach users in rural Montana, Texas, and Alaska, and everywhere in between. Using MDandMe, you can brainstorm about your health concerns from anywhere at any time. When necessary, we direct you to a doctor and help you get the most out of your appointments.
Our typical user spends 10 minutes completing an initial interview about their symptoms, then 3 minutes reading our assessment, and then a few more reading stories similar to theirs. Users then continue the conversation to ask specific questions or come back to us after seeing a doctor or receiving test results. Roughly 80 percent of MDandMe users were female at birth. While our users in aggregate skew toward young women, more engaged users (who engage in the community or pay for premium features) tend to be middle-aged.
Across all users, the types of symptoms reported have not dramatically shifted since our last blog post, with gastrointestinal concerns still in the lead and respiratory concerns falling by 3%, mirroring flu and COVID trends. However, among community users, neurological, rheumatoid, and OB-GYN concerns are more prevalent. An even more dramatic trend is seen among paid users, of whom nearly 40% report complex neurological symptoms and 9% have dermatological conditions.
Usage trends and feedback show that our community provides a voice to those whose health experiences have been under-addressed or dismissed. For users whose conditions have eluded real doctors, our A.I. serves as a brainstorming buddy with more time and availability than the current healthcare system could dream to provide. With recently debuted patient history and medication records, continuity enables us to give health insights that may not be apparent day to day. Soon, we will introduce new features such as journaling to help you make sense of complex conditions over time, and image uploads so you can interpret documents or photos of a symptom.
Stop thinking of AI as competition to doctors
“Not only did MDandMe make me realize that I needed medical care, it also helped me understand where to start when talking to a doctor in real life.”
The net impact of MDandMe has been to identify people with high-risk symptoms or long-standing medical conditions and to help them realize they would benefit from medical care. 72% of MDandMe visitors report using the platform with the primary intent of “deciding whether or not to seek care” or “deciding how urgently [they] need care.” Prior to using MDandMe, 42% of our users report not intending to seek medical care, but after using MDandMe, 27% switched to choosing to seek care.
Medical emergencies that we have escalated from “no care” to “emergency room” include symptoms highly suggestive of unstable angina, brain bleed, strangulated hernia, appendicitis, bowel obstruction, cholangitis, pancreatitis, advanced pyelonephritis, pulmonary embolism, testicular torsion, and traumatic brain injury. De-escalation from urgent or emergency care intent tends to be for simple viral infections in younger people (<40 years old) with few comorbidities, or symptoms related to existing conditions such as GERD or joint pain without red flags.
We help you no matter where you choose to get care
In spite of the ubiquitous healthcare needs unmet by the traditional healthcare system, 2024 has been a tough time financially to be a non-traditional healthcare provider. Digital health companies are down 96% since their peak in mid-pandemic 2021. In March 2024, Walgreens shut down 50% of its VillageMD facilities. Shortly thereafter, UnitedHealth’s Optum announced it would end its entire Virtual Care business and Walmart decided it would shutter the doors on all 51 of its health centers and its entire digital health operation. A big part of the failure of virtual and digital care is that it is not sticky. Patients can get help only in a limited scope of problems, they are provided very little time, and when they have complicated issues they have to go to traditional providers with the digital health giving little support.
We believe that to support the patient, digital health solutions need to follow the patient no matter what provider they use and offer value no matter the complexity of the patient's problem. At the end of the day, the key stakeholder in the endeavor of healthcare is not the provider, insurance company, or technology vendor, it is the patient. Only by maximally aligning with patients, we will adapt to their needs wherever they choose to bring us and follow them into the dawn of tech-enabled healthcare.
So to all who struggle with health issues but feel that their concerns are not heard, to all who feel invisible: we see you. MDandMe is here for you.
Have a comment? Email our co-founder, William, at william@mdme.ai.