Over the last several years, we've seen rapid movement around care models in the digital health space - especially with teletherapy going mainstream. One way to think about these models is on a "technology spectrum" - what is the amount of technology involved in each solution? Where your care model lies on the technology spectrum is critical for your scalability, business model, and defensibility. The models are organized from least tech-centric to most:

1. Tech-enabled brick and mortar

Known as "bricks and clicks", these models have built tech around a brick and mortar office. In some cases, the patient's engagement is centered around an annual office visit (e.g., One Medical, Tia). Others have a suite of services and don't require an annual office visit (e.g., Carbon). Benefits of this model include strong brand/presence, defensibility, and an ability to treat a wide range of conditions. I'm bullish on this model if you can raise the capital and manage the operations. However, these businesses are capital-intensive and difficult to scale.

2. Teletherapy

Virtual video, SMS or phone call based visits. Teletherapy has come roaring onto the scene, and is now being reimbursed by payors - this is a benefit for standing a business model up quickly. But the teletherapy model and tech is quickly becoming commoditized. If you choose this route you need to have another differentiator (care model, provider network, etc), or be on the path to Care Model #1 or #3 -- where there is more defensibility.

3. Digital Care

Digital Care provides telemedicine and also integrates elements of a digital only care model driven by content and data, to improve the efficiency and efficacy of its providers. Examples here include Omada Health and Meru Health. Digital Care businesses have the benefit of a reimbursable service (for the payors) and ability to keep the human in the loop to improve outcomes. They are more defensible and scaleable than telemedicine only, and are an easy evolution from teletherapy.

4. Digital Therapeutic

Digital therapeutic care models are technology-only care delivery systems, powered by content, data and logic. Examples include Pear Therapeutics and Big Health. These models are extremely scaleable and margin-positive. However, they are also capital-intensive to build and the path to FDA clearance and reimbursement from the payors is long. Outcomes are still in question.

Choose your technology model wisely

Choose your technology model wisely: I see many companies popping up in teletherapy, but I don't believe teletherapy-only businesses will survive long-term without another differentiator.