Examining Forward Health's Bold Leap into Automated Primary Care

Direct primary care startup Forward Health will launch self-serve CarePods that will automate medical check-ups in malls, offices, and gyms.

Is this the future of “primary care”: Random CarePods dispersed in nearby locations, allowing you to walk in, get typical preventive screening, and then leave?

Some say yes; I say no.

In this article, I’ll highlight Forward Health, dive into their new CarePods, and then tell you why I’m cautiously optimistic about this new product.

Forward Health

Forward Health is a direct primary care company, meaning they’re subscription-based—no insurance (I covered the DPC model here). The company is perhaps best known for bringing an Apple Store-like experience to primary care: tech-enabled, streamlined, and humanized.

For around $150/month, Forward members get access to in-person and virtual visits, a 24/7 care team, and specialized programs. Some of their specialized programs include the following:

• Weight management

• Heart health

• Women’s health

To date, Forward has raised around $660 million, including a recent $100 million Series E round to build and rollout the CarePods.

CarePods: The Autonomous Doctor’s Office

Forward’s self-serve CarePods will attempt to automate medical check-ups with artificial intelligence and other technology to create an “autonomous doctor’s office.”

These CarePods are equipped with biometric body scans, blood testing capabilities, and diagnostic screening sensors to screen for diseases and provide health evaluations. For example, with the CarePod’s skin cancer scanner, users can scan a suspicious lesion with each CarePod visit to see if there’re any red-flag changes over time (e.g. discoloration). All results are synced with Forward’s health apps that address several chronic diseases including type 2 diabetes, hypertension, and depression.

Here’s an example of the workflow:

• You walk up to the CarePod and unlock it with Forward’s app.

• Inside, there’ll be a large touchscreen and a chair.

• If you choose “heart health” on the app, for example, a hidden drawer will provide a heart sensor, for which the touchscreen will instruct you how to use.

• The diagnosis will display on the touchscreen, and if any further treatment is needed, one of Forward’s doctors will review the findings and instruct on the next steps in real time.

While the CarePods appear autonomous without any physician oversight, there will be clinicians reviewing health data and confirming care plans.

Forward plans to launch 3,200 CarePods in the next year, first focusing on major metropolitan areas like San Francisco, New York, Chicago, and Philadelphia. Within these cities, CarePods may be found in malls, gyms, and offices. So, for just $99/month, you can hop into one of these CarePods and check them out. As far as I know, you won’t get access to Forward’s brick-and-mortar services—just the CarePods.

Dashevsky’s Dissection

Before I get into my dissection, I’ll share this quote from Forward’s CEO:

Now, I remain cautiously optimistic about Forward’s CarePods:

• Cautious: there’s a poorly defined target market (and it cannot be the “whole planet”); the business model defeats the purpose of streamlined care; and, healthcare isn’t a product—it’s a service that blends together science, medicine, and art.

• Optimistic: I’m all for new and shiny things in healthcare, and will give any new product a chance.

First, Forward seems to be positioning these CarePods in urban areas already saturated with high-quality healthcare facilities as opposed to areas lacking healthcare resources (e.g. rural areas). So I question the need for such CarePod services in locations where access to prestigious medical institutions, well-established labs like LabCorp or Quest Diagnostics, and ubiquitous Urgent Care centers are readily available.

I can’t see the utility and appeal of CarePods in these environments since these urban populations are less likely to face significant barriers to accessing traditional healthcare services. Just look at the density of PCPs in the cities where CarePods will launch compared to the rest of the U.S. The only appeal I see in these populations is they have more cash on hand to spend on a $99/month subscription.

I’m also concerned about the business model, particularly in the setting of when abnormal results are obtained from a CarePod check-up. In such scenarios, the pathway for further medical intervention is unclear. If a CarePod subscriber receives concerning test results, what are the next steps? Forward's model doesn't include access to their brick-and-mortar clinics as part of the CarePod subscription. This disconnect could lead to a fragmented care experience, where patients are left to navigate the next steps independently, potentially delaying crucial follow-up care. Contrast this with a primary care physician who can plug the patient into care right away.

Furthermore, healthcare is fundamentally a service that intricately blends science, medicine, and the art of human interaction and empathy, something that cannot be fully replicated by automated CarePods. The relationship between primary care physicians and their patients is built on trust, ongoing dialogue, and a deep understanding of the patient's health history and lifestyle. This relationship is crucial for guiding patients through preventive screenings and medical decisions. Without the guidance of a physician, patients may be left to self-direct their care, which could lead to missed screenings or misinterpretation of health data. I truly cannot picture any of my patients relying on these CarePods for automated check-ups. I also recognize that this take sounds paternalistic. There is likely a need for quick-in-quick-out healthcare with minimal human contact among a select population of Millennials or Gen Z.

So, while the CarePods introduce an innovative approach to healthcare delivery, their current model raises concerns about their practicality, effectiveness, and integration into the larger healthcare ecosystem. The potential disconnection from comprehensive care and the lack of clarity in the patient journey post-CarePod consultation represent substantial hurdles to their successful implementation as a reliable healthcare solution.