Warby Parker makes the case for new health care models. Plus, Lyft to health care VP and urgent-care centers give out too many antibiotics

Welcome to The Checkup, a weekly newsletter for health care professionals who want to know what’s next for an industry in transformation.

Follow me for more like this.

Companies like Hims, Nurx and Warby Parker are providing prescriptions directly to consumers in a bid to bypass the standard, time-consuming process of making a doctor’s appointment.

This kind of direct-to-consumer business model in healthcare is nothing new. You can already buy reading glasses and aspirin at CVS Health and 23andMe genetic testing kits at Target.

But as consumers become more comfortable ordering vegan meal kits and mattresses online — and investors are furiously taking notes — the appetite for direct selling in healthcare has grown.

“So many dollars are being spent in healthcare and so many are spent inefficiently, there is more and more pressure for companies and healthcare providers to offer consumer-friendly services,” Dave Gilboa, Warby Parker’s co-founder and co-CEO, told LinkedIn. “For the first time, you’re seeing different models emerge.”

Just last week, Nurx, a sexual health startup that sells and delivers birth control and emergency contraceptives directly to patients, announced a $41.4 million investment round. Another startup, Hims, which sells men’s health products like Rogaine and erectile dysfunction drugs, has already raised $97 million. Bloomberg described Hims as emblematic of a set of new “direct-to-consumer, hipster-branded startups” selling drugs to men.

Hipster branding aside, what the companies say they are trying to do is streamline a process that has yet to keep pace with consumers who are increasingly relying on technology in their daily lives.

Warby Parker in 2017 launched an app that allows some consumers to take a vision test using a computer and an iPhone rather than having to make a trip to the eye doctor before buying a pair of their glasses. Like Nurx, the company has doctors on staff to evaluate each prescription before deciding whether to okay the order.

I took Warby Parker’s refraction test this week after discovering that my prescription had lapsed. I downloaded the app, took the 20-minute test, and paid $40. (The process, while simple, wasn’t without glitches. My dated MacBook struggled to recognize my distance, a requirement of the exam, and I ended up using my work laptop to complete the test. However, the fact that my order is complete more than makes up for the workaround.)

No one disputes that this kind of consumer comfort is important. But this nascent model in health care has a long way to go. Insurers have to get on board and find ways to reimburse for new types of clinical examinations. So do doctors, who in some cases have expressed concern about whether patients will see these tools as reasons to skip in-person visits with their providers used to detect other diseases and conditions.

“As long as it doesn’t reduce the likelihood of obtaining a medical eye exam at regular intervals,” said Dr. David Glasser, an ophthalmologist in Maryland.

Most of the companies in this space fall into the same category. They sell “things that are low risk, but with high consumer demand,” the kinds of products and services that fall in the gray area between consumer packaged goods and healthcare, said Nikhil Krishnan, an analyst for CB Insights. And, in some ways, these services are a gateway to telemedicine. If people better understand how telemedicine works for lower key products like prescription glasses, Krishnan added, they will become “more comfortable getting their healthcare handled online.”

One more thing to note: The Food and Drug Administration earlier this week issued draft guidance that would allow some prescription drugs to be sold over-the-counter, a process that the regulator says will save the system money and improve access to consumers.

What medical services or products would you feel comfortable buying online? Share your thoughts in the comments, using #TheCheckup.

What We’re Watching

1. Urgent care, a booming $15 billion industry, prescribes too many antibiotics. A new study found that 45% of the antibiotics prescribed by urgent-care providers are for inappropriate reasons, such as to treat a flu or the cold. Other types of providers, like emergency departments (24%) and medical offices (17%), also over-prescribe antibiotics but to a lesser extent. Some researchers are concerned because the growing number of urgent-care centers in the U.S. may mean more patients will be given even more unnecessary antibiotic prescriptions in the coming years.

2. 2018’s front-running healthcare buzzword? “Social determinants of health.” The march toward making social determinants of health (a fancy way of explaining why things like food insecurity and other socioeconomic factors affect someone’s health) part of the day-to-day healthcare conversation moves forward. Intermountain Healthcare, the Utah-based hospital network, and UnitedHealthcare separately announced plans to give $12 million and $1.95 million, respectively, to programs addressing these issues.

3. Study links ADHD symptoms and digital use in teens. About 11% of the 51 teens characterized as “high frequency users” of smartphones and tablets developed ADHD symptoms during the two years the study was conducted. The study evaluated 2,500 teens in Los Angeles, examining how often they texted, watched videos and engaged in other forms of activity on their mobile devices. “I’d be very interested in seeing these kids in five to 10 years,” one expert told the Los Angeles Times. “Their life situation has changed and I’d bet you find that the gaming and social media tails off.”

Healthcare’s changing workforce

Lyft, the ride-sharing giant, is hiring a VP of health care. The role is technically a new one although health care is already one of the largest of Lyft’s business units, a spokeswoman said. 

What you should know: Lyft and Uber are competing for the top spot for transporting patients to and from their doctors’ appointments, with both companies announcing in the spring a series of initiatives (Lyft with EHR provider Allscripts, the health insurer Blue Cross Blue Shield Association and a health care transportation platform Hitch Health, Uber with the launch of Uber Health).

One Big Conversation

What’s next for a National Health Service under pressure? As the U.K.’s NHS celebrates its 70th birthday, it faces a critical moment. It is struggling to staff its clinical facilities. Nurses took to the streets two weeks ago to protest cuts in funding. And a key Brexit promise argued that a vote to leave the European Union was a vote for a stronger health care system. LinkedIn healthcare editor Beth Kutscher wants to know: Can technology help solve these woes?

Ken Wakatama, a clinical nurse specialist for the West London Mental Health NHS Trust, weighs in:

Join the conversation here.

What's your take on this week’s stories? Share your thoughts in the comments.