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Wellness

What it's like inside the doctor’s office of the future

For $149 a month, Forward Health's futuristic health center wants to replace your primary care clinic.

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Forward's "front of house" includes self-check in for members and a 3D body scanner (left).

Forward Health

I step into a clean, minimalist lobby of a futuristic medical clinic where alt-pop music wafts throughout. Actually, I step into the lobby only on my third go-around: I walked past Forward twice because its entrance to the Glendale location is just as glossy and polished as every other building in the Americana at Brand shopping center.

When I say minimalist, I really mean it -- only two chairs sit in the waiting room. Dr. Nate Favini, Forward's medical lead, doesn't like to call it a waiting room, though, because patients don't actually wait there. Oh, and patients aren't just patients, either. Favini prefers to call them members.

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Instead, in Forward's "front of house," members check themselves in on tablets, where initials pop up according to what appointments are in queue. After checking in, members stand in front of a 3D body scanner that uses a variety of technologies -- infrared, bioelectrical impedance, structured light -- and a rotating platform to gather measurements that they then discuss with their physician.

Forward Health considers itself the doctor's office of the future, where tech and medicine meet to create a seamless, collaborative primary care experience. I visited Forward Health to find out how different this place really is compared to the typical doctor's office.

What is Forward Health?

In short, it's a new, tech-driven type of primary care office.

By the time members make it from the body scanner to their exam room, Forward's algorithms have already translated the scan data into easy-to-understand tidbits about the members' health. Member and doctor then collaboratively review the data together on a massive touchscreen.

Favini shows me a sample account and walks me through the fake member's health history. At the flick of a finger, Favini summons a slew of words, graphs and numbers that's honestly hard to digest.

But not to worry about that: At Forward, members get an entire hour with their doctor, so there's plenty of time to go over any and all pertinent info. Favini says Forward physicians use this ample time to discuss things normally forgotten in primary care, such as nutrition, exercise and mindfulness.

What did I think was the absolute coolest feature out of everything I experienced at Forward? The way the giant touchscreen captures information as the member and doctor speak, translating spoken words into text onscreen. This reduces your doc's need to scribble notes, increasing time for eye contact and meaningful conversation.

"I've had patients come in for appointments and cry because it's such a powerful experience for them," Favini told CNET. "Until this point, they've probably hardly made eye contact with their doctor, and now they're seeing all of this information intuitively show up in front of them."

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There's an app for that 

Additionally, members get access to the Forward app, where all of their health data from every appointment is stored. The app is compatible with anything that connects to Apple Health, including the Motiv Ring, MisFit Ray, Omron Evolv, AliveCor Kardia, Withings smart scales and many others.

There are some limitations to the app integrations. For instance, your Apple Watch won't send activity data straight to the Forward app, but if you integrate the Forward app and Apple Health app, you should still see all your data in one place.

The app beams the member's vitals (including heart rate), activity history and food diary to Forward's 24/7 care team of nurse practitioners who can reach out if something seems askew. For example, if you use the Omron Evolv to measure your blood pressure, the Omron sends readings to the Forward app, which then sends that information to the care team.

Favini told CNET that Forward's app is secure and HIPAA-compliant, but members don't have to use it if they don't want to.

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Forward members can chat 24/7 with nurse practitioners about symptoms, vital signs and more. 

Forward Health

It's not as if the nurses are 24/7 watching every member's data -- that would be impossible. Rather, they can check in on whoever they want, whenever. But they also get pinged if, say, a member's app sends over a blood pressure reading of 160/110, which is really high.

Favini tells me a story about one member who might have died if it weren't for Forward's app: In the early stages of a heart attack, the member said he felt fine and didn't intend to seek medical care. But Forward's care team had a different agenda.

Because the member used a compatible blood pressure monitor, the care team received an alert that the member's vitals were wacky, took action and helped him get to an emergency care center that accepted his insurance.

What do I get as a member?

For $149 per month, you get unlimited visits to Forward, including the very thorough baseline visit. Your visits are all included in the membership fee, so you don't have to pay a co-pay.

Forward almost acts as an all-in-one clinic. Rather than visiting a personal trainer and nutritionist to get diet plans, exercise regimens and even mindfulness techniques, Forward physicians will recommend those based on your health status, lifestyle and other factors.

Picture a member who has very high blood pressure, a high-stress job, a family of four and creaky knee joints. This member's doctor might suggest he try out the DASH Diet to lower his blood pressure; engage in deep breathing twice a day; and take up cycling so he can exercise without too much strain on his knees.

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Members review their body scan and health history with their physician on a large touchscreen in the exam room.

Forward Health

Forward offers blood testing on site (with an impressive 12-minute turnaround for your results), HIV testing, standard vaccinations and travel vaccinations. Members can also opt in to genetic testing for even more insights, such as food sensitivities and disease risk, at no additional charge.

Members get access to the Forward app after their baseline visit, which includes a 24/7 chat feature to get instant answers about symptoms, conditions and more.  

What about insurance?

Favini encourages Forward members to keep their insurance, even though Forward doesn't currently take any insurance plans to cover the monthly fee.

Most everything you need from a primary care doctor is included in your membership fee: office visits, bloodwork, basic lab tests. If your doctor needs to refer you out for special imaging or procedure, such as an MRI or a biopsy, you'll need insurance to see a specialist.

In cases like the member's story above, Forward will do its best to find emergency care or a specialist that takes the member's insurance. And though Forward does a lot, it's still only offers primary care, and physicians will refer out when a member needs a specialist.

Though your insurance won't cover the cost of Forward's monthly $149 fee, some current members use their FSA or HSA accounts for it.

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All visits to Forward are included in the membership fee, as are blood tests, genetic testing and vaccinations.

Forward Health

How do I join?

You can become a Forward member by simply signing up online and choosing your preferred location. There are currently seven Forward locations throughout California and New York, with an eighth opening later this year in Washington, D.C.

Favini told CNET that several more locations are in the works, but Forward isn't ready to disclose details on those yet.

What this means for primary care

"Of all the things that are changing, health care seems to be one of the furthest behind," Favini told CNET. "We want to show people the value in taking care of themselves, and show them that it doesn't have to be the inconvenience that it's historically been."

Long-term, Forward wants to increase access to quality, comprehensive care for as many groups as possible by lowering the membership fee and working to accept insurance. Favini wants to see a shift in the focus of primary care: Rather than treating illnesses, primary care should prevent them in the first place.

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Perhaps most importantly, Forward wants to make the delivery of care more efficient, which means constant innovations in care models to match the technology people already use. For now, this means continuing to improve the Forward app so it works with more devices and captures more information, as well as improving methods of communication like the 24/7 nurse access feature.

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Membership-based practice One Medical offers members mental health counseling and health workshops.

One Medical

Forward isn't the only startup attacking these fronts. Parsley Health, another membership-based primary care company, also combines nutrition, lifestyle and medical care to offer holistic services to members.

Founded by Dr. Robin Berzin, a med-school graduate frustrated with the current health care landscape, Parsley promises impressive benefits, such as long-term improvements for chronic conditions and personalized health plans.

One Medical boasts 72 locations across the country that tout the same things: prevention, overall wellness and comprehensive primary care for a membership fee.

One Medical offers a few extras, like group programs and mental health counseling. Their model also accepts most major insurance plans, and the annual membership fee is said to pay for things that insurance doesn't typically cover, like the group programs.

In general, expect to see a gradual shift in the way primary care is executed. As Favini put it, people deserve more than what traditional doctor's offices can give them. 

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