Twenty years of digital care taught us a surprising lesson: innovation wasn't the hard part

When my brother Roy and I founded Amwell (then called American Well) in 2006, we believed access would be healthcare’s defining challenge, and we invested everything in democratizing access to care. At the time, accessing care beyond the walls of a clinic or a hospital was still largely aspirational. Geography, scheduling, clinician shortages, and a lack of nontraditional care modalities like virtual visits kept millions of people from getting the care they needed.

Two decades later, healthcare has been transformed. Virtual care moved from the margins to the mainstream. Digital technology became embedded in nearly every part of care delivery. Consumers gained new ways to access care, clinicians gained new ways to deliver it, and organizations adopted models that once seemed out of reach.

We are now confronting a consequence of that success: more innovation, but also more fragmentation.¹ Every day, I wake up to new concepts and new solutions. No wonder, given the number of active digital health ventures has climbed to roughly 16,000. And every person navigating their own healthcare is confronting the same reality: too many choices and too little help making sense of them. What kind of care do I need? What’s safe to use? Whose advice do I follow? What guidance and systems can I trust?

After 20 years of helping health plans, health systems, government organizations, clinicians, and consumers navigate change, the lesson I keep returning to is not the one I expected.

Innovation was never our bottleneck. It’s adoption – and adoption requires trust, earned one interaction at a time over millions of interactions.

In healthcare, trust is not a marketing concept. It is built through consistent experiences, real clinical relationships, proven outcomes, strong governance, and confidence that the system understands and remembers the person using it. When trust is present, adoption accelerates. When trust is absent, even the most promising innovation struggles to gain traction.

Innovation moved faster than integration

Healthcare did not digitize as one connected system. It digitized as thousands of separate innovations.

Every year brought new capabilities, clinical programs, data sources, and vendors. Today, health plans and healthcare organizations manage sprawling portfolios of point solutions, each built to solve one problem well but not designed to work together. It is not uncommon for a health plan or employer to be managing 20 or more of these point solutions at once.² Consumers navigate multiple entry points. Clinicians work across numerous systems. Administrative teams spend enormous effort connecting processes that were never designed to meet.

The resulting problem is not only cost and complexity. It is also a trust problem.

Every disconnected application, separate login, repeated intake form, and fragmented workflow asks consumers to relearn the system and rebuild confidence from scratch. Instead of feeling known, people often feel like they are starting over. The cost of that erosion is measurable: nearly half of consumers say they have left a health plan altogether because they were dissatisfied with the experience.³

Too often, the programs go underutilized. And when every program runs on its own rails, nobody can answer the only question that ultimately matters:

Did this work, for whom, and compared to what?

Fragmentation is not only inefficient. It makes results more difficult to prove, eroding trust and slowing adoption.

In many organizations, demonstrating value requires assembling data from multiple vendors, programs, and reporting systems through a largely manual process. By the time leaders can evaluate outcomes, the market has already moved on to the next innovation.

A connected platform creates a different reality. With shared data, common reporting, and integrated workflows, organizations can evaluate performance across programs in near real-time. They can see what is working, for whom, and under what conditions. That visibility strengthens confidence in individual solutions and in the broader care ecosystem supporting them.

Proof drives trust. Trust drives adoption.

The question has changed from access to adoption

“Healthcare needs less fragmentation” has quietly become one of our industry’s most common observations. But integration is not the goal; it’s the mechanism. The goal is adoption. The constraint is trust.

Healthcare does not suffer from a shortage of innovation, but rather from a shortage of trusted pathways to innovation. More than a quarter of health plan purchasers, 27%, already say they would switch digital health vendors for better integration alone.⁴ The challenge is no longer creating programs. It is helping people discover, trust, and consistently use them.

Trust is the constraint of our industry. For the organizations that earn it, it is also the most durable advantage there is.

In healthcare, trust is not merely a brand attribute. It is an operating requirement. Organizations must move quickly enough to improve care, but carefully enough to protect the people they serve.

For consumers, trust is built through familiar experiences, trusted clinical relationships, and a sense of continuity across the care journey. When technology helps people access care without repeating their story, delivers consistent recommendations, and makes care feel connected rather than fragmented, adoption becomes easier.

A common platform makes that kind of trusted experience possible. It gives consumers a familiar way to move among programs and gives organizations integrated infrastructure for managing them.

Instead of introducing a new destination for every new service, a platform allows innovation to be delivered through relationships and channels people already trust. New capabilities can be added without requiring people to learn a new system, adopt a new brand, or start over with a new experience.

It also makes it easier to see what was deployed, under which rules, and with what outcomes. In a fast-moving industry, trust comes not from promises, but from proof, consistently delivered over time.

What 20 years has taught us to build

Since 2006, we have helped some of the nation’s largest health plans, health systems, and government healthcare organizations deliver tens of millions of virtual care visits and make digital care available to approximately 90 million covered lives.

Two experiences show what this requires: earning trust to drive adoption at scale, and reaching people through a program they will actually use.

The first is the Military Health System (MHS). The MHS serves approximately 9.6 million beneficiaries. Its challenge was not access alone, but delivering consistent, timely, and secure care at scale. The work went beyond expanding virtual care: it replaced a standalone video solution with a connected, enterprise-wide technology-enabled care capability. That transformation required the trust of MHS leadership, care teams, service members, and families. Trust was not established through promises. It was earned through years of reliable performance, rigorous security standards, successful deployments, and seamless integration of the Amwell Platform into the MHS electronic health record and existing, daily clinical workflows. Since replacing the previous video capability, virtual visits have nearly tripled, and deployed units in a combat zone have used the platform to connect with a military hospital in the United States. Learn more.

The second is sustained improvement for population mental health. This year, an independently led, federally funded randomized trial of the SilverCloud® by Amwell® behavioral health program was published in Nature Human Behaviour. Led by investigators from Washington University, Penn State, and UCLA, it followed more than 6,200 students across 26 institutions for two years. Students with clinical levels or high risk for anxiety, depression, or eating disorders were randomized to screening plus SilverCloud®, a guided digital self-help program, or screening plus referral to in-person care. Uptake in SilverCloud® utilization was roughly 74 percent, versus 30 percent participation in traditional care, and the SilverCloud® group had lower prevalence of mental disorders through two years. The lesson was not simply that a digital program existed. It was that students trusted and engaged with it at a rate that traditional referral pathways often fail to achieve. Read the study.

Together, these experiences reinforce one key lesson.

Trust is not built by introducing more technology. It is built by making innovation understandable, measurable, dependable, and easy to adopt.

That lesson is built into the Amwell Platform. Programs from partners run alongside our own, behind our customer’s trusted brand and their own front door, under one experience and one shared set of data. Customers can monitor, add, swap, and scale programs without disrupting consumers or creating another disconnected experience. And when a customer prefers a different program, we can integrate it into the same experience.

Our approach has been externally validated. Frost & Sullivan recently recognized Amwell with its 2026 Technology Innovation Leadership Recognition in the United States Technology-enabled Care Platforms industry.⁵ Their evaluation found that every third-party program integrated into the Amwell Platform passes through a four-part validation — clinical effectiveness, business sustainability, technical scalability, and enterprise-level security — the kind of discipline that, in their assessment, builds not just a better user experience but trust and regulatory integrity.

The next 20 years

The coming decades will bring extraordinary advances, more quickly than ever. Intelligent systems will make care more responsive. Data will make it more anticipatory. Automation will lift administrative weight that has crushed clinicians for a generation. Experiences will become far more personal.

None of it will reach its promise inside fragmented environments, and none of it will be adopted at the pace it deserves without trust.

Artificial intelligence makes this challenge more urgent. Consumers are already signaling openness to it: 73% of Millennials and Gen Xers, and 53% of consumers overall, say they are using or interested in AI-powered tools that recommend the right provider or care setting.⁶ The industry has moved quickly from systems that transcribe and summarize information to systems that can help execute workflows, manage tasks, and support decisions. AI is not creating a new trust challenge. It is amplifying the one healthcare has been addressing for decades: how to help clinicians, consumers, and organizations confidently adopt new ways of delivering care in an industry where the consequences of error are not a bug report.

A common platform becomes even more important in this environment. It gives organizations a trusted foundation for evaluating, deploying, monitoring, and improving new capabilities without creating additional fragmentation. Governance, reporting, workflows, and user experiences do not need to be rebuilt each time a new innovation emerges. Leaders gain a clearer view of outcomes. Clinicians gain continuity. Consumers gain simplicity. Most importantly, technology can reinforce rather than disrupt the human relationships at the center of care.

Twenty years ago, we set out to make care accessible. That work is not finished, but access alone is no longer enough.

The first era of digital health expanded access to care. The next will be defined by something harder: helping people trust and adopt innovation at the pace of change.

The organizations that succeed will not be the ones with the most technology, but the ones that can turn innovation into trusted experiences at scale.

Forward-looking statements

This article contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, including statements about the future of digital health, the role of artificial intelligence, data, and automation in care delivery, and Amwell's strategy and priorities. These statements reflect current expectations and are subject to risks and uncertainties that could cause actual results to differ materially, including those described under "Risk Factors" in Amwell's most recent Annual Report on Form 10-K and in subsequent Quarterly Reports on Form 10-Q, available at investors.amwell.com. Amwell undertakes no obligation to update any forward-looking statement.

Sources

1. Galen Growth, "HT50 Core Investors 2025," Dec. 16, 2025, https://www.galengrowth.com/50-core-digital-health-investors-2025/.
2. MedCity News, "Health Plans and Employers Are Suffering an Onslaught of Point Solutions. Here's How Digital Health Companies Can Ease Their Pain," June 23, 2023, https://medcitynews.com/2023/06/health-plans-and-employers-are-suffering-an-onslaught-of-point-solutions-heres-how-digital-health-companies-can-ease-their-pain/.
3. Accenture, "Healthcare Experience: The Difference Between Loyalty and Leaving," 2022, https://www.accenture.com/content/dam/accenture/final/accenture-com/document/Accenture-Humanizing-Healthcare-Experience-POV.pdf.
4. Peterson Health Technology Institute, "2025 State of Digital Health Purchasing," Oct. 15, 2025, https://phti.org/wp-content/uploads/sites/3/2025/10/2025-State-of-Digital-Health-Purchasing.pdf.
5. Frost & Sullivan, "2026 United States Technology Innovation Leadership Recognition: Technology-Enabled Care Platforms," Amwell, Sept. 2, 2026, https://business.amwell.com/resources/2026/whitepaper/2026-frost-sullivan-best-practices-awards-amwell-awarded-for-technology-innovation-leadership-in-united-states-technology-enabled-care-platforms.
6. PwC Health Research Institute, "2025 US Healthcare Consumer Insights Survey," Oct. 2025, https://www.pwc.com/us/en/industries/health-industries/library/healthcare-consumer-insights-survey.html.’