By Hope Chang, PharmD and Amanda McGuill, NP-C, CDCES
This edition covers:
Amid soaring demand for the new generation of anti-obesity medications like semaglutide (Wegovy) and tirzepatide (Zepbound), a number of digital health companies are rising to the occasion by offering prescriptions for these novel medications — many in a direct-to-consumer (DTC) telehealth model, such as Hims and Ro.
As a virtual care provider, Omada fully supports innovation that improves the patient experience and health outcomes. Yet, as these companies open new avenues for patients to receive third-party telehealth prescriptions for GLP-1s, primary care physicians (PCPs) have reported that their patients aren’t keeping them in the loop. This poses safety concerns like medication interactions and lack of care continuity, which are commonly coordinated by the PCP, i.e. the medical home.
While care coordination with the medical home is vital to any patient’s care experience, it’s especially important for people taking anti-obesity medications due to potential presence of co-morbidities, medication monitoring and dose adjustments, side effect management, contraindications, warnings and precautions, and the lifestyle modifications needed to achieve optimal health outcomes.
Given these complexities, we were moved to examine the role of the medical home, and discuss opportunities for new and emerging providers, like the third-party telehealth prescribers mentioned above, to coordinate care for an optimal patient experience.
In a time when health care can be provided in a number of ways, be it in-person, via telehealth or virtual, and administered by a variety of physicians with different specialties, it’s important to clarify the meaning and function of the medical home. Each patient’s medical home can look a little different depending on their needs, and where they get their care.
A patient-centered medical home (referred to as PCMH or medical home) refers to a concept of care that emphasizes a bidirectional, highly communicative, team-based primary care model that puts patients at the center of their care. Setting up a PCMH is an upfront investment, but it’s worth it. Extensive research has shown that PCMH’s result in:
In the medical home, communication and coordination of care typically start with the PCP, which includes, and is not limited to, treatment plans, referrals to specialists and keeping an accurate medication list (e.g. to monitor interactions between anti-obesity medications and other prescriptions).
Due to the overarching aspect of their role, we often refer to PCPs as the quarterback of their patients’ care, hence why people are typically asked who their PCP is when visiting the emergency room, hospital or any other healthcare facility. These facilities need to know who to inform regarding changes to a patient's health to support continuity of care.
Patients also often require specialty care for cardiometabolic conditions — such as obesity specialists, endocrinologists for diabetes, or cardiologists for heart health. These specialists work closely with the patient’s PCP and other members of the medical home, sometimes in fully integrated systems, to create a medical neighborhood.
However, at this current juncture in healthcare, third-party prescribers may not have moved into the neighborhood, so to speak.
According to a January 2025 survey of over 2,000 PCPs, about half (54%) reported that their patients had asked them about accessing GLP-1/GIPs through third-party telehealth prescribers, and the majority of the PCPs (67%) felt that accessing GLP-1s for weight loss through a third party telehealth prescriber may put their patients’ health at risk.
Furthermore, 61% agreed or strongly agreed that patients don’t always tell them when they get a GLP-1 prescription for weight loss from a third-party telehealth prescriber. That means that more than half the time, the medical home may be unaware their patients are taking an anti-obesity medication.
This disconnect between the medical home and third-party telehealth prescribers raises concerns among PCPs regarding patient safety and their ability to provide holistic care without full visibility into their patients’ care plans.
It’s important to note that PCP concerns about care continuity aren’t exclusive to third-party telehealth prescribers. A 2024 qualitative study by Omada Health and the Stanford Healthcare AI Applied Research (HEA3RT) team revealed that PCPs share these concerns across digital health providers, yet feel there is also a role for virtual care solutions in patient care as long as they provide value to their traditional practice.
Based on our experiences working in specialty clinics within large health systems—Amanda, a trained nurse practitioner who formerly worked in an endocrinology clinic, and Hope, a former ambulatory care pharmacist in HIV care—integrated specialty care is indeed optimal for clinical outcomes, as well as the patient and provider experience. However, patients can also get great care from specialists even when the specialists are not in an integrated clinic setting with the PCP, as long as they prioritize continuity of care and employ systems that “close the loop” with the medical home. In both cases, specialists may be considered as part of the medical neighborhood as long as there are systems in place to prioritize communication and coordination of care.
In cardiometabolic care especially, being a specialist requires tight communication with the medical home so that when something changes in one treatment plan, the rest of the treatment plan, including the patient’s medications and lifestyle changes, are also adapted if needed.
Omada’s VP of Cardiometabolic Operations Lisa McCormick, FNP-BC, RD, CDCES, describes her experience working at a specialty clinic in the weight loss space:
Working in a low-carb weight loss clinic as a nurse practitioner, we communicated directly with the referring provider’s office. Many of our patients had hypertension or type 2 diabetes, and their medications had to be changed fairly quickly because of a dramatic reduction in carbohydrates. In fact, for patients taking insulin for their type 2 diabetes, guidelines in the clinic were to cut the insulin dose by 50%, due to the risk of hypoglycemia. We absolutely had to ensure that message was clearly imparted to the primary provider (as well as the pharmacy) so no dosing errors were made. Patient safety was our number one priority. In fact, we would fax dosing requirements to PCPs and required PCP sign off before patients could even start our program!
To foster favorable clinical outcomes and elevate the patient experience, the goals of care for a specialist or third-party provider, whether via traditional, telehealth, or virtual care like Omada, are to:
Despite advances in information sharing, the reality is that integration challenges still exist amid healthcare providers. For the digital health industry, seamless continuity of care with the medical home can be very challenging to achieve at scale. Due to these challenges, Omada is actively partnering with PCPs to take steps toward achieving seamless integration. At the same time, we believe that the patient’s medical home or specialists integrated with the medical home’s EHR are in the best position to clinically evaluate patients for anti-obesity medications, including GLP-1s.
When assessing third-party telehealth prescribers that offer anti-obesity medications, consider their level of commitment to coordinating with the medical home and promoting the patient-PCP relationship. Doing so may reveal meaningful insights about their safety measures and patient experience.
As a virtual care provider that doesn’t prescribe medications, Omada promotes the relationship between patient and PCP by supporting each unique member’s treatment plan and health journey with evidence-based lifestyle and behavior change between provider visits.
Because when it comes down to it, we believe virtual care should complete — not compete with—primary care.