The Telehealth Feature That Makes Patients Happy and Doctors Slower

Lyric's platform has offered asynchronous capabilities for years. An industry report from late 2023 documented them. Their own API documentation treats async visits as a standard state. The company launched in 2015, rebranded from MyTelemedicine in 2022, and has been iterating on this model since well before the pandemic normalized telehealth.

Calling it an introduction is a press release trick. But the more interesting question isn't about timing. It's about whether asynchronous telehealth actually does what its sellers claim.

Asynchronous care - sometimes called "store-and-forward" - lets a patient submit symptoms, photos, medical history, or test results at any time. A physician reviews the material later, at their own pace, and sends back a diagnosis or treatment plan. No scheduling. No waiting room. No two humans needing to be in the same place at the same time.

On paper, it's the anti-appointment. And for certain use cases, it works. Hims, the consumer telehealth company, built its entire business model on asynchronous visits before the word "telehealth" was mainstream. You submit your information through a structured intake form. A licensed provider reviews it. You get a prescription or a care plan. It's how they handled hair loss, erectile dysfunction, and weight management without ever booking you into a calendar slot.

The research supports it for narrow conditions. A comparative study found that store-and-forward dermatology consultations were more cost-effective than real-time video visits. E-consults across 11 specialties, studied in a paper analyzing 1,543 inpatient cases, had a median response time of 3.7 hours versus 7.3 hours for in-person consultations. For well-understood, visual, or routine conditions, the model is genuinely useful.

But here's the thing the press releases skip. One systematic review of asynchronous telemedicine, cited 42 times, found that asynchronous care increases provider workload and is less clinically efficient than face-to-face interaction.

The mechanism is simple enough to see if you think about it. In a synchronous visit, a doctor asks a question and gets an answer immediately. If the patient's response raises a new concern, the doctor follows up. The conversation has a shape. In asynchronous care, the provider receives a one-way packet of information. They can't ask a clarifying question and wait for the reply. So they either over-prescribe - covering possibilities the patient didn't mention - or they request additional information, which creates another round of back-and-forth that eats into the time savings the model was supposed to create.

The study of dermatology consultations put it plainly: store-and-forward was more cost-effective but less clinically efficient precisely because of the missing interactive dialogue. The provider can't probe.

This is the contradiction at the center of the asynchronous care pitch. It promises efficiency by removing the scheduling friction of appointments. But it delivers efficiency only on the patient's calendar. On the provider's end, it often makes things slower. You're replacing a 12-minute conversation with a 12-minute conversation plus email latency.

Lyric isn't unique in facing this. Teladoc and Amwell, the two public telehealth giants, have both seen their stocks fall more than 90% from their pandemic peaks. The broader telehealth market is shaking out. A 2024 analysis of clinical employment across 400 telemedicine companies found the industry still represents only 3–4% of medical clinician jobs. The sub-verticals that survived - mental health, metabolic health, physical therapy - are the ones where either the condition is hard to assess remotely (making async less risky) or where the care plan is structured enough that a one-way packet of information is sufficient.

What Lyric is actually doing, I suspect, is broadening the set of conditions it can handle asynchronously. Their platform already covers primary care, urgent care, behavioral health, dermatology, musculoskeletal care, chronic condition management, labs, and a GLP-1 weight-loss program they added in late 2024. Pairing all of that with async capability means a health plan or employer buying their service gets one more modality to route patients through.

For the buyer - a health plan or an employer - this is genuinely attractive. More care pathways without adding clinic infrastructure. For the patient, it's more convenient than finding a doctor's office during working hours. For the physician whose time is the actual scarce resource in healthcare, the evidence is less optimistic.

I haven't seen data on how many providers Lyric employs or how their async visits are distributed across clinical conditions. The company describes a nationwide network of licensed physicians, pediatricians, dermatologists, psychiatrists, and therapists - but the workload dynamics of that network, under an async-heavy model, aren't public. That's the missing piece. If most async visits are concentrated in the conditions where the model actually works - dermatology, follow-ups, medication management - the efficiency claim holds. If they're spreading async into acute triage or complex primary care, the workload problem gets worse fast.

The way to evaluate asynchronous care is not to ask whether patients find it convenient. They do. Ask whether the total time - provider time plus patient time plus latency - is lower than the synchronous alternative. For a handful of conditions, the answer is yes. For the rest, it probably isn't.

If you're a health plan deciding whether to add async telehealth to your benefits package, the test is simple. Look at the conditions your members actually present with. Then check which of those conditions have evidence supporting asynchronous clinical efficiency, not just patient satisfaction. The gap between those two lists is where the hidden cost lives.