Commercial digital health platforms and online prescribing is a rapidly growing multi-billion-dollar global industry.
Unlike traditional telehealth, which functions as one modality within a broader range of care, these services are standalone, consumer-facing platforms. Many focus on high-demand, low-complexity issues such as weight loss, skincare, sexual health and hair loss. They frequently offer diagnosis, prescribing, and medication delivery as an all-in-one service, with some charging for their services through monthly subscriptions or memberships. Popular medications include the GLP-1 receptor agonists, such as Ozempic. These platforms advertise extensively on social media, usually with care framed around specific outcomes (“clear skin,” “weight loss”) or particular services, such as issuing medical certificates or prescription repeats.
These mode of care delivery may offer benefits for a portion of the population, particularlyfor acute concerns or where conditions are a low priority for resource allocation in the public healthcare system. However, access is shaped more by digital literacy and financial resourcesthan medical need. These platforms generally lack integrations into the broader healthcare system or with electronic health records, which increases the risk of fragmentation of care. Media coverage has largely focused on potential harms from inappropriate prescribing and compounded medications. In Australia, bodies such as AHPRA, the RACGP and the TGA have raised concerns about these platforms.
More fundamentally, the market logics of these platforms reshape the dynamic of care. They reposition the patient as a customer and the clinical encounter as a transaction, with healthcare professionals becoming fungible “platform economy” workers. The process of diagnosis is narrowed from an open-ended and differential process to one oriented around eligibility for a specific solution. In this seminar I present a typology of these digital clinics, and describe key features that characterise this rapidly growing and evolving sector. I also examine the implications for clinical ethics, regulation, and service delivery in an increasingly commercialised digital health environment.
About the speaker
Dr Hilary Bowman-Smart is a Research Fellow in the College of Health at Adelaide University. Hilary works within empirical bioethics and philosophy, with a focus on reproductive ethics, genomics, technology and diagnosis. She was awarded her PhD by the University of Melbourne in 2022. She has an interdisciplinary background and training in biomedical science, philosophy, classics, and public health. Her research approach involves ethical analysis that is informed by various types of empirical research, such as surveys, data linkage, and qualitative interview studies.
Prior to her role at Adelaide University, she held a position as Researcher in the Ethics of Prenatal Genetics and Genomics at the University of Oxford between 2021 and 2023. In this role, she worked on a project comparing the implementation of non-invasive prenatal testing (NIPT) in England, France and Germany, with her research conducted in both English and German. She has also been a visiting fellow at the University of Augsburg, and holds honorary positions at the Murdoch Children’s Research Institute and Monash University. She is currently an Empirical Bioethics stream lead for the Australasian Association of Bioethics and Health Law.