Integrated Virtual Care

Transform Patient-Provider Journeys With Integrated Virtual Care

David Nickelson

David Nickelson

VP of Client Growth, Healthcare

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Earlier this year, as COVID-19 disrupted traditional in-person care delivery, virtual care platforms became a top priority for clinics, hospitals, health systems and integrated delivery networks (IDNs). For most, this did not mean that digital healthcare transformation projects underway prior to the pandemic were forgotten — virtual care simply reshuffled the project priority list.

This urgency forced virtual care efforts to come together quickly — meeting the immediate need but not solving for the long term. Providers who are willing to strategically upgrade their recent quick-fix solution to an integrated virtual care platform will find a relevant and ready-made opportunity to transform patient-provider journeys, improve care delivery, and differentiate themselves from competing healthcare systems and disruptive outsiders.

Virtual care: STAT!

Prior to the pandemic, many providers were experimenting with a patchwork of email, text, asynchronous and synchronous audio and video care delivery options. Patient uptake was limited, and few doctors and nurses were able to take time to learn how to best integrate them into their clinical and administrative routines.

COVID-19 changed things almost overnight. A recent Department of Health and Human Services report found that telehealth adoption increased by nearly 50% in primary care from January through early June 2020. Surveys conducted during this same time period found that consumer interest in using telehealth rose from 11% to 76%; provider sentiment also changed, with 57% of providers viewing telehealth “more favorably” than before the pandemic, and 64% becoming “more comfortable” with using it.

Taken together, these and other findings (see footnote) about virtual care adoption show that it will continue to be a significant and in some cases the preferred delivery channel for both patients and providers from here forward.

“Providers willing to immediately revisit their virtual care offerings and build an integrated patient-centric virtual care platform using DBT "best practices" will be ideally positioned to meet future consumer and physician demand for remote care.”

Virtual care and digital transformation

As states began issuing “stay-at-home” orders, the need for easy-to-use, high-volume virtual care options was obvious and immediate. Providers cobbled solutions together; policymakers expanded eligible services, providers and platforms; and payers expanded eligibility and adjusted claims processing. It was an astonishing effort. Many providers (and payers and regulators) accomplished more digital transformation in eight weeks than in the previous eight months (and in some cases, eight years).

While some were more prepared than others, many of the temporary solutions were developed hastily, with very little connection to a broader, long-term digital transformation strategy. In most cases, the patient and provider experiences are less-than-ideal, and data cannot be pushed/pulled between enterprise and virtual care platforms. That means double entry of routine data, gaps in care continuity and missed opportunities to improve operational and administrative efficiency and effectiveness.

As patients get more familiar with virtual care, they expect hospital and clinic offerings to be as predictive, seamless, integrated and accessible as their everyday consumer experiences with retail, e-commerce and banking.

Providers willing to immediately revisit their virtual care offerings and build an integrated patient-centric care platform will be best positioned to meet the demand. Here’s how four key digital business transformation trends are influencing integrated patient-centric virtual care platform development.

Consumer and provider experience:

The significance of the post-COVID-19 increase in physician acceptance of virtual care is an often overlooked game-changer. While it will take some time for them to become completely comfortable with the tools, technologies and the ideal use cases, virtual care is likely to follow the same adoption patterns as other medical technologies, with “best practices” emerging for tele-presence, technology, security, privacy and IT integration. Providers should be actively talking with care delivery leaders to better understand how virtual care tools are being used now, what works (and what does not), and what features are required to make a virtual care platform clinically and administratively efficient and effective.

It’s also well documented that physicians’ professional satisfaction is at an all-time low, due in part to multi-year efforts to integrate EHRs that have increased administrative burdens without yielding promised individual and population-based care insights. Providing a safe, secure, easy-to-use platform that both accommodates remote-care delivery and reduces data entry will reduce burnout, increase quality of life, and increase the appropriate physician adoption of virtual care.

Experience and service design are key tools for getting started. Done well, they will surface the gaps in your people, processes and technology that are critical to the success of a digital transformation.

Efficiency and effectiveness:

Central to any digital transformation is delivering better value to the customer; in healthcare, that means better quality, less-costly and more convenient care. Taking the time needed to strategically develop a virtual care platform will identify where misaligned patient, provider and administrative-facing activities create bottlenecks, delays and frustrations. In most cases, these challenges are not unique to virtual care, and often span the entire organization. A good virtual care solution roadmap clearly demonstrates how these problems impact almost any patient and provider journey, and will draw a direct line between poor experience and quantifiable losses in acquisition, volume and revenue.

Interoperability and integration:

Creating successful experiences for patients and providers requires data to move safely, securely and freely between the key platforms and technologies (EHR, CRM, etc.). Ideally, as a patient moves through an incident of care, data and algorithms should appropriately predict what information and options are needed, and guide the patient toward the best care option. A diabetic patient, experiencing significant loss of sensation in their toes or feet may start their care journey via virtual care. Ideally, the virtual care tool will “know” about the severity of their condition, ask a set of personalized questions about current symptoms, and determine whether virtual or in-person care is required. No matter the channel selected, the platform should share available appointment options based on patient location, provider availability, and urgency of the current condition.

To date, connecting data inside of a provider to deliver this kind of experience has been a significant challenge. However, the increasing adoption of FHIR and a recent federal rule requiring vendors to allow development of APIs for moving data in/out of proprietary platforms creates an opportunity to architect an integration layer to support the kind of experience that patients and providers expect.

Data science, machine learning and artificial intelligence:

Prior to COVID-19, only 51% of providers surveyed indicated that they had an enterprise level AI strategy. Post-COVID-19, that percentage is expected to grow to over 90%, and market analysts are predicting that healthcare AI will lead overall investment.

Virtual care provides a number of administrative and operational opportunities to put these tools to work. For example, using a series of brief questions that could be answered via text or voice recognition, a patient can be appropriately triaged between email, chat, video or an urgent care or emergency room visit. As the system “learns” individual and population preferences (with appropriate initial oversight from human data scientists), it will continue to improve both accuracy and efficiency. Ideally, an AI-powered patient journey will also deliver the feeling of being cared for (empathy); data is used to recreate the same kinds of language, decisions and responses that effective caregivers would use if they were interacting with the patient directly.

This example shows that the above four elements combined can create transformative patient and provider experience that deliver meaningful results.

Virtual care transformation = digital enterprise transformation

The digital transformation of virtual care is more than a solution to a pandemic problem; it’s an opportunity to strategically and systematically demonstrate the clinical, administrative and business value of developing a digitally enabled patient and provider-centric care platform.

If your organization had virtual care or other similar initiatives underway prior to the pandemic, it’s time to strategically double down. If not, a virtual care platform presents an ideal way to start.

Even as patients, providers and payers start to offer in-person visits again, there are clear signs that virtual care is here to stay, particularly for some specialties and use cases. For example, data from The Commonwealth Fund shows that while the initial surge of virtual care in March through April has declined, virtual care is now consistently being used at a higher rate than pre-pandemic, representing more than 7% of all outpatient visits.

There is also evidence from the Commonwealth data that virtual care is helping providers close at least a portion of the revenue and volume gaps created by the pandemic. The same Commonwealth Fund research shows that providers who have embraced virtual care alongside in-person visits — either for virtual triage or for patient safety and convenience — have been able to maintain overall primary care visit volume at pre-pandemic levels.

The required shift to virtual care has also affected individual physicians and physician practices, with some specialties finding virtual care a particularly good fit. Digging deeper into the Commonwealth data, dermatology and ophthalmology appear to have quickly leveraged virtual care to return to and now exceed their pre-COVID-19 baseline outpatient visit volumes. While too soon to say definitively, adult primary care is poised to exceed previous volumes and meet deferred patient demand through significant ongoing adoption of virtual care tools as well.

The same data set also reveals a significant opportunity (as well as a potential public health concern): Post-COVID-19 visit rates for children remain substantially lower than for adults, and this trend is most pronounced for children under the age of five — critical years for child development, vaccination and intervention.

Taken together, these and other findings about virtual care adoption show that virtual care will continue to be a significant and in some cases a preferred delivery channel for both patients and providers from here forward.

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