Virtual care – patients and providers see better experiences ahead
Technology and other market forces are enabling care to be extended in new ways, meeting patients’ wishes for easier access and availability.
As healthcare organizations understand the urgency to improve patient experience in care settings, they’re seeing some intriguing possibilities to do so by expanding the use of virtual care.
It’s a timely convergence of opportunities for both patients and providers.
Across all industries, consumers increasingly have come to expect that goods and services can be delivered without the need for in-person interactions. While this has come slowly to healthcare, the COVID-19 pandemic gave consumers a quick education on the benefits of virtual care, boosting the use of approaches such as telemedicine and virtual delivery models.
For providers, virtual care represents a continuation of an evolution of care that reflects workforce reductions, changes in consumer expectations and growing capabilities of technologies that enable digital approaches to formerly manual-only delivery models.
The combination of these trends offers an enticing opportunity – happier, healthier patients and cost savings for providers.
“The horse is out of the barn with virtual care,” contends Frank McGillin, CEO of The Clinic at Cleveland Clinic – the program he leads specializes in virtual second opinions in partnership with Amwell, leveraging 3,500 specialists from Cleveland Clinic. That program, which enables patients to have their cases reviewed by specialists without in-person encounters, exemplifies the potential for virtual care that makes life easier for patients.
Providers jump on board
Healthcare organizations already are seeing the potential synergies between emerging patient expectations and new delivery trends.
One growing example is the use of hospital at home programs that enable organizations to provide acute care services in patients’ homes. Changes in federal policy, in tandem with the urgent need to provide remote care during the COVID crisis, have hyper-accelerated the movement to offer acute care in the home. Patients also are showing increased desire to receive care in their homes, and as of March, about 319 hospitals in 37 states have opted into the program as of mid-March, according to research by the Chartis Group.
The pandemic provided significant impetus virtual care, acculturating patients to the notion of using virtual care instead of insisting on in-person encounters.
The need to move to more virtual care during the pandemic demonstrated the quality and ease of receiving care remotely, many in the industry noted. While the volume of virtual care has fallen since the pandemic, patients have become accustomed to getting care without making in-person visits.
For example, Cedars-Sinai Connect is a joint venture between Cedars-Sinai and K Health that offers an app-based primary care option to consumers, enabling round-the-clock access to care, says Allon Bloch, K Health’s co-founder and CEO. The video chat capability gives patients the opportunity to talk to clinicians about sick care, chronic care and routine care functions, such as medication management, birth control and specialist referrals. K Health has formed a similar relationship with the Mayo Clinic.
Another example of virtual care delivery can be found in KeyCare, a virtual care organization that operates as a national medical group, says Lyle Berkowitz, MD, its founder and CEO. KeyCare, which uses Epic’s electronic medical records system, as of this spring had developed partnerships with 15 integrated healthcare systems over 18 months, offering -based virtual care in areas such as primary care, behavioral health and other specialties.
“A third of all patients would prefer to do virtual care; there’s a huge demand from patients. But health systems are focused on seeing patients in the office, where they excel,” Berkowitz explains. “We are a population health enabler. A lot of patients have routine issues, and systems shouldn’t be overloading physical doctors with that. We can do it in a safe, high-quality way.”
These virtual care models are growing nationwide, says Sonia Singh, chief insights officer for AVIA, a consultancy specializing in advising organizations on digital transformation. She has been tracking growth in virtual care such as remote monitoring, digital therapeutics, remote consultations and other nascent use cases. “We’re excited about new ecosystem partnerships, with the thought being, ‘Let’s co-develop something,’ “ she adds.
Organizations considering virtual care are considering four questions surrounding current healthcare trends:
Virtual care enables several transformations now under way, including consumerism, care, workforce, operations and business model, Singh contends.
How technology enables virtual care
Technology companies are detecting the shift and innovating solutions that are enabling broader oversight of patients without requiring physical presence.
Some technology enables a provider to offer better oversight of its patients. For example, Artisight offers a smart-hospital platform built around cameras, speakers and sensors that enable two-way video that can enable interactions with the patient that involve the bedside nurse and a remote nurse, says Andrew Gostine, MD, CEO of the company. The technology uses AI to anticipate issues, offering the potential to use the technology in patients’ homes for hospital at home care.
Another company enabled by technology is Avasure, which uses AI-augmented virtual sitters and a virtual care platform to augment onsite staffs, enabling better care and reductions in patient safety incidents, such as patient falls or those attempting to leave the hospital before discharge, says Adam McMullin, CEO of the company. Avasure is adapting its offerings to improve efforts to monitor sepsis risk and complex patients, he adds.
Baptist Health in Jacksonville, Fla., uses remote sitters to ensure better care for patients, says Aaron Miri, the system’s senior vice president and chief digital and information officer. This capability helps ensure frail patients don’t have incidents that cause them harm. “It’s a one-to-many solution that can help multiple patients and makes a huge difference for our patients,” he says. The concept possibly can be expanded to support hospital care at home, Miri adds.
Technology also is supporting a new care model at OhioHealth, enabling the development of a smart room concept linked to team-based care. The approach is supported by 65-inch television screens in rooms that serves as both whiteboards and TVs. Co-designed by nurses and patients, the monitors contain basic information, such as the care teams serving the patient, anticipated discharge dates and next medications, among other information, says Tom Gutman, senior consultant of learning simulation at OhioHealth.
“We want to find ways to support our care team and patients; how can we make it simpler?” says Erika Braun, advisor of user experience and product design. “Technology must have a backseat to allow us to provide more human moments.”
Virtual care also holds the promise of improving care in rural areas. For example, telehealth can support patients who have strokes or chronic kidney disease, says Eric Wallace, medical director of UAB eMedicine, which helps connect patients and their families with the medical system’s care via patients’ mobile devices or computers. “We’re redistributing care across rural hospitals,” Wallace says. “We can do things better for patients and providers, taking tasks off of providers’ plates. We can reduce costs, and we can ensure survival of our rural hospitals.” For example, use of technology can support home-based dialysis, using a clinician to support the procedure through a virtual connection.
Supporting new care models
Virtual care has benefits for healthcare organizations, which are dealing with workforce shortages, supporting younger and less experienced nurses and adopting hybrid care models.
Organizations are “moving to team-based nursing models, combining with virtual care and what work can be done virtually – where do those two roles support each other?” says McMullin of Avasure. “As organizations put people in virtual care … it enables better load balancing of team members.”
Hybrid care models hold significant potential to not only improve patients’ experience with existing healthcare systems but also to support nurses who provide care in healthcare organizations, says Oriana Beaudet, vice president of nursing innovation for ANA Enterprise, the family of organizations that comprises the American Nurses Association, American Nurses Credentialing Center and American Nurses Foundation.
Provider organizations and nurses both see the potential for virtual approaches to improve care, she says. In addition to serving as a nurse multiplier, technology-enabled virtual care can help alleviate or even reverse staffing declines. “It is creating capacity. Some organizations are seeing nurses return and view it as a retention tool. Some nurses are postponing retirement – instead of having to work multiple 12-hour shifts on their feet, technology-enabled virtual care enables them to provide broader care coordination.”
Hybrid care models have been used for years in certain areas, such as intensive care units. Nurse education must be broadened to better prepare them to provide care in models involving a combination of bedside and remote or virtual nurses, experts note.