Virtual Health Tegria

Virtual Care/Digital Health - Beyond COVID Response

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Lisa Johnson, Managing Director, Tegria

In my conversations with healthcare leaders across the US, I keep hearing about two common themes:

1) fragmentation of the Virtual Care Solution industry and

2) shortcomings of the virtual patient/provider experience.

These areas of concern have emerged from the inertia of embracing virtual care amid pandemic-driven necessity.  And now, moving forward, we can take the opportunity to learn from that experience and reimagine how to design and deliver care to enable and enhance the patient-provider experience.  

Skyrocketing use and retrenchment 

Let’s first talk a bit about the feedback I am hearing from our healthcare colleagues and clients regarding the current virtual care/digital health experience. Then we’ll move our focus to what the opportunities could be if we reimagine this for the future.

The healthcare industry has demonstrated that it could be nimble and innovative in response to the pandemic.  Now organizations need to secure and translate the gains and momentum in virtual care over the long term.  Many organizations talk about the need to re-evaluate their virtual strategy to think about what the right target should be. In my opinion, our focus should not be a target percentage, but rather on what is the right way to engage patients/providers in virtual health. And this should be based on the entire care journey, taking into account different services and the stage of the care experience, to be able to execute on a value-added balance of virtual/digital health and in-clinic face-to-face visits.

I believe it’s not a matter of one OR the other, but rather one AND the other in context of the care journey. Finding that ideal balance or mix requires first understanding the different use cases based on the types of services patients/providers are using and then making strategic decisions for what the experience could optimally be at different points of care. This approach calls for an experience view vs an episodic view of the services and moving beyond the core EHR and virtual care plug in capabilities that many executed on quickly under the practical constraints and time pressures of the pandemic. 

Building on our decisions for strategy and approach we must re-evaluate technology and third-party vendors. Amid pandemic pressures to quickly establish virtual capabilities, many healthcare delivery systems did not have a chance to evaluate the best partners to execute their virtual/digital health experience at an enterprise scale. Many of them utilized existing resources, leveraging current EHR vendors and infrastructure, simply adding a virtual plug-in vendor to get up and running in response to pandemic needs.

This patchwork approach to the execution of services is suboptimal for moving forward to mature and expand our delivery models into the future. We should seek to establish partnerships with vendors and enterprise solutions that enable patient and provider conversations at all points of the care journey. The industry is currently fragmented with niche solutions for inpatient acute needs, ambulatory needs, and specialties. The net result of this can be fragmented interactions with little interoperability between systems across the care experience which does not lay a foundation for humanizing healthcare. 

I had a less-than-positive virtual care experience recently that is likely similar to what others are experiencing and, unfortunately, not at all unique. My primary care provider recommended a specialist in my community. I agreed to a virtual care visit because the wait time to see her was shorter if I agreed to a virtual visit vs. an in-clinic face-to-face visit.

When I made my appointment, the system initiated two emails.  The first message directed me into a very lengthy account set-up process for their niche patient portal which has no interoperability with my Epic MyChart portal I am used to interacting with. The second email contained my Microsoft Teams meeting video plug in link.

My appointment was still a six-week wait so I had to remember where those emails were and be able to call them up closer to my appointment time to be able to execute the virtual visit in the way they had instructed. The Teams meeting link was only sent out once. On the other hand, I kept receiving email reminders to fill out the intake forms or my virtual visit would be canceled -- even though I had already taken 30 minutes to provide thorough answers on the intake form.

Fast forward to the day of my visit… I launched the Teams video visit 15 minutes prior to my appointment time as the instructions requested. While awaiting the video visit, there was nothing prompting me that the provider would be their shortly or any sort of message. While I was waiting on the Teams video visit, I got a call on my cell phone. The first time, I did not answer because I was on the video visit appointment. When the same number called back, I answered. It was the provider office calling to get me “ready for the visit”. I told her I was on the video visit as their instructions requested. She responded, “Oh…I just needed to see if you filled out your questionnaires but now, I see in the system you have… so I don’t need to talk to you… I will tell the provider you are on the virtual visit, and she will join shortly.”

Now, how fragmented of an experience was this even for someone who is comfortable with, and loves, technology? Quite honestly, if this provider had not come so highly recommended, I likely would have already canceled my appointment based on the experience I was having leading up to the visit.

In the balance, I will say that once I got on the virtual visit with the provider, it was the best visit I have ever had with a specialist. She was prepared, had reviewed my intake, and partnered with me on a plan for next steps. The provider and the patient (me) were able to have a successfully positive and meaningful interaction despite the people, processes, and technology barriers.

Hope for the future if we act and innovate

This must change. We must apply the same attention to operational workflows, enlisting the whole care team, and implement technology that enables the continuum of the experience from setting the appointment to post-visit follow-up. No other industry would put up with this inefficiency and lack of optimal virtual workflows.

Technologies must fully support, honor and enable the way patients and providers experience healthcare, and there are very few that do today. We need to create platforms that work for patients and providers — not the other way around.

Andor is a great example of a company developing technology to support the way healthcare works. With ThinkAndor®, healthcare institutions can optimize virtual health experiences which are integrated with the core EMR and clinical workflow. This integration allows for an orchestrated approach to virtual health, allowing healthcare institutions to configure clinical and operational workflows in a unified dashboard experience for providers, while enabling a simple but tailored journey for every patient — no matter how tech-savvy.

The ability to curate digital experiences for patients while simultaneously instrumenting clinical and care team dashboards enables flexibility and sustainability for health systems.  The platform enables organizations to extend and unify several core platform capabilities in one enterprise virtual experience — Virtual Health Enablement, Secure Clinical Collaboration, Community Collaboration, Virtual Inpatient Rounding and Virtual Patient Monitoring.

We need technology solutions that take an enterprise-wide approach to facilitate healthcare work, open up access, and enhance reach. Let’s move forward in a spirit of cooperation as we leverage what we’ve been learning to improve the future of healthcare for all.

Originally posted by Tegria