Inflections bring challenges. How can our providers, healthcare executives, and innovators best prepare for the challenges and changes we’ll see in virtual care?
1. Digital: Devote 15% of your budget to a digital backbone. (The exact amount is your decision—but it should be significant.) Capture and claim this coalescence of digital and telemedicine. There is an opportunity to fill the digital infrastructure gaps in the patient journey. Telemedicine pre-COVID moved at the snail’s pace of traditional doctor-patient interactions. That is the past. 2021 and the future will require health systems to understand—and assimilate—with true digital health, which moves at the speed of computers.
Doctor having a video call with patient and preparing prescription.
2. Integration: Telemedicine, in the past, was much about automation—today it’s about integration—of the entire patient experience. And not just at a point in time, or over the course of an acute illness—but longitudinally over the course of chronic disease, and even a lifetime.
An example: In August, Teladoc Health (where I serve on the board) acquired chronic care management platform Livongo. The whole purpose was to provide “whole person” care that will change how customers access care over time. It brought together Teladoc’s traditional telehealth platform with Livongo’s longitudinal digital coaching services, using data for greater insights about a person’s health. Allowing more “wholistic” and more seamless care.
3. Partner: Partner with health systems. Health systems are today highly motivated to incorporate telemedicine. Their goal is to intelligently orchestrate digital demand and health system capacity across all lines of care, using virtual health/telemedicine to do so. Virtual care providers can claim this ground and be an inextricable part of the solution. A solution of value-based care.
And partner with the new care delivery models. 2021 will be the year of an exploding number and variety of new care delivery models aimed at the home. For example, two of my companies, Aspire Health and Ready Responders grounded their home-centeredness on telemedicine – the first, in community-based palliative care and the latter in urgent care delivered in the home.
4. Interoperability. Align with interoperability, so all the information traditionally surrounding a physical visit is digitally—or instantaneously—accessible and shareable in the virtual space. Be an integral part of the newly created seamless digital backbone for all interactions—in-person and virtual—by devoting resources to interoperable information technology, machine learning and big data.
5. Continuous patient engagement. We can make diagnoses and we can monitor, and we can treat. But if we do not engage the patient over time, it means little. Telemedicine must move beyond just a physician on a video, or a nurse on the phone. Otherwise, we are just a commodity, and the world will treat us as a commodity.
Incorporate disparate data sets and use computer learning and artificial intelligence to streamline the patient experience. Today’s patient journey is discontinuous and fragmented and chaotic and nonlinear. It is frustrating. It is characterized by inefficient front-end access, lack of individualized care navigation.
Telemedicine cannot just be the endpoint to which a patient is referred; it must be an integral part of the triaging of patients to the appropriate setting across any line of care or business based on health care needs, insurance/coverage financial situation and health system capacity.
6. Standards of care. We need to answer questions, and create standards of virtual care, that establish what is the right mix between office visits and virtual visits for various health conditions and care bundles. The lack of published research on which clinical circumstances command in-person attention and which cases are appropriate for a virtual visit warrants attention. For example, we do not yet understand how a patient’s demographic and medical history impact their optimal cadence of face-to-face visits versus virtual visits.
These are all questions we together much tackle as we move forward into the next frontier of virtual care.
The pandemic created a seismic shift in the culture of telehealth, and the use of virtual care—delivered from a remote location by text, phone, or video—has been accelerated by five years or more. In this moment of crisis lies a crucial opportunity to build a stronger and more resilient healthcare system, a system that is value-based and centers on the patient journey.
We saw what telehealth can do in terms of getting much needed care to patients outside of the hospital setting. We saw how quickly it can be ramped up and accelerated within health system settings. And perhaps most interestingly, we saw how the removal of antiquated regulations, such as the permission to allow access regardless of patient and provider location, can open the way for greater accessibility.
We should not let these gains be rolled back when this public health emergency comes to an end. With an eye towards quality, value, and enhanced patient experience, we can use this opportunity to usher in the health care systems of the future.
This op-ed is based on remarks I delivered on January 12, 2021 at the American Telemedicine Association EDGE Policy Conference. A video of the full remarks is available online.
