The pandemic drastically transformed healthcare delivery from almost 100% in-office to primarily virtual visits following strict lockdowns and from the general fear of contracting the deadly virus.
At present, the healthcare industry has somewhat transitioned back to in-office visits but the general consensus is that virtual healthcare will continue to be used and preferred by consumers mainly because it is easy and convenient.
The widespread adoption of virtual healthcare has reduced the need for in-office visits and enabled providers to offer more proactive, preventative care in a lower-cost setting. Virtual care delivery is crucial not only as a convenient supplement to in-office visits but as an important service for the patients, physicians, clinical teams, and health systems alike.
However, there still exists a substantial gap between its potential and its reality. There are stakeholders that do not obtain the care that they need while trying to navigate a new and innovative care paradigm.
A Framework For A Successful Virtual Healthcare
For virtual healthcare to deliver on its promise of providing wider access to care, it needs a framework that prioritizes the needs of the patients and those who care for them. This is especially true for patient populations suffering from complex chronic conditions, with limited means, or from those living in remote and secluded areas.
The University of Texas MD Anderson Cancer Center and Texas A&M University’s Mays Business School have developed a framework called DIBS that uses a needs-based approach. It follows the best practices of in-office visits while leveraging telehealth technology to efficiently provide remote care.
DIBS stands for Documentation, Integration, Best Practices, and Support. Each category has potential benefits for all stakeholders so anyone can call “dibs on optimal design and no one gets overlooked.”
1. Documentation
Identifying and documenting in detail the activities and interdependencies of each individual with direct or indirect involvement in providing, designing, or receiving care. Documenting in-office care encounters will help to identify which of these processes will be duplicated, removed, or improved upon in a virtual setting. In identifying the crucial before, during, and after care-related processes, physicians can readily provide technical assistance to patients who are struggling with a virtual care delivery.
This first category is also crucial to describe the care infrastructure needed like the technology for Remote Patient Monitoring (RPM), which uses in-home devices to capture and transmit real-time clinical data. It should also include the billing and reimbursement mechanisms for all the non-face-to-face services.
2. Integration
Integrating all the vital elements will enhance the overall patient-doctor experience to make it as seamless as possible. Using the right technology is crucial but so are the minor ones like choosing good lighting and audio tools, selecting an appropriate virtual background if preferred, using a quiet space with no distractions, and teaching both patients and clinicians to look at the camera during conversations.
More than the actual teleconsultation, integrating all ancillary logistics needs to cover scheduling future appointments, managing medication refills, and monitoring health status through in-home devices.
Virtual healthcare services need to cater to varying patient needs like Chronic Care Management (CCM), RPM, behavioral health, health and wellness checks, and urgent care. The key is for patients to receive a continuity of care at any time and place.
In addition, clinicians and their care team should also use broad-based communication platforms in communicating with patients and keeping them engaged in their self-monitoring and self-care.
3. Best Practices
Virtual healthcare is not the be-all-end-all solution because in some cases, it may not be the appropriate approach to delivering care. The most crucial task is for clinicians to use evidence-based decision criteria to ensure the effective delivery of remote care.
The key is not only to provide the best care but to keep patients engaged in their care journey. Will the patients respond well to a remote consultation or would need the in-person interaction with their providers? It is important for clinicians to fully understand their patients and their health status before their teleconsultation and also have access to the notes and records of other treating specialists before and during the call.
Replicate the best practices of in-office care visits by also involving the care team of nurses and medical assistants to prepare the patients during the virtual visit or schedule the next appointment. In this way, the physician will not just do all the extra work but delegates the tasks to the entire team to enhance staff productivity and efficiency while enhancing the patient’s overall experience with virtual care.
4. Support
Virtual healthcare is not just a continuity of care, but also of real-time and timely support to serve the needs of all stakeholders effectively. This requires investing in ready-to-serve technical support and the right infrastructure to resolve common issues like connectivity problems, device glitches, backup charging requirements, or replacement requests.
Patients will continue to trust and participate in virtual care if there is a seamless delivery of the service. It will also help to look into the support systems of patients by involving family members or caregivers or calling on specialists to contribute to the diagnosis or treatment with particular attention to reimbursement mechanisms for such encounters.
In addition, clinicians can leverage telehealth technologies like RPM where patients are encouraged to take their own measurements and be involved in their own care journey.
This final component of DIBS addresses the digital divide and disparities in accessing needed virtual healthcare. The team recommends that telehealth centers be installed in low-income community centers or housing complexes. RPM can be used for those with chronic conditions in need of frequent care by having a dedicated device like an affordable tablet that can be their means of receiving virtual care.
On a final note, the DIBS recommendations are intended to provide a checklist to guide providers in starting their virtual healthcare services. Incorporating the needs of the patients, physicians, care teams and health systems is the foremost consideration to ensure the long-term success of the program.
Finding the Right Navigator
The prescription for a successful virtual healthcare program can be extensive and costly requiring huge capital investment. There are many considerations like the technology, infrastructure, staffing, capabilities, and the business aspect to it. Outsourcing may be the most practical solution.
Primary care providers can navigate this new paradigm by finding the right vendor to provide key remote care services and the required support network for them. These services include Chronic Care Management (CCM) for patients with multiple chronic conditions or in post-acute care or RPM for those in need of close and urgent monitoring of their medical condition through in-home devices to capture vital signs, blood glucose, blood oxygen, temperature, and more.
Ascent Care Partners (ACP) is a virtual healthcare service provider with the goal of helping primary care physicians practices to optimize their care and realize a much-deserved income without increased overhead, no upfront cost, or risk. Our turnkey CCM and RPM solutions provide the assistance a practice needs like identifying eligible patients, documenting non-face-to-face services, preparing billing reports, and ensuring patients receive the best care they need.
