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What Does Access Really Mean?

Working closely with our customers, I hear over and over that patient access is a key strategy and reason for launching virtual care. Taking a cue from our health system customers, we talk a lot about virtual care’s ability to expand and facilitate access to care. But what does that really mean? Who benefits from the expanded access that virtual care provides?

Meet Kate

One of the things I find really refreshing about working at Zipnosis is that we don’t stop at thinking about what our health system customers need. What I mean here is we’re also thinking about tMiddle Aged Telemedicine Patientheir patients. Who is using their virtual care platform? Why are they using it? What can we do to improve the experience for them?

We actually have well-realized personas covering several known users. The flagship persona is someone we call “Kate.” Kate is in her mid-30s, married with two kids who she chauffeurs  around in a late-model SUV. Kate works full-time and has insurance through her employer. She’s also the persona who drives our standard product demo – if you’ve ever seen the Zipnosis platform in action, it’s probably through the lens of Kate.

Recently, I began to think about Kate because access for her means something different than it does for a lot of the population. It’s really about convenience more than need. Kate could take time away from work, she could drive to see her primary care doctor for care, it’s just inconvenient to do so. But what it we took away Kate’s SUV, her employer-sponsored insurance, even her full-time job?

Meet Katie

Katie looks a lot like Kate on the outside. She’s also in her mid-30s with two kids, but instead of Kate’s SUV, Katie relies on public transportation. Instead of Kate’s employer-sponsored insurance, Katie has a high-deductible health plan that means she pays for most healthcare costs out-of-pocket. Instead of Kate’s full-time job, Katie works two part-time jobs and doesn’t have paid time off. What does healthcare access mean to Katie?

To answer that question, I gave myself an exercise: Put myself in Katie’s shoes and understand the decisions she needs to make when looking at where—and whether—to seek care for a common condition like a UTI. Here’s what I learned:

In-Person Care Options

I looked at 4 in-person care delivery options: A primary care clinic, an urgent care center, a retail clinic, and the emergency room.

Work Schedules

Working two part-time jobs without PTO, Katie needs to find time to go to the doctor. That may mean determining if she can afford to take time off of work, coordinating shift coverage with co-workers, or finding an option that’s open when she’s free. That means the hours of operation and when an appointment would be available are major factors in decision making.

Primary care: 8 am – 6 pm; appointment availability “tomorrow”

Urgent care: 7 am – 7 pm most weekdays

Retail clinic (average): Weekdays, 9 am – 7:30 pm; weekends, 9 am – 4 pm*

Emergency room: 24 hours daily

*Lunch hours: Practitioners take a daily, required lunch break each day. Please note that lunch time are approximate and may vary.

Transportation

Part of managing schedules is figuring out the impact of public transportation. Katie needs to factor in schedules and routes. Then, she needs to determine how much time she’ll need to spend in transit. Using my house as a starting point, I determined that transportation would take anywhere between 15 and 45 minutes each way, most of which required walking about ½ mile in addition to the bus.

Child care

If Katie needs to seek care outside of her typical working hours or when the kids are not in school, she needs to consider what to do with her children. Does she haul them along to the doctor’s office? Does she get a last-minute babysitter – and is that practical from a financial standpoint?

Cost

Finally, with her high-deductible health plan transitioning the full cost of care to Katie, how much will she have to pay out-of-pocket for each of her options? The data shows costs varying widely for services, but the following are pulled from a Blue Cross Blue Shield (MA) fact sheet on typical costs for common services and Consumer Reports:

  • Primary care: $130 – $180
  • Urgent Care: $120
  • Retail Clinic: $55 – $75
  • Emergency Room: $400 – $700

Access with Virtual Care

Imagine the impact a virtual care offering could have on Katie. Access to a virtual care service effectively eliminates the need to balance her competing priorities.

Work Schedules – With virtual visits available via any internet-connected device, Katie doesn’t have to worry about missing work.

Transportation – Katie can access virtual care anywhere, so transportation ceases to be a concern.

Child care – Katie can complete a virtual visit while her kids do their homework at the kitchen table, or while they’re playing at the park.

Cost – Unlike the more costly in-person options, most of our health system customers charge between $20 and $40 for a virtual visit, making it far and away the most affordable option.

With virtual care, Katie can quickly, easily, and affordably receive care for her UTI – without the stress and worry. Virtual care may well be working to bring convenience to the Kates of the world – and that’s no small thing – but our greater impact is in the benefit we bring to the Katies.