The Virtual Care Insider

Under the Hood: Developing and Maintaining Clinical Content for Virtual Care

in Strategy

Dr. Lisa Ide

Dr. Lisa Ide
Chief Medical Officer
April 19, 2018

One of the big compliments we receive from customers is around the strength of our proprietary clinical content that forms the foundation of our virtual care platform. This means a lot to our team. As individuals and as an organization, we maintain a rigorous focus on clinical quality, and that comes through in our algorithms and clinical protocols.

What you don’t necessarily get to see is the amount of work and expertise that goes into developing, maintaining and improving our clinical content. We have a full team of clinicians and informatics specialists devoted exclusively to creating and maintaining our protocols and clinical content – and their contribution to the Zipnosis platform is worth talking about.

Starting off with Clinical Content Development

When we launched the Zipnosis platform, we knew that the only way the technology would work is if it was backed by unassailable clinical content. Remember, this was 2008, and nothing like the Zipnosis platform had been available before. Store-and-forward virtual care was still considered the providence of provider-to-provider care, specifically in imaging for radiology, dermatology, pathology, etc. It definitely wasn’t considered a means for collecting patient-generated symptom and health history information for diagnosis and treatment of common, low-acuity conditions.

Our original clinical content was something truly brand new in the outpatient healthcare space. We started with an enormous quantity of clinical guidelines for in-person care and painstakingly translated them into a few targeted protocols for virtual care.

From those humble beginnings, we expanded our protocol library to support diagnosing and treating more than 90 conditions. Each one required not only research into the standard of care, but a reframing of what care delivery for that particular patient complaint means without lowering the standard.

Clinical Content: Care and Feeding

Considering the extensive amount of work that goes into developing clinical protocols, you may be surprised to learn that protocol maintenance and improvement is where our clinical content team truly shines. The truth is, once a protocol is built, that’s not the end of the work it requires. Like a pet, clinical content supporting virtual care requires constant care and feeding.

At Zipnosis we have a rigorous maintenance process that includes annual content reviews, during which our content team delves into the latest research to ensure that our protocols meet the standard of care and can offer the same or greater guideline adherence as in-person care.

We also closely monitor alerts and updates from the CDC, departments of health, and the FDA to ensure that the treatment recommendations are in line with the latest guidelines. These alerts don’t always align with our protocol review schedule, so we also update protocols on an ad hoc basis when guidelines change.

Clinical Content Beyond the Standard of Care

Our clinical content is the foundation on which the entire Zipnosis platform rests. That means its importance to the quality of care providers deliver through Zipnosis is critical, but it also means that clinical content has a major impact on patient experience.

We dig into how protocols are utilized by patients and consult with our customers to identify opportunities for enhancing our content. This is a more intensive process than our annual clinical reviews, looking at how patients experience the content.

  • Is the language clear, conversational and understandable?
  • Are we effectively conveying empathy?
  • How many questions do patients have to answer at maximum and minimum? Can we reduce the number of questions?
  • Where are patients being referred out of the online system and into our customers’ brick-and-mortar clinics?
  • Do the patient education information and questions match health literacy targets?

A full protocol enhancement project takes 10 weeks, and involves the clinical content team as well as people throughout Zipnosis – and even our customers. We perform a deep dive into how patients are interacting with the content, and make modifications – sometimes minor tweaks, sometimes major overhauls – to ensure patients are having a positive experience. And, through it all, we maintain that laser focus on the standard of care.

What’s Next for Zipnosis Content

As we expand the platform into new areas like surgical care and behavioral health, our clinical team just keeps blazing new trails. And, with our Clinical Quality Advisory Council’s assistance and input, our team is even better able to monitor and report on adherence to clinical guidelines. Keep your eyes peeled – there’s always more on the horizon.

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