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Challenges and Opportunities in Virtual Care — Are You In?

In our recent Benchmark Survey Report, we examined some of the trends that are shaping how healthcare organizations are deploying virtual care solutions. We examined the opportunities that exist for new players to get into the game, as well as how those that are already playing can expand their offerings. We also dove into some of the challenges that are being felt throughout the industry – whether in the day-to-day management of currently deployed virtual care platforms or the challenges that are expected by those that have yet to launch any telemedicine services. One thing was clear from our survey however, as virtual care continues to advance, the opportunities that exist in the industry greatly outweigh the challenges.

We’ve Come a Long Way

The truth is virtual care is nowhere near where it was 10 years ago, or even just last year for that matter. For example, our Benchmark Survey indicates that while the industry still leans heavily on video – one of the more traditional modes of careModality Type Deployment, video alone isn’t sufficient to meet the changing needs of today’s patients and providers. Because of this, many are turning to multi-modal care, with 61% of health systems reporting they offer more than one mode of care today. Which of these is gaining the most momentum? Believe it or not, it’s chat, with 44% of health systems saying they expect to include chat in their virtual care launch.

As technology changes, the clinical impact that these platforms provide also improves. Our study shows that virtual care solutions have the power to impact both clinical quality and efficiency. Quality reporting has always been difficult for healthcare providers, but 33% of survey respondents say their technology provider offers a reporting and analytics solution and 30% say their technology provider offers scheduled or ad hoc reporting. At the same time, virtual care is enabling providers to shorten patient visits by as much as 15 minutes – from the current patient visit average which is approximately 16 minutes to between one and five minutes, as reported in our survey. I don’t know about you but the ability to make five or ten times the health impact is an amazing opportunity I would not want to miss out on!

Miles to Go Before We Sleep

As much as virtual care has evolved, there are still hurdles that we need to get over before we can realize the adoption rates that we seek. What’s fascinating however is that the actual challenges providers face in their day-to-day operations are different from those that respondents anticipate they’ll encounter, which include integration, patient utilization, and claim management. Diving into each of these a bit deeper:

  • Program ChallengesIntegration – EMR integration specifically, has long been a pain point for providers and our research shows that this is only growing as an important focus area as virtual care adoption moves into the mainstream. About 21% of survey respondents who have virtual care identify lack of EMR integration as a challenge, even though 42% say their service doesn’t integrate with the EMR at all. That’s in comparison to the fact that nearly 54% of our survey respondents expect EMR integration to be a major challenge.
  • Patient Utilization – There’s still a bit of a “Field of Dreams” assumption to virtual care, despite research from multiple sources, including a 2018 Deloitte study, showing slow adoption. If you don’t believe me, just look at the disparity in the number of respondents in our survey who identified patient utilization as a challenge. Only 31% of those without a virtual care solution, compared to 64% of those with a virtual care service already deployed.
  • Managing Claims – We also saw an under-realization of the challenges associated with managing claims and reimbursement. In fact, only 15% of respondents without a virtual care solution thought that this would be a top challenge, versus the 39% of those with virtual care services who acknowledged this obstacle. The truth is, the healthcare revenue cycle has many parts, making it difficult to manage. Increased integration of virtual care solutions with EMRs and other legacy systems are important and can help make your life a lot easier.

What Lies Ahead

As patients, providers and as those with a stake in the virtual care industry, we should feel encouraged by the opportunities we have at our fingertips. Our survey shows that nearly 100% of health systems expect utilization to increase in the next 12 months – and that’s great news for everyone! So where should we focus our efforts and what can we expect? Undoubtedly, there are many applications for virtual care, but there’s a growing desire for it to be used for more complex conditions, with a big focus on behavioral health. However, to realize this in an effective way, we need increased collaboration between the technology companies that are creating the virtual care solutions and the health systems that are deploying them.

Regardless, the fact that we’re seeing such confidence from health systems when it comes to expanding their virtual care offerings in the coming year, signals to us that the industry is ripe for incredible growth. And it’s about time! Virtual care has long suffered from slow adoption rates, brought on by patients who were hesitant about leaving their trusted physicians and providers who were weary of expected financial and technological barriers. But virtual care doesn’t have to be scary and as our survey shows, many organizations have skewed ideas about the challenges that actually exist in the industry. To overcome this perception, we must educate patients and providers about the opportunities associated with virtual care, while continuing to focus on improving the patient experience. Though technology vendors may provide the platform, I believe, it’s with health systems, who are in a unique position to confidently vouch for the integrity of virtual care, and effectively market the service to truly increase adoption expand access to quality health care.

Interested in learning more about the On-Demand Virtual Care Benchmark Report?

We called out our key business, technology, and clinical findings, discussed what they mean for virtual care in 2019, and hosted an open discussion about the research in our latest webinar: Top Virtual Care Trends for 2019.

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HIMSS19: A Sunny Outlook for Virtual Care

Sunny Outlook for Virtual Care

Last week, myself and some of our Zipnosis team had the privilege of attending HIMSS19 in Orlando, Florida – a global conference bringing together over 45,000 health information and technology professionals, clinicians, executives and market suppliers. Due to the rapid changes in today’s current healthcare climate, this year’s event had a strong focus on innovative ways to improve the patient experience, monitor the patient journey and drive synergy across the industry. In the face of change, the brightest minds convened on ways to generate new efficiencies while improving levels of convenience, safety and accessibility across the healthcare continuum.

As innovation builds, policy changes and trends surface. Sometimes this can make the healthcare industry look cloudy at best. Below are three major takeaways from HIMMS19, giving way to a much sunnier forecast, especially when it comes to the evolution of virtual care:

Utilizing Data in a Turbulent Atmosphere

Often times, salient trends are a direct result of major legislation. Day 1 at HIMSS19, the Trump administration released its proposed interoperability and data blocking rules. It’s no coincidence that a major theme at the conference this year revolved around the idea of data-sharing and new technologies to support the free flow of data between patients and physicians. As data is integrated and utilized, it’s vital that it also be safe guarded.

Cybersecurity and the idea of securing actionable data was a prominent theme at HIMSS19. When it comes to virtual care, both the exchange and safety of patient data is key. We need to assure patients that their health data will be used responsibly, while also finding new ways to free data previously locked in silos to do our part to advance population health and provide more personalized care.

Making it a Breeze to Personalize the Patient Experience

Another major theme prevalent at HIMSS19 was the overarching idea of empowering patients to make more informed decisions about their health. What patients want today, is interactions that are as specific and personalized as possible, but also innately human. Ironically, humans alone often struggle to create the type of personalized experiences that patients today crave. As such, wearables and other devices were once again prevalent at this year at HIMSS, with many innovators demonstrating how these technologies are empowering patients to take control of health experiences.

Leaning on AI and innovation to continue to address complexities across the healthcare continuum is something we will continue to see more of as personalization becomes increasingly important. For virtual care, adaptive interviews are a game-changer: asking patients only the most relevant questions determined by demographic information and previous responses. Aside from the convenience of virtual care, patients also receive personalized and clinically impactful interactions that are synonymous with the typical doctor’s visit to keep that human touch alive and well.

Spotting the Reimbursement Rainbow

As strategies to engage patient populations change, it’s important to consider the impact of these programs on reimbursement models, which are shifting to accommodate the rise of virtual care. At HIMSS19, while various sessions focused on the power of technology to improve patient care outcomes, many also focused on helping providers execute on a future-forward vision. Improving payment accuracy and developing a reimbursement strategy that is supportive of new technologies is essential to changing the public perception of newer methodologies. Capturing reimbursements that prop up provider budgets as justified by the utilization of virtual care will be essential moving forward.

HIMSS19 made it quite apparent that the healthcare industry is changing rapidly to make patient/provider interactions more personable, streamlined, cost-effective and more efficient than ever before. In today’s digital age, it’s important to consider how our strategies and processes can be enhanced with innovation. While a storm of change is inevitable amidst intense innovation and policy modifications, like with every storm, once it’s over the sky and our future will become clear once again.

Killing the Video Myth

There’s a pervasive myth in the telemedicine space that video might be necessary for effective virtual treatment of patients – for any condition. Proponents argue that there’s no way clinicians can fully understand a patient and provide a diagnosis without a face-to-face interaction, even if that interaction is digital. This is simply not true.

Virtual care using adaptive online interview technology gives clinicians the ability to effectively diagnose and treat patients without a video encounter. How effectively? A Zipnosis review of more than 1,700 virtual encounters for sinusitis found that clinicians provided guideline-adherent care in 95.4 percent of cases.

Sometimes called asynchronous visits or “store-and-forward,” adaptive online interviews offer the patient benefits of convenience and access, while providing high levels of clinical quality, efficient diagnoses and a streamlined provider workflow.

What is an Adaptive Online Interview, really?

Maybe it’s best to start by stating what an adaptive interview isn’t. An adaptive online interview isn’t an online questionnaire like the Epic toolkit provides. Rather, it is a powerful expert system that uses branching logic to intelligently interview a patient about their symptoms. This smart approach asks patients only relevant questions determined by demographic information and previous responses, just like an interview with a provider during an inpatient visit.

Zipnosis Online Adaptive Interview

Adaptive online interview (also called structured asynchronous or store-and-forward) collects patient data and sends electronically to the provider.

What’s so Great About the Adaptive Online Interview?

On the Zipnosis platform, we leverage the adaptive online interview to gather patient-entered information in a structured and efficient way. Our adaptive online interview asks the same questions a clinician would ask during  in-person visit – but never forgets a question. The information collected is packaged into a comprehensive clinical note and sent to the clinician for diagnosis and treatment. The result is a totally digital diagnosis and treatment process. Unlike any other platform on the market, Zipnosis unlocks immense benefits:

Time savings: On average, patients complete their adaptive online interview in a fraction of the time taken by an in-person visit. No travel time, no waiting rooms – just convenient access anywhere, anytime.

Clinical quality: The adaptive online interview is grounded in clinical best practices, and the Zipnosis platform leverages patient responses and clinical guidelines to offer clinical decision support, including curated diagnosis and treatment pathways. This helps clinicians provide high quality, guideline-adherent care.

Clinical efficiency: On average, providers trained on the Zipnosis platform can review the provided clinical note and make a diagnosis and treatment recommendation in approximately 2 minutes. And patients typically receive diagnosis and treatment recommendations within an hour of completing their virtual visit.

Provider experience: Providers appreciate the comprehensive information provided, the ease of use and the ability to focus their time on patients with more complex needs, while still offering high quality care for common conditions.

Reporting and analytics: The adaptive online interview model captures a great deal of visit and program data. Using our Statnosis™ reporting and analytics tool, health systems can follow trends related to conditions treated, visit timing, guideline adherence, and triaged patients. All data is de-identified and HIPAA compliant.

But Don’t I Need Video?

Short answer: maybe. But the efficiencies of virtual care are best realized when tasks are shifted from the clinician to the patient. Leading health systems understand this and leverage the adaptive online interview in concert with video to reap the benefits of clinical quality and efficiency while meeting patient or regulatory needs. And with Zipnosis’ intelligent video capabilities, you can, in fact, have it all.

Some health systems incorporate video as an additional step to help treat some patients that would otherwise be triaged to physical locations. Others operate in a regulatory environment that requires video; they leverage the adaptive interview on the front end of the encounter to help save time for both clinicians and patients. Still others choose to launch an adaptive online interview platform alongside their existing video telemedicine service as an additional entry point to their system.

As for video alone? Well, our CEO Jon Pearce says it best: “When’s the last time you ordered something from Amazon with a video call?”

So, what you’re saying is…

Whether employed alone or alongside a video or telephone encounter, adaptive online interview technology offers both patients and providers a quicker, more effective diagnosis and treatment option. Adaptive online interview technology is the future of virtual care; welcome to the future.

Shopping the System by Zipnosis

Can Virtual Care Reverse Clerical Burden Induced Physician Burnout?

The healthcare industry is faced with a crisis: physician burnout. An article in the September/October edition of Family Practice Management labeled physician burnout an “epidemic.” And this epidemic is costing health systems in a major way.

Physicians experiencing burnout are less engaged, leading to higher levels of turnover and an increased likelihood of medical errors – both of which can dramatically affect a health system’s bottom line. Moreover, burnout may lead to increased substance abuse, depression and suicide among medical professionals.

While there is no one single cause of burnout, recent research published in Mayo Clinic Proceedings indicates a correlation between use of EHR/EMR systems and physician burnout. Mirroring findings from a report issued in 2013, this new research indicates that things have not improved over the past several years.

The link between EHR/EMR systems and physician burnout is the amount of time spent on administrative or clerical tasks, such as data entry. The more time physicians are required to spend entering data into their EMR, the lower their job satisfaction and the higher their likelihood of burnout.

Traditional Telemedicine Falls Short

Traditional telemedicine, where physicians interact with patients via telephone or video chat, doesn’t lessen the burden of data entry. Physicians must still spend significant time on documenting the encounter. This type of telemedicine service requires a physician be waiting at a computer terminal for a patient to request a virtual visit. Consequently, physicians supporting telemedicine may be tasked with additional clerical or administrative work to fill the time between patient calls.

Far from lessening administrative burden, this may actually put greater strain on clinicians who support a direct-to-video telemedicine service.

Technology May Still be the Answer

While traditional telemedicine doesn’t offer a solution to physicians’ ever-growing list of administrative tasks, technology applications can still offer some respite. QuantidaMD, a community and educational resource for physicians, suggests that mobile health and virtual care might offer a solution to combat burnout. They indicate that technology can empower patients to take control of their health, as well as offering physicians simple means of capturing patient data.

Mobile health (mHealth) and virtual care have the potential to significantly decrease the amount of data entry required of physicians. In a recent whitepaper on mobile technology, Athena Health noted that mobile devices and apps can help optimize clinical workflows and patient care through clinical decision support, enhancing clinical efficiency, and providing tools for engaging patients and supporting population health.

So, How Does that Work in Practice?

At Zipnosis, we view virtual care technology as a means to meet patient needs while making life easier for physicians. We leverage an online adaptive interview, which asks the same questions a clinician would and records patient responses. Clinicians then receive a comprehensive clinical note, along with clinical decision support in the form of curated diagnosis and treatment options. Physicians can diagnose and prescribe treatment for common conditions with just a few taps on their smartphone or tablet.

The best part? All data from the virtual visit is securely transmitted to the health system for inclusion in the EMR, eliminating the need for physicians to spend their time entering information into an EMR. And, we offer health systems deeper integration options, which can further simplify the process and enhance physician experience.

People don’t seek out a career in medicine because they want to spend hours each day on data entry. Rather, they want to solve problems and help patients. At Zipnosis, our goal is to offer innovative access to mainstream medicine, while easing the burden on providers. We’re gratified to find that our obsessive focus on ease of use has created a platform that can help address this growing cause of physician burnout.