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The Telemedicine Switch: Taking Healthcare Delivery from Analog to Digital

When telemedicine was born, making a phone call required an operator from one of the Bells to physically switch lines in her circuit board. To buy another “line” literally meant running a phone line from that switching board to your house through the ground and air.

Analog healthcare delivery

Today, we have a “standard” of telemedicine that is still phone calls. Yes, we have video, but if the data from the industry is valid, it’s still #2 to phone calls by a long shot. (And, if you read my other posts you know that video won’t be the standard in healthcare because…well…it’s not the standard in any other industry).

Previously, I noted that it’s important to distinguish between a new healthcare experience in telemedicine and embracing telemedicine as the future. It’s true that most patients have never engaged in telemedicine (though that’s rapidly changing), so the analog still feels fresh. We perceive telemedicine as being state-of-the-art. But it’s not.

This is especially true for regulators and payers who are just now beginning to embrace alternative care models. They are tied to the mode of care that looks most like what care has always been – so a bit of an “innovation bias” still exists in the industry.

Telemedicine 2.0The trouble is that telemedicine’s DNA is the same as Blockbuster’s or Ma Bell’s: it’s analog. It’s tied to physical objects or locations, like cathode ray tubes, cords, carts, and call-centers. Improvements touted in telemedicine are higher definition screens and faster call-back times. Imagine if Steve Jobs had not released the iPhone but instead released a flip phone that simply had a faster speed-dial with a prettier display – that’s “Telemedicine 2.0.”

 

The Digital Age is Here

Unfortunately, Telemedicine’s analog DNA has reached its evolutionary pinnacle. Call-back times and call centers can only scale so far; their flawed unit economics collapse; their data silos crumble.

As digital technologies become more and more commonplace, the old telemedicine models are beginning to show their age.

Virtual Care: The Next (Digital) Frontier

Just like cell phones and WiFi are the natural digital successors to land lines and dial-up modems, we have virtual care as a digital progenitor of telemedicine. Where telemedicine grew out of hard-wired, analog telecommunications, virtual care’s roots are digital, meaning that it has almost no reliance on physical objects. Instead, virtual care is logical, device agnostic, and data-driven. Virtual care connects systems and data by nature, not exception. APIs and SDKs frolic between platforms.

What this means for healthcare cannot be understated.

The transition to virtual care will usher in wide-spread adoption by patients, it will break down data silos that muck up efficient and effective healthcare delivery, and it will uncork pent up economic innovation in the industry. This is certain – how fast this it all happens depends on, well, the switching costs.

Telemedicine = Analog Virtual Care = Digital
  • Equipment: Hardware-specific
  • Equipment: Device-agnostic
  • Connection: Call center
  • Connection: Cloud-based
  • Quality: Proprietary data
  • Quality: Standards-based
  • Integration: One-off interfaces
  • Integration: API & SDK
  • Efficiency: Limited difference from in-person
  • Efficiency: High for patient and provider

About the Author

Zipnosis CEO and virtual healthcare delivery visionary, Jon Pearce

Jon Pearce is co-founder and CEO of Zipnosis. As a healthcare entrepreneur with experience in med-tech start-ups and as a venture analyst, he is focused on leveraging the power of technology to improve the way health systems engage with and treat their patients.

Walk Before You Run: Driving Success with a Scalable Virtual Healthcare Business Model

When it’s time to pull the trigger on a new technology investment, particularly one with the potential to revolutionize care delivery in your health system, it’s tempting to shoot for the moon and include all the shiny bells and whistles. Like many large-scale improvements where change management is present, that is not always the best strategy. When developing a virtual healthcare business model, health system leaders need to balance the desire to employ the latest growth strategies with a systematic approach. A phased approach facilitates effective change management and the necessary checkpoints to support success.

Virtual Care Scalable Business Model

 

Change Starts from Within

Health systems frequently start their foray into virtual care by offering the service  internally to their employees. This strategy helps build acceptance and understanding of virtual care. It also helps get employees excited and become more knowledgeable about the service. Once your employees experience virtual care as a patient, they feel more comfortable recommending it to patients later on.

In addition to gaining buy-in from key employees, launching internally provides time to monitor the service and make any needed adjustments to the workflow. This means that when you are ready to expand to a broader population, your service is dialed in and working on all cylinders – for both patients and providers.

Grow With Confidence

After the initial phase, it’s time to grow your virtual care service by expanding your patient population. This may include current patients and/or the broader marketplace, depending on your acquisition and retention strategies as well as your regulatory environment.

This phase is the time to begin scaling your service beyond current patient population targets. Use your organizational strategy and virtual care goals to create a comprehensive growth roadmap.

Your plan may include adding employer and health plan contracts, integrating virtual care technology with internal systems, adding access points, or expanding the number and types of conditions that can be treated.

Whatever your scaling and integration plan includes, a methodical, step-by-step approach will serve you best. This supports analyzing the impact of each new addition and gives you the flexibility to make adjustments and optimize staffing to meet organizational goals.

Hit Your Stride

Being part of the virtual care revolution can be exciting – after all, you’re a pioneer on the forefront of innovative healthcare delivery. And, once you have a fully realized, mature virtual care service, innovation is the next step.

Virtual care is a rapidly evolving industry, and the sky’s the limit to its potential impact to your health system. Leading virtual care technology companies are beginning to expand into serving varied needs along the care continuum. For example, support for longitudinal care, such as chronic care management and post-operative care.

The growth and advance of technology is enabling ever-deeper systems integration, helping to eliminate silos and support greater connectivity throughout health systems. And expanding interoperability of your virtual care software is another way to be on the leading edge of healthcare information technology.

Moreover, by collaborating with your virtual care partner to offer the next generation of online care as a pilot site, beta tester or innovation partner, you give your clinicians and patients a voice in the future of care delivery.

Move at Your Own Pace – This Is Not a Sprint

Steady doesn’t necessarily mean slow. Following a phased plan for your virtual healthcare business model enables you to move as fast as makes sense for your health system. Healthcare leaders gain three main benefits from this strategic approach:

Change management: A systematic approach to launching, growing and optimizing your virtual care service can minimize the challenges that come with implementing a new service line. Effective change management relies on this type of phased approach. Being methodical and gathering information and feedback at every step will help set the stage for virtual care success.
Budget management: Launching a new service line means up-front investment – whether you’re going for traditional telemedicine access points like phone and video, or pushing into new frontiers with virtual care. Starting small, with a clear roadmap for scaling means more effective budget management, including the ability to strategically time capital investments.

Risk reduction: Innovation in healthcare is always a bit of a risk, but by starting small and scaling your virtual care service, you are mitigating the risk that comes with investing in something new. Starting small reduces risk by lowering up-front investment. And, using a documented plan to grow your service enables careful monitoring, which limits the likelihood of making an investment that doesn’t pay off.  

Find out how one leading health system successfully employed a measured approach to launching their virtual care service. Get the case study.

5 Unexpected Benefits Integration Brings to Your Virtual Care Service

Offering virtual care is a great way to meet market demand and attract new patients. But to get the most out of your virtual care service, integration with your internal IT systems is a must. Benefits of integration, like enhancing the value of your patient portal and ensuring continuity of care, are just the tip of the iceberg. Choosing a virtual care partner who offers advanced integration with your internal IT systems can bring you some surprising advantages.

1.  Enhance patient experience

Patient experience is a major focus in healthcare these days. Health systems are launching virtual care services in an attempt to improve patient experience, but when the virtual care experience is disconnected from other care delivery systems, this goal is hard to attain. Integrating virtual care with your patient portal and EHR, however, can tie a virtual care offering to patient experience objectives.

    • A CCDA integration with your EHR can help make the online adaptive interview more personalized by accessing information from the patient health record, including medication allergies and health history.
    • Offering single sign-on (SSO) from the patient portal to your virtual care service means patients experience a seamless handoff when moving between these systems

2.  Improve patient retention

The healthcare landscape is becoming more competitive, and patients are making healthcare purchasing decisions differently. This combination means that healthcare consumers are increasingly likely to seek care outside of their primary care provider or medical home. Offering virtual care can help attract and retain these patients, and integrating with your patient portal through SSO can foster closer ties with your health system. Integrating with your appointment scheduling system can help prevent patients from seeking care elsewhere by making scheduling follow-up care or other appointments quick and easy.

3.  Seamlessly transition between virtual and in-person care

Systems integration can help marry the virtual visit with in-clinic services. Integrating your virtual care platform with your patient scheduling system, as well as with systems like labs, can help fit virtual care into the overall care continuum. Pairing virtual visits with in-clinic services can also increase the number of conditions your health system can safely treat through your virtual care platform. Start by pairing virtual visits with in-clinic services such as lab testing or imaging, and grow your virtual care service by incorporating follow-up care or referrals. Our ZipTicket® workflow and integration with lab systems brings the virtual visit and in-clinic services together in a process that saves patients time and adds depth to clients’ virtual care services.

4.  Reduce physician time spent on EHR data entry

Let’s face it, your health system has spent good money on your EHR system. But recent studies show it’s eating into patient interactions and physicians’ personal time, and that EHR-related data entry is a major cause of physician burnout. Effective integration, however, can reduce time spent entering data into the EHR. A standard EHR integration with a store-and-forward virtual care platform like Zipnosis can map information from the virtual visit directly to the EMR, eliminating the need for double documentation. Advanced integrations can take things even further. HL7 and other EHR integration options can create patient records in the EHR, eliminating the need to create a new record when the patient comes in for an office visit. And, by pairing EHR integration with certain patient scheduling integrations, your health system can add an adaptive interview to the front end of an office visit. This provides the clinician with a structured clinical note already added to the EHR, giving them more time to interact with the patient and minimizing the amount of data entry necessary per visit.

5.  Get ready for the future

Moving forward, consumer driven data from wearables and the “internet of things” is going to inform health decisions – both from a patient and provider standpoint. The healthcare industry is poised to see numerous benefits from this transition, according to a recent CIO article. However, flexibility and communication are going to be increasingly important to reaping these benefits, particularly as technology moves forward. Effective integration between virtual care and your IT systems can tighten workflows, improve communication and give your health system the foundation to adapt as your patients further embed technology in their lives.

Put integration to work for you

At Zipnosis, we offer advanced integration options to effectively connect your existing systems with our leading-edge virtual care platform. We interoperate effectively with any EHR, and offer advanced options including:

    • HL7 integration, covering use cases for patient registration, transcriptions, billing, results, and more
    • CCDA integration with your EHR provides a more streamlined workflow and personalized adaptive interview
    • Advanced EHR integrations reduce the need for double documentation, since information is securely transferred from one system to another
    • Single sign-on (SSO) – both patient and provider portal options offer a more seamless experience
    • Integration with your patient scheduling system removes barriers to care and ties patients more closely to your health system
    • ZipTicket effectively provides service continuity between virtual visits and in-clinic services, increasing the number and type of conditions your virtual care platform can address

Want more information on virtual care? Check out our guide to best practices!

Maintaining Quality in Healthcare Continuum

Imagine having the equivalent of a clinic in your pocket without the concern that the quality of care would be less than you want or deserve. When done well, virtual care can improve access, decrease cost, and save time without sacrificing quality and continuity of care.

As the market becomes crowded with organizations offering various iterations of telemedicine, healthcare organizations must consider several key factors to determine whether a particular offering is right for the organization. For instance, will clinicians within your network field the inquiries of your patients or will they be handled by clinicians outside the network? Another key factor is whether you will have the ability to integrate information about a patient’s visit into your electronic health records (EHR) system – a key element for providers who strive to utilize all information about a patient in their encounters.

Through its virtual care solution, Zipnosis patients receive treatment for minor medical conditions quickly and safely from healthcare providers within their own network. Patients are treated using its pioneering software-guided online interview that mimics the questions physicians would ask in a clinic. An in-network clinician reviews the interview and either offers a treatment protocol, triages the patient into a phone or video encounter or directs them to visit a clinic.

The entire process is grounded in evidence-based medicine and complies with national best-practice guidelines. If at any point the patient provides information indicating a serious illness, Zipnosis will determine that virtual care is not appropriate and direct the patient to the most appropriate level of care. For example, if a patient believes she/he has a sinus infection and also indicates a fever of 103, the Zipnosis platform will stop the virtual visit and recommend an appropriate in-person site, such as the health system’s urgent care clinic.

With its white-labeled, fully integrated virtual care platform, Zipnosis also offers the technology that will enable you to seamlessly integrate patient visits into your EHR.

Virtual care, if designed to fit not only into the slipstream of your patient’s life, but also into the continuum of care your organization strives to provide, can make clinical care more convenient while maintaining quality – one patient at a time.

2015 Predictions for Telemedicine

Resources

Webinar: How to Get Virtual Care Right the First Time with Bryan Health

Bryan Health Webinar: How to Get Virtual Care Right the First Time

Learn how a leading health system successfully launched and took their virtual care service to market. Dr. Brian Bossard and Andy Whitney from Bryan Telemedicine, the virtual care arm of Bryan Health, share their first-hand experience selecting and launching their virtual care service line. They provide insight into the differences between virtual care solutions, best practices for bringing a virtual care service to market, and how virtual care can improve patient acquisition.

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Case Study: Bryan Health Meets Demand for Virtual Care Without Sacrificing Quality

Click here to view the case study!

bryan-health-case-study

Report: 2018 On-Demand Virtual Care Benchmark Survey Report

2018 On-Demand Virtual Care Benchmark Survey Report

Virtual care is increasingly critical in healthcare delivery, and numerous surveys and studies have been done evaluating everything from effectiveness to patient readiness to provider adoption. This body of research is lacking in one crucial area: how health systems are deploying and using virtual care. The 2018 On-Demand Virtual Care Benchmark survey is our attempt to fill that gap.

The results of this report are organized into three key categories: virtual care operations, technology and clinical.

Virtual Care Operations

This section explores how virtual care is set up and supported in healthcare organizations.

Topics include: Patient populations and utilization, strategy and operational responsibility, budget and finance, goals and challenges, and future plans.

Technology

This section looks at the technology used for on-demand virtual care, as well as how virtual care fits into the digital health landscape.

Topics include: Modalities, integration, other telehealth solutions in place, other patient-facing technologies in use.

Clinical

This section delves into clinical uses and outcomes from on-demand virtual care programs.

Topics include: Staffing and efficiency, conditions treated, and clinical quality.

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eBook: Best Practices Guide to Virtual Care

Best Practices Guide to Virtual Care

Health systems across the nation are increasingly deploying virtual care strategies to complement current access points to care. But why? Research indicates that virtual care and telemedicine services will continue to grow as patients increasingly choose online and mobile delivery for their healthcare needs.

Through our years of working with leading health systems across the country, we know the questions a crowded marketplace can raise. We’ve developed a guide to help you understand the different virtual care models and illustrate the impact of these services on your health system.

  • Understand environment and define strategic objectives
  • Determine business model and mode of care delivery
  • Identify organizational stakeholders and assemble team
  • Create an internal cadence of accountability
  • Ensure ongoing training and support mechanisms are in place
  • Craft a continuous marketing and communications plan for new and current patients
  • Develop roadmap for technology integration and service scaling

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