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Want to Hug Your Health Data?

The other day, the Zip team attended the MSP Business Journal Healthcare Update Forum at the Hyatt Regency in downtown Minneapolis. It was a well assembled panel of MN healthcare leaders:

  • Dr. Kenneth Holmen, CEO of CentraCare Health
  • Barbara Joers, CEO of Gillette Children’s Specialty Healthcare
  • Philip Kaufman, CEO of UnitedHealthcare of Minnesota, North Dakota and South Dakota
  • Dr. Craig Samitt, CEO of Blue Cross and Blue Shield of Minnesota
  • Troy Simonson, CEO of Twin Cities Orthopedics

Early in the discussion, Philip Kaufman made a comment about how consumers need better health data to improve engagement/costs/etc.  

Data is important, but I was struck by how disconnected this sounded. Philip isn’t alone – many leaders in the healthcare space carry this perspective about the role of data in our lives. But after years of working with provider organizations, and knowing or being a patient, it just doesn’t feel applicable to most healthcare decisions.

Health Data for Comfort

I asked myself “when was the last time I used a white-paper or clinical trial data to make a healthcare decision?” Not once. Now, maybe when I need a heart transplant I would do research on the best options for me (like my uncle is doing now…), but much of it isn’t about the data. It’s about “where’s the best place?” or “who’s the best doctor for…”  

If you unpack this a bit, it’s really about emotions. Trust. Stopping the pain. Grappling with the sobering fragility and finiteness of our lives. Fear of the unknown. Human responses to uniquely human afflictions.

Candidly, I’ve never once run to my database or spreadsheet when I’m scared or hurting. I run to someone I love & trust. I hug my mom. I reach out for my wife. I turn to my friends.

Which gets at, what I believe, a perspective flaw in digital health experience design: data and logic over empathy and humanity. And I’m not leaving us out of the accountability pool. I, too, suffer(ed) from the same bias in designing Zipnosis as Philip suffers as he seeks a more engaged patient population.  

Empathy First

At Zipnosis, we’ve come a long way in terms of incorporating empathy into our platform, but today, I’m challenging us to go further. It’s time to take the reins and build experiences rather than technologies.

As we make product choices, we must ask ourselves what fundamental, human emotional need does it meet at that moment in the patient’s journey. It may not be elegant – but it will be effective.

When a customer (patient or provider) requests a feature, their reasons aren’t typically logical but emotional. A provider who needs to ask one more question has an underlying sense of duty to treat a patient as best as possible. A patient who wants to give context around their symptoms or health history wants to get the care they need.  

As our team works toward our vision of making Zipnosis the undisputed standard in virtual care, we must acknowledge that we won’t succeed unless and until we put human and emotional needs first.

As with many challenges in healthcare technology, there are no quick fixes here. But I believe that we – not just Zipnosis, but companies all across the healthcare space – have a duty to put patients’ needs first. That means  addressing their clinical concerns with quality and precision (hello, data!) and meeting their emotional needs with empathy and understanding.

‘Cause even the hottest data model in the world can’t hug it out with you.

The Flip Side of ROI: Virtual Care and Cost Containment

The other day, I saw the Advisory Board released new research indicating that healthcare executives’ primary priority is cost containment, even over revenue growth. This focus shouldn’t surprise anyone remotely familiar with U.S. healthcare. Increasingly, health systems are being asked to do more with less – more patients, less staff; more innovation, less budget.

Working closely with our customers, I see first-hand the budgetary constraints and financial scrutiny that are an everyday part of operations. That’s why our team has worked hard to provide health systems with a clear understanding of the financial implications of an on-demand virtual care service, starting with revenue.

Why Revenue Still Matters

The Advisory Board’s study didn’t say healthcare executives were uninterested in revenue, just that often takes a back seat to cost containment. When it comes to effectively managing the bottom line, a two-pronged approach addressing both revenue and cost containment is vital.

As mission-driven organizations, non-profit health systems need to think about revenue. Grants and donations can only cover so much of a health system’s operating budget. In order to effectively provide services for their communities, health systems need to have additional sources of revenue.

A quick Google search yields numerous articles, seminars, webinars and other resources for health systems looking to maximize payer contracts. With the growing trend toward value-based care, effective contracting is critical to healthcare organizations bringing in revenue. Many of our customers use their virtual care services to support and enhance local payer contracts.

Virtual Care’s Revenue Impact

Traditionally, virtual care has been viewed as a patient satisfier (and sometimes market requirement) first and revenue generator second. The trouble is that revenue is seen primarily as visit fees, which often can’t cover the cost of care delivery much less software licensing. In reality, virtual care’s ability to generate revenue and return on investment for health systems lies in its utility as a patient acquisition channel. I won’t go into the nuts and bolts today, because it’s been done extensively in previous blog posts (here and here), as well as in case studies (here and here).

Cost Containment with Virtual Care

Cost containment is the flip side of the ROI coin

While revenue is important, health system executives are right to make cost containment a priority. Last year, expense growth outpaced revenue growth by 1.2%. And, just as health systems can’t achieve their missions without revenue, they can’t effectively operate in a deficit.

I really view cost containment and revenue growth as two sides of the same coin. And, while Zipnosis has been vocally focused on revenue, we have also been focused on the flip side. So, how does virtual care support health systems’ cost control initiatives? Two ways:

Expense Reduction for Risk-Based Populations

Health systems are also big employers, and employee compensation is one of the biggest expenses they face. To help control compensation costs, health systems are often self-insured. This creates a somewhat ironic situation where healthcare costs are actually a major health system expense.

Virtual care offers health systems a low-cost access point for convenient care delivery. When focused on risk-based populations like self-insured employees, this can translate to a major cost savings. A recent study by Humana found video visit costs paid out at approximately ⅓ the cost of in-person care while producing comparable follow-up rates and lower incidence of antibiotic prescriptions.

Looking at data from across the country, we calculate the mean cost of in-person care at $320 per visit (note: we’ve seen this as high as $500-$600). Conversely, our customers see the cost of delivering care via the virtual care platform at approximately $5. That’s an average per-visit savings of $315. On an individual visit level that may not look like much, but imagine the savings possible across an entire self-insured population. Even with activation between 5% and 10%, significant cost savings is possiTake the 2018 On-Demand Virtual Care Benchmark Surveyble – enough to cover software costs and free up budget to support important programs.

Enhancing Clinical Efficiency

I alluded to this somewhat in the previous section. Virtual care, in particular asynchronous modalities, can produce significant clinical efficiencies. On average, providers spend 15 minutes per in-person visit and are saddled with the administrative overhead of documentation later in their day, often after hours. With Zipnosis’s asynchronous modality, the visit time is a fraction of an in-person visit and there is no documentation.   

That efficiency is part of why virtual care can be an effective low-cost access point, but it also can help drive significant cost savings, since health system providers are able to grow their patient panels while avoiding the costs of adding staff, outsourcing, or the health system adding brick-and-mortar locations.

What’s in a Name? Online Healthcare Terminology and Why it Matters

We are at a critical inflection point in healthcare delivery. This inflection point is front and center for online healthcare as traditional telemedicine evolves into virtual care. It is important that the industry adopts the right vernacular to define and capture the shift, just a biology has allowed us to classify species and their evolution. To that end, I propose we clarify and define the terms we use to describe the new online care delivery models. Specifically, “telemedicine” and “virtual care.”

Over the past couple months, I’ve shared some thoughts on how telemedicine and virtual care differ. To recap:

Telemedicine = Testing; Virtual Care = Viable

For nearly 70 years, we have been testing with telemedicine. They have been vital tests of technology, payment models, clinical quality, patient satisfaction and all the bits and pieces between each of those components.

Telemedicine = Analog; Virtual Care = Digital

Telemedicine was developed when cathode ray tubes were en vogue. Telemedicine providers are not technology companies, but service companies that use technology to assist with care delivery. It’s a model that fits the pants healthcare has worn for the past 70 years, but is woefully ill-fitting for the new models.

Virtual Care has digital DNA. These companies are technology providers who facilitate care delivery on their platforms. They assume healthcare is going to be dominated by data and devices.

Telemedicine = Transactions; Virtual Care = Value

Telemedicine is all about handling healthcare transactions for a fee. Each time the phone rings or the video conference queues up, a charge is initiated. Telemedicine is anchored in fee-for-service payment models.

Virtual Care is required for value-based care payment models. These companies push the transactional cost of care as close to $0.00 as possible while unlocking new value streams off their platforms and data.

What about other terms like mHealth, connected care, digital medicine or digital health? I won’t spend much time here digesting, but I throw out my gut reaction:

mHealth: The “m” already feels like shag carpet. It was cool for a moment but no body wants to live with it.

Connected Care: It sounds like horse without a hitching post. What are we connecting to – proprietary data sets companies may not want to share? Facebook? Instagram? The Apple Watch only the affluent can afford?

Digital Medicine: It sounds antiseptic; cold, clinical and focused on data not care.

Digital Health: I actually kind of like this one, but it feels a little too broad for our purposes. In my mind digital health encompasses all the electronic tools that patients and providers use to facilitate care and wellness.

So, there you have it. My 12 cents on how and why we need to segment the market between virtual care and telemedicine. It’s time turn our eyes to the next 20 years, thank the telemedicine times and venture towards virtual care.

Transforming Telemedicine into Virtual Care

There is a long-running discussion on what to call this next generation of healthcare tools. Is it telemedicine? mHealth? Virtual care? Connected care? For the time being, “telemedicine” is in the ascendency, but that appears to be changing.

I have always been challenged by the term “telemedicine,” and I’m going to spend a little time in the coming weeks framing up a way to look at the difference between the term and delivery model that has been prevalent for decades, compared to the care delivery tools and models that will carry us forward.

At the heart, Telemedicine is a term born in the 1960’s, a Brubeck-esque fusion of tele-matic modes of communication (phone and video) and medicine. This history is important to understand so we can better usher in the new generation of tools and nomenclature.

Let’s start with “tele.” It sounds like “8-track” to me. It harkens back to a time when I would look up Domino’s Pizza in the phone book. To when I had to avoid tripping over the phone cord as my mom talked in the hallway. It feels like green vinyl in a Pinto. Like the anti-Mackclemore leisure suit at the Salvation Army. It’s stale and, let’s be honest, out-dated.

I’ll frame this up with a few simple word associations:

Telemedicine = Testing
Virtual Care = Viability

For some, having a healthcare encounter over the phone is novel and new – but it’s not state-of-the-art. This is an important distinction between our first EXPERIENCE with telemedicine and its relevance as a term for future experiences. I would make a significant wager that the majority of our healthcare interactions over the next 10 years will not be the phone calls or 1-1 video visits with a healthcare provider the industry has been testing since the 60s. Instead, we will experience of stream of healthcare that disposes of the analog shackles, unlocks new economic models not built around transactions and delivers durable value.

Telemedicine = Analog
Virtual Care  = Digital

The telemedicine gene pool is analog. The other day, I took a cab from downtown Miami to the airport. The cabbie was genial enough, but when we got to the airport, he frowned when I wanted to use my credit card. He manually typed in my card info onto his terminal, submitted for approval (queue dial-up noises) and waited for the print-out. The printer ran out of paper – so he had to dig through his glove box for a replacement roll, re-thread it and re-print. It was a stark reminder of a time—not long ago—when getting an analog ride to the airport was common place. Telemedicine is like that transaction: labored and inefficient.

Telemedicine = Transactions
Virtual Care = Value

Finally, there’s a transactional feel to the term: I “do” telemedicine; I “practice” telemedicine. It implies a direct connection between a patient and provider – or the healthcare ecosystem. We’re at an important transition in healthcare delivery. The combination of moving care from brick-and-mortar to the digital world and changing payment from fee-for-service into value-based care is forcing healthcare providers and the innovators who support them to develop new ways of providing value.

So there you have it. Telemedicine is dead – well, on life support. Virtual care is the future, and the future looks bright.

Next time, I’ll dig a bit deeper into the testing and viability differences between telemedicine and virtual care. Until then, don’t trip on the telemedicine cords in the hallway.

Virtual Care Helps Ease Bottlenecks And Spread Of Disease During Flu Season

Telemedicine is not just for diagnosis and chronic care, but also population health management.

As healthcare costs spike and greater emphasis is placed on reducing costs, improving outcomes, and creating greater efficiency, telemedicine is stepping into the spotlight as a way to diagnose simple conditions, track and provide chronic care, provide behavioral and mental health treatment, and even help with population health management.

But telemedicine also has the power to help contain epidemics by diagnosing and treating flu and other contagious diseases via virtual visits, therefore reducing the contact infected individuals have with others.

Using Telehealth, mHealth to Fight the Flu

Leading health systems across the country are recognizing the value of using virtual care to curb the spread of influenza. By enabling providers to diagnose and treat patients online, virtual care can help keep contagious patients at home rather than forcing them to visit a busy doctor’s office.

Dr. Dan Tran of Fairview Health Services notes that, “Virtual care is a great ‘relief valve’ to ensure all who need care receive it promptly, especially during cold and flu season.”

Read more on how Zipnosis is leading the way in leveraging virtual care to mitigate the impacts of cold and flu season on health systems, and check out the full article on mHealthintelligence.com.

Solving the Patient Engagement Puzzle with Virtual Care

Patient engagement is becoming increasingly important, and virtual care offers health systems a solution to meet patient needs while fitting healthcare into their lives. Kevin Smith, Zipnosis’ Chief Clinical Officer and innovative healthcare pioneer, discusses how virtual care can help health systems better engage with patients to boos patient retention and minimize patient leakage.