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The Virtual Care Insider Ep. 1: The Analog and Digital Divide

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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How to Grow Market Share with Virtual Care

This past week, I was at the American Telemedicine Association’s annual conference, and one of the things I heard over and over was the growing need for health systems and providers to offer virtual care. But health systems are often in a difficult position when it comes to technology investments like virtual care. They need, not only to prove it aligns with their mission and organizational objectives, but that it makes financial sense.

Healthcare organizations are increasingly being asked to do more with less—to think as businesses with an aim to expand and grow revenues. In fact, non-profit health systems are often caught between their business needs, the aims of their missions, and of course, delivering high quality care to diverse patient populations. The great news is that virtual care can help bridge that gap, supporting health systems in expanding access to care, both by increasing convenience and lowering costs while aiding in expansion and growth.

The Business Case for Virtual Care

When I say that building a business case is less clear that doesn’t mean it is difficult, more that, because the technology is relatively new and evolving, health systems sometimes find it challenging to pin down how they want virtual care to impact their business. While expanding access and enhancing patient experience are mission-driven goals, they also can create impacts on the bottom line. Other facets of virtual care, like increased clinical efficiency can bring a positive impact to the bottom line, particularly for populations where the health system owns a portion of their risk (e.g., self-insured employees or other owned health plans). But the real winner in building a business case has to do with gaining market share.

Virtual Care Meets Market Share

We recently published a study with MultiCare Health System in Washington that demonstrated the patient acquisition potential of offering a virtual care service to the marketplace. Through the study, we found that 34% of virtual care users who had not received care from MultiCare in the 24 months preceding their virtual visit sought in-person care in the 12 months after their virtual care experience – more than 3 times that of a control group.

So, how do you set patient acquisition goals relative to your market? Start by figuring out how much of the market you currently have—your market share.

What’s Your Market Share?Grabbing a piece of the market share pie

To calculate market share, try this for a nice-round-numbers approach. You, or someone at your organization, probably have a relatively good handle on how many patients you treat per year, on average. Divide that by your approximate market size, which you can find this with a quick Google search.

Setting Market Share Goals

The 34% patient conversion rate MultiCare achieved is tied to the closely circumscribed study cohort, imagine what that could look like relative to a major metropolitan market. For example, imagine you have 12% of a market of 3 million – that’s a nice size patient panel of 360,000. But, what could increasing your market share just 1% do? Before you pull out your calculators, I’ll tell you that it would add 26,400 patients to your health system—or 1% of your market potential.

Market Potential

market potential equation

Once you know your current market share, set attainable goals. Start with an aim of increasing your market share .25%. Using our hypothetical scenario above, that translates to 6,600 new patients.

Working with the 34% conversion rate, how many virtual visits would you need to achieve that .25% increase? Once again, I’ll do the math for you. You would need just over 19,000 new patients to come through your virtual care service to gain your 6,600 new patients and .25% market share increase.

That may sound like a lot, but there are budget sensitive strategies to increase growth and virtual visit volume that can help you achieve your market share and patient acquisition goals.

Accelerating Growth

From my perspective, one of the most interesting findings of our study with MultiCare is not the patient conversion rate but the market opportunity. The independent analytics firm who compiled and analyzed the study data found that understanding the demographics of patients who were likely to use virtual care meant that targeting just 20% of the market would yield 82% of the people most likely to use virtual care. That means highly focused, targeted marketing efforts could significantly increase virtual care utilization.

It’s exciting to hear from various health system customers about how they are leveraging virtual care to reach new patients and broaden access to care. Several of our health system partners are unlocking market potential by contracting with local health plans and employers to offer virtual care to their members and employees. Combined with targeted marketing, this approach can help accelerate your health system growth and put you well on your way to achieving your objectives.

Avoid the Avoidable: 5 Common Virtual Care Mistakes and How not to Make Them

You may have heard the latest news coming out of Texas – A major piece of telemedicine legislation has just been signed into law that will change the game for health systems looking to deploy virtual care. This bill abolishes the requirement that patient-physician relationships be established with an in-person visit before telemedicine or virtual care can be used. For health systems, that means they can now offer virtual care to the broader marketplace, rather than just to current patients. With virtual care proven to add patients to health systems, this presents an opportunity to employ virtual care as part of a patient acquisition strategy. Game-changing.

In Texas (and elsewhere), health systems new to telemedicine and virtual care are now looking at launching their own services to support patient acquisition. But without a foundation in virtual care, health systems moving quickly to take advantage of the new environment may be making decisions that have potential long-term implications for their organizations and patients. More good news for Texas health systems: By avoiding these 5 common virtual care mistakes, success is within reach.

1. Lack of organizational support

Often, health systems will decide there’s a need for virtual care, and begin with the best of intentions, delegating a department or individual to work on finding and implementing a solution. But without a clear plan, regular communication, and stakeholder engagement, the virtual care project does not get the proper attention and true buy-in needed to create a successful, long-standing virtual care offering.

The Fix

Think of virtual care as a large, strategic technology investment – something that can support organization-wide objectives and strategies while adding value to your patients’ experience and your providers’ work. Make sure you have a clear plan around launching, and assemble a steering committee of leaders throughout the organization to guide the implementation and growth of your virtual care service.

After launch, maintain a communication plan to help keep virtual care front-of-mind throughout the organization. From clinical operations through marketing, your team should understand why virtual care is an important part of your strategy and how they can help make it a success.

2. Unclear reporting structure

Traditionally, telemedicine and virtual care service lines have been subject to a surprising lack of oversight. Health systems that don’t set up a clear reporting structure or determine which metrics to track will never be sure whether their virtual care service is meeting its objectives, and won’t have the insight needed to improve or grow the service.

Virtual care mistake: Unclear reporting structure

The Fix

This is an easy mistake to avoid – just make developing a cadence of accountability part of the implementation process. Understand what data your partner can capture and report on and what data you have access to. Decide on a reporting schedule—and identify who will be responsible for assembling and who will be responsible for reviewing reports.

If you need help identifying metrics or developing a reporting structure, our eBook, Measuring Success in Virtual Care, has the information you need to get off on the right foot.

3. Lack of marketing support

“If you build it, they will come” only works in baseball fantasy movies. But some health systems think that just having the service is enough. The truth is that patients won’t use your virtual care service if they don’t know it exists. And, in the digital age, marketing techniques need to be updated to match your audience.

The Fix

It’s not enough to buy billboard space. When launching a virtual care service, you need a multi-channel, long-term marketing plan to drive virtual care adoption. This may include elements like a press release and local media strategy, prominent website placement, social media strategy, direct mail, email marketing, and in-clinic marketing. Likewise, an initial introductory push will only do so much for the service. If you want to see long-term success with virtual care, create a continuous cadence of communication, including seasonal marketing pushes around things like cold and flu or seasonal allergies.

Internal communications are also key. Providing training and information to nurse line and front desk staff to help them direct patients to the virtual care service can do a great deal toward driving adoption. Additionally, getting physicians, physician assistants, and nursing staff on board with talking about and recommending virtual care can make a tremendous difference in virtual care adoption.

4. Not understanding big-picture value

People are people, and people get locked into old ways of thinking. This is particularly true when looking at payment and revenue. Health system finance departments sometimes view the return on a virtual care investment by subtracting revenue from cost – but that’s not how virtual care adds value. The true value of virtual care lies in downstream revenues and cost savings as evident in a recent study.

The Fix

Virtual care’s organizational impact can appear in any combination of the following:

    • Increased patient acquisition
    • Reduced patient leakage
  • Lower cost of delivering care – or cost shift

If you want more information about the potential revenue impacts of virtual care on your health system, our revenue calculators can give you a starting point:

ROI Calculator

Cost Shift Calculator

ROI Calculator

Patient Acquisition Calculator

ROI Calculator

Patient Leakage Calculator

5. Choosing the wrong partner

Not all telemedicine and virtual care companies are created equal – the technologies, business models, support, and product roadmaps can vary widely. For example, many telemedicine companies have a direct-to-consumer model, meaning that they have the potential to create a relationship with your patients that could lead to those patients circumventing your system altogether in the future.

Many health systems rush their decision due to pressure from increasing competition or fail to perform their due diligence in the belief that telemedicine and virtual care companies are all the same. Often, healthcare organizations will find that their partner isn’t providing what they need six months to a year into a multi-year contract. Concerns can be as simple as workflow alerts, to low utilization, to lack of flexibility and scalability in the technology. And then they’re stuck. Fortunately, with planning and care, it’s possible to select the partner best suited to your health system’s needs.

The Fix

First, talk to your stakeholders – understand patient and provider needs so you can choose the partner that is best suited to meet those needs. Don’t assume. Next, take a look at your organizational strategy and understand how virtual care fits into your overarching goals. Finally, develop your criteria for selecting a virtual care partner, including technology, support, staffing, and integration, to name a few.

Virtual care mistake: Choosing the wrong partnerThe partner you choose should offer technologies that meet your patients’ needs, while fitting seamlessly into their lives. They should also offer solutions that fit into provider workflows to maximize clinical efficiency and support a positive provider experience. Your virtual care partner should also be able to demonstrate support for providing the highest levels of care quality that your patients expect from your health system. Finally, find a partner that will be just that – a partner. Find a company that will work alongside you to help create a successful virtual care service line – from launch through growth, scaling, and innovating.

Get Set for Virtual Care Success

Virtual care holds the potential to bring health systems a lot of value. Keep your eyes peeled, put in some effort in planning on the front end, and avoid these five virtual care mistakes, and you’ll be in a great position to win – whether you’re a Texas health system taking advantage of the new regulatory environment or just ready to take the next step in launching an online care delivery service.

Why Virtual Care Should be Part of Your Health System’s 2017 Growth Strategy

As 2016 comes to a close, health systems—like most businesses and non-profit organizations—are deep into planning their growth strategy for the new year. Faced with rising consumerism in patient populations, increasing competition from traditional and non-traditional healthcare companies, and the continued transition to value-based reimbursement, leading health systems are looking to virtual care as a means of supporting organizational growth strategies.

Aligning Virtual Care with Health System Growth Strategy

Any way you slice it, adding a virtual care service line is a strategic business decision. Your virtual care strategy should reflect your health system’s big-picture growth strategy. But how, precisely, do the two tie together?

The Virtual Care SWOT

Every health system is different, with unique cultures, competitive environments and goals. However, many health systems face similar challenges and opportunities. When it comes to health system strategic growth planning, virtual care can help make the most of strengths and capitalize on opportunities while shoring up weaknesses and mitigating external threats.

Leverage Strengths

With a virtual care platform in place, health systems can:

    • Offer patients online access to their clinicians by staffing the virtual care service internally
    • Increase patient engagement and satisfaction through convenient access and digital tools that fit into their lives
    • Maintain high levels of clinical quality and capture structured data to support quality initiatives

Capitalize on Opportunities

Launching a virtual care service line can help health systems:

    • Attract and retain new patients – particularly younger generations who have yet to settle into a primary care relationship
    • Build a foundation for continued innovation and partnership with a virtual care provider committed to keeping clients on the leading edge
    • Strengthen or develop new contract relationships with large employers, insurers and/or educational institutions to drive revenue

Address Weaknesses

Virtual care can help health systems work within internal constraints by:

    • Leveraging marginal capacity to treat more patients with current staff
    • Meeting patient demand for convenient care and improve access without adding physical locations
    • Offering virtual care at a free or reduced cost to employees and their dependents to reduce overall healthcare costs

Mitigate Threats

Offering virtual care supports health systems through:

    • Staying in step with – and/or offering a point of differentiation from – competitors’ online service offerings
    • Supporting patient retention by offering a convenient, online access point
    • Creating a lower-cost channel to provide care to patients in value-based reimbursement populations

For more information on how virtual care can support organizational growth strategies, check out our free Best Practices Guide to Virtual Care  – your handbook for successfully launching, operationalizing and growing a virtual care service.

virtual-care-best-practices

Bryan Health Goes Virtual with Zipnosis

In growing numbers, patients are expecting convenient, accessible care from health systems. At Zipnosis, we hear this all the time. This need is compounded in areas where patients may need to drive hours to reach a physical clinic. Seeing these market forces play out in their community, Bryan Telemedicine, the virtual care arm of Bryan Health—a leading health system based in Lincoln, NE—decided to meet this challenge head-on by offering virtual care.

The Search Begins

Like many health systems, Bryan Telemedicine began looking for a virtual care solution to meet the demand for accessible, convenient care. They had a wish list that included being able to leverage current staffing and internal clinical expertise, support continuity of care for their patients, and achieve high levels of clinical guideline adherence. Initially, it seemed they might have to settle for a traditional video only (synchronous) telemedicine solution – then they found a unique approach by Zipnosis that better addresses their requirements.

The Start of a Beautiful Partnership

Bryan Telemedicine was attracted to Zipnosis’ evidence-based protocols and proven clinical quality they deliver. Bryan Telemedicine was also excited by how Zipnosis leverages marginal clinical capacity – a feature that allows them to provide 24/7 virtual care without adding staff. But what about those patients that can’t be treated online? The Zipnosis platform routes these patients to the most appropriate level of care within the Bryan Health system. You see, we’re all about delivering the right care at the right time – whether online or in person.Bryan Health - Zipnosis

One Year Later…

Bryan Telemedicine launched their virtual care service, Bryan Health eVisits, in late summer 2015. Since then, they’ve been pleased to see how virtual care fits seamlessly into their overall continuum of care. They have also seen an increase in new patient acquisition and a reduction in patient leakage to other virtual care solutions and health systems.

Recently, Bryan Telemedicine has expanded their virtual care service through a partnership with Memorial Health Care Systems (MHCS) in Seward, Nebraska. The arrangement takes advantage of the virtual care expertise of Bryan Telemedicine and their Nebraska board certified physicians. Bryan Telemedicine physicians will staff the new service, reviewing patient information and making an appropriate on-line diagnosis.

The Zipnosis team is continually impressed by Bryan Telemedicine’s innovative approach to care delivery. Check out our joint case study to learn more about Bryan Telemedicine’s journey and the results they’re seeing as a Zipnosis partner.

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

It’s Not Too Late for Health Systems: Get Ahead of Cold & Flu with Virtual Care

Cold and flu season is just around the corner and as health systems across the country prepare to meet the challenge of full waiting rooms and sniffly noses, there’s one solution that can help: virtual care. Having a virtual care service in place during cold and flu season can help mitigate the sick visit surge and strain that many health systems face as fall turns to winter. 

Cold and Flu Season Puts Health Systems Under Pressure

Upper respiratory illnesses, in particular influenza-like illness (ILI), account for a major portion of annual visit volume in settings such as retail clinics, urgent cares and emergency rooms. Throughout the US, cold and flu visits account for 27.4% of all retail clinic visits, 9.7% of all primary care visits and 5% of all emergency department visits each year, according to research published on healthaffairs.org

According to a study published in Academic Emergency Medicine, the greatest number of urgent care visits occur during the winter, with the highest number of daily visits recorded from November through February. At Zipnosis we see this each year, with visit volume increasing during the fall and winter months (see Figure 1). Information from Google Trends, which aggregates web search data, follows a similar curve with more searches on cold and flu occurring during the winter (see Figure 2).

Cold and flu visits peak during the winter months

Figure 1: Zipnosis visit volume for cold and flu follows the general trajectory for urgent care and primary care clinics. 12-month visit data from the Zipnosis platform.

Cold and flu searches peak during the winter

Figure 2: 12-month data on Google Trends “cold and flu” searches

How Can Virtual Care Help ?

Implementing a virtual care solution can help health systems mitigate some of the challenges that come with cold and flu season.

Take the strain off of brick and mortar care locations

Regardless of how visit volume from cold and flu is distributed across your health system—urgent care, retail clinic, primary care or emergency department—it’s likely that locations are operating at or beyond maximum capacity during cold and flu season. Moving visits to a virtual care service takes some of the strain off your clinicians and support staff, and can free up visit slots for higher value, more complex conditions.

Virtual care has the potential to significantly reduce the burden of clinics during cold and flu season (Tweet this). For example, a large midwestern health system with a well-established virtual care service through Zipnosis saw nearly 6% of cold and flu visits shifted from in-person to virtual care, opening up appointment slots for more complex patient needs and relieving pressure on providers and staff.*

Keep your waiting rooms safe

Keeping patients healthy is important, and one element of this is minimizing exposure to illness. In a recent study, researchers from the University of Iowa noted that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points. This seemingly incremental risk translates to more than 700,000 preventable illnesses annually with a price tag of nearly $500 million. By moving office visits for highly contagious conditions like influenza to a virtual visit, risk of healthy patients becoming sick decreases (Tweet this).

Support patient retention and continuity of care

During the high volume times associated with cold and flu season—particularly when health systems are at capacity—it’s increasingly likely patients will seek care elsewhere. Whether they choose a retail clinic, competing urgent care or direct-to-consumer telemedicine service, visits outside your health system open the door to potential patient leakage. Moreover, seeking episodic care means that if patients return to their primary care provider, their record may not be reflective of the care they received elsewhere. Offering your own virtual care service can help capture these patients who might otherwise seek care elsewhere, while supporting continuity of care and maintaining accurate patient records.

There’s Still Time to Act

Many health systems are already beginning to see patients for cold and flu visits, but with peak influenza activity predicted for mid February to mid March 2017 according to the Epidemic Prediction Initiative, there is still time to launch and market a virtual care service. With Zipnosis’ 60-day guaranteed implementation, you can have your virtual care service up and running to handle cold and flu season – and help provide safer care for your patients.

*Assuming 9.7% of visits are for cold and flu (per the healthaffairs.org study referenced).

Attracting Millennials Through Virtual Care

Today’s millennials are adept at all things mobile and look to technology as a starting point for most things in their digital lives. As healthcare systems work to build their future patient base, it is imperative to meet these digital natives where they are by offering clinical care options that are convenient as well as effective.

Virtual care is a perfect conduit for health care providers to build a relationship with millennials, however it can be difficult to instigate the initial relationship. The current medical regulatory environment often requires that patients establish a relationship with a provider via a bricks and mortar site before enabling them to offer virtual care options.

And while this may be seen as a hurdle, it is one that is easily scalable and well worth it. This demographic is keenly aware of the digital landscape and more often than not will choose a provider that will enable them to have the equivalent of a clinic in their pocket via a mobile device.

In addition, in marketing your virtual care offering to millennials and beyond, it is important to position it as a natural extension of your mission – versus an either-or alternative to the traditional clinic. Not only will this build your reputation as a provider that offers an array of options to its patients but it also further strengthens your identity in the community.

Given that more and more healthcare systems are transitioning from a fee-for-service to a fee-for-value proposition, millennials will not only appreciate the trend but embrace the options that are available to them.

Resources

Webinar: Top Virtual Care Trends for 2019

ATA Webinar: Top Virtual Care Trends for 2019

We are proud to offer the Top Virtual Care Trends for 2019 Webinar, hosted in partnership with the American Telemedicine Association.

In this webinar, Zipnosis CEO and ATA Chair Jon Pearce identifies the key business, technology, and clinical findings from the On-Demand Virtual Care Benchmark Survey Report, discuss what they mean for virtual care in 2019, and host an open discussion about the research. Key callouts include:

  • Virtual care is growing fast: 96.4% of respondents plan to expand their virtual care program within the next 12 months
  • Health systems are recognizing patients as consumers: a great patient experience is the top priority for 64% of our respondents’ virtual care programs
  • Multiple modes of care is essential: 67% of respondents say they have plans to expand offered modes of care

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