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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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Virtual Care in a Trump America: Making Care Great Again

So, there was this election last November. You might remember it or you might be trying to forget, but either way a new president was sworn in January 20th. Ever since the results were tallied, I’ve been inundated with a barrage of predictions for what the new administration means for the healthcare industry – in particular, for virtual care and telemedicine.

The one thing everyone can agree on is that with Trump in the White House, healthcare policy is going to change. So, what place does virtual care have in a Trump America?

No One Really Knows the Future

OK, it might seem kind of counterintuitive to say that after I just wrote about my forecasts for virtual care in 2017, but bear with me. Speculation about how lawmakers at the federal level approach healthcare policy can be well founded. It can be based on campaign promises (we all know how those go), party politics and previous voting records. But, our democracy is complex and unpredictable. And despite speaking Russian, I have no real insight into the policy direction the Trump administration will take with regards to healthcare.

Here’s What I do Know

While I can’t tell you precisely what legislative changes will come with the new Congress and President, I can tell you that there are macro-level trends in the healthcare industry that will continue to influence digital healthcare, telemedicine and virtual care, regardless of who’s in office. (Tweet)

And that’s where I can effectively make predictions. Like tiny snowballs starting downhill, the following trends have become avalanches in the healthcare mountainscape. Their momentum – more than federal policy – will be the major influencers of virtual care over the next several years.

The Transition to Value-Based Care Will Continue to Gain Momentum

Value-based reimbursement is here, and it’s here to stay. You can check out my post on Becker’s Hospital Review for a primer on value-based care and its impact on virtual care. Suffice to say, virtual care offers health systems a real means to cope with the changes the shift to value-based payment is producing.

Right now, value-based care is still gaining traction, but a number of factors make this shift inevitable. For one, healthcare costs are continuing to rise. Value-based reimbursement can help curtail those costs while supporting high quality care. A recently published study in JAMA found that using bundled payments for joint replacement decreased Medicare costs between 13% and 21% and produced fewer readmissions, emergency visits and prolonged hospital stays.

With insurers seeking to improve the bottom line and the move to high deductible health plans (HDHPs) and health savings accounts (HSAs) leaving patients paying more out-of-pocket, the transition to value-based care is only going forward.

Predicted Primary Care Physician Shortages and Patient Access Remain Challenges

Back in 2013, the Health Resources and Services Administration predicted a primary care physician shortage of more than 20,000 by 2020. Just this past year, the American Association of Medical Colleges issued a report projecting a shortfall of between 14,900 and 35,600 PCPs. This report went further and noted that if all barriers to care were removed, the U.S. would need an additional 96,000 doctors to meet patient needs – today.

All signs point to the population expanding relative to the number physicians available, meaning that improving patient access to care is only going to be more important going forward. I anticipate virtual care – with its increased clinical efficiency – is going to be a critical piece to solving these challenges.

Patient Demand for Virtual Care isn’t Going Anywhere

In our infographic, Virtual Care by the Numbers, we outline how patient demand for virtual care is impacting the industry. Some of the highlights include 76% of patients rating access over in-person care, and 62% of patients stating they’d be willing to replace an in-person visit with an online visit.

This demand is only going to increase as technology becomes more embedded in people’s lives.

People are Increasingly Spending Their Time Online

So, show of hands: Who has a Facebook account? Twitter? LinkedIn? Instagram? How about Netflix or Hulu? The world is more digital than it was even a few years ago. We shop, access entertainment, and even build and maintain our friendships and business relationships online. According to the Pew Research Center, 38% of all adults’ primary news sources are online – a number that goes up to 50% between the ages of 18 and 49.

This shift to a virtual world is only going to grow as more and more resources are available via digital channels. And, this holds true for healthcare, as well.

Virtual Care’s Place Going Forward

These trends may have started as a tiny shift in the snow cover, but they’re full-blown, unstoppable avalanches now. While I can’t predict policy, I feel confident that moving forward, virtual care has an important role in helping health systems and patients deliver and receive care as the landscape changes.

Forecasting the Future of Virtual Care in 2017: 5 Mystical Predictions

So long, 2016, we’ve officially begun a new orbit around the sun. It’s becoming a new year’s tradition for me to don my mystic robes, gaze deep into my son’s Magic 8 Ball and come up with predictions for the future of virtual care in the year ahead. (If the new year has you feeling nostalgic, check out my forecasts for 2015 and 2016.) So, let’s dive in.

1. Demonstrable ROI will be a requirement
Magic 8 Ball response: “Signs point to yes”

To date, the return health systems receive from their virtual care investments has been shadowy and not clearly understood. In fact, when I asked my Magic 8 Ball about the ROI of traditional telemedicine, it said, “Reply hazy try again.”

Some of this ambiguity is due to the relative newness of patient-to-provider virtual care. During the early stages of adoption, throwing things at the wall to see what sticks isn’t an unreasonable strategy. Alternatively, ROI has been a smoke and mirrors game with traditional telemedicine companies decreasing health system investment and inflating adoption hopes. But as virtual care becomes increasingly mainstream, clouding ROI in mystery or promoting unsustainable models will no longer be acceptable (tweet this).

In 2017, Health systems are going to expect a holistic, clear view of the return on their virtual care investment. That will include elements like how virtual care is helping to attract and retain patients and produce positive health outcomes.

2. Health systems will have higher expectations for care quality
Magic 8 Ball response: “Without a doubt”

2016 saw several high-profile telemedicine quality studies published, and traditional telemedicine did not come out looking great. Hospitals and health systems understand the need to increase access by offering online care, but are unwilling to launch services that could negatively impact their quality ratings. As a consequence, quality will become a much larger evaluation factor in areas including:

    • Clinical quality: Health systems will require hard data on clinical quality for care provided via digital channels. If not already in place, telemedicine and virtual care companies will need to find ways to collect and make this data available to their clients.
    • Interoperability: Electronic Medical Record (EMR) integration is no longer a “nice-to-have;” it’s a requirement for maintaining continuity of care and effectively tracking patients’ health data.
  • Data, reporting and analytics: Real-time data will be increasingly important, and health systems will require means of accessing and analyzing the performance of their virtual care service.

3. Driving internal adoption of virtual care will be a priority
Magic 8 Ball response: “Most likely”

Patient demand for virtual care continues to rise. My Magic 8 Ball says, “You may rely on it.” If that’s not enough for you, a recent survey by Rock Health found that 46% of consumers are active digital health adopters, up from 19% the previous year. The upshot is health systems will need their providers fully engaged and supportive of this mode of care delivery.

This year, health systems will focus on change management, provider engagement and making a cultural shift toward embracing virtual care and other digital health technologies (tweet this). Fortunately for health systems, online channels are gaining traction as a mode of care delivery. For example, a study by the Robert Graham Center found that 85% of physicians would consider using telehealth. This acceptance by physicians should make change management and the cultural shift toward embracing virtual access points much easier.

4. Policy support for digital health including virtual care will increase
Magic 8 Ball response: “Outlook good”

2016 saw a great deal of legislative movement in the area of digital health and virtual care. According to the Center for Connected Health Policy, more than 150 pieces of telemedicine-related legislation had been introduced in 44 states as of August. I anticipate a lot more movement on the legislative front for the coming year. It doesn’t hurt that a recent survey by the Federation of State Medical Boards identified “telemedicine” as “the most important medical regulatory topic to state medical boards.”

I also expect that, similar to recent legislation that passed in Wisconsin and Michigan, the policy we’ll see coming in 2017 will be friendly to digital health in general and virtual care in particular. Much of this policy will be driven, or at least influenced, by health systems seeking the best option to bring high quality, convenient care to their patient populations in a way that meets their business objectives.

5. Leading virtual care providers will expand to support more service lines
Magic 8 Ball response: “Signs point to yes”

Virtual care is increasingly venturing out of the acute urgent care space and into supporting a wider range of service lines. This means that virtual care providers will need to identify ways of meeting a wider array of health system needs, likely including forays into longitudinal care such as chronic condition management and/or post-operative care.

Health Systems Move Into the Driver’s Seat

Going through my list, you might have noticed a theme (beyond my surprisingly positive run with the Magic 8 Ball): Health systems are increasingly impacting the direction of this industry. Decision makers at leading health systems are getting more sophisticated about technology; have greater insight into patient and provider satisfaction, engagement, and expectations; and will require real value from their virtual care partner(s). And I, for one, am looking forward to it. “It is decidedly so.”

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