The words “Virtual Care” have taken center stage in the wake of the COVID-19 global pandemic, but what does virtual care really mean?
Virtual Care is a broad term that encompasses countless telehealth strategies. A common mistake is to think about Virtual Care as a binary rather than a continuum. Virtual Care isn’t something you either have or you don’t, but rather it’s a collection of tools from which to choose. Each practice must determine which tools to place in its Virtual Care Toolbox based on the patient constituents it serves.
Just like a plumber needs different tools than an electrician, your Virtual Care Toolbox should be customized to the job you are performing. A complete review of your patient interaction points, the demographic makeup of your customers, and even your geography all contribute to which telehealth tools to select. With all these considerations, you might be tempted to just throw extra tools in the toolbox to cover your bases, but be careful as having unnecessary tools isn’t always a good thing either, as it can make it harder to find the right tools when you really need them.
So how do you know which Virtual Care tools are right for your practice?
The first step is knowing what tools are available and their main functions. Below we will discuss some of the most common Virtual Care tools in the market today.
Categories of Virtual Care
The American Telemedicine Association categorizes Virtual Care into three main groups. These include Real-Time Virtual Visits, Remote Patient Monitoring, and Asynchronous Store-and-Forward.
Let’s explore each in more detail.
Real-Time Virtual Visits
When most people think of telehealth or virtual care, they picture Real-Time Virtual Visits. A virtual visit typically includes a synchronous teleconference between the physician and the patient. While videoconferencing is the medium most associated with Real-Time Virtual Visits, live phone visits and real-time secure messaging or chat are also tools that fall into this category.
Prior to the COVID-19 pandemic less than 1% of all patient visits were virtual. However, according to the Advisory Board, this number exploded to almost 80% of all visits at the height of the pandemic lockdowns across the United States in 2020. This number has now found a more stable range, hovering between 5-15% of all visits, as of the writing of this article. The widespread belief is that much of the increase in adoption will be sustained going forward.
That said, practices need to determine how and when to integrate Real-Time Virtual Visits into their care pathway. Remember, just because a visit can be conducted virtually doesn’t always mean that it should. For instance, it is not always appropriate to substitute a virtual care visit in place of an in-person encounter when hands-on care is required or when a visual check would add to the richness of the examination. This would be the equivalent of trying to use a screwdriver to hammer a nail. It may work, but it’s not optimal for the job at hand.
Patient interest in trying virtual visits has increased substantially this year, but practices should consider the demographics of their patient base when building out their virtual visits program.
Research now shows that 60% of all consumers are willing to try virtual visits if the alternative is waiting an additional day or more to see a physician in-person. While you might expect that this adoption is skewed toward younger, tech savvy patients, the opposite is actually turning out to be true. When wait-time to see a physician in person is increased to 2 weeks, 75% of patients over the age of 74 stated that they would be willing to switch to virtual care compared to only 37% of younger patients surveyed. In the current landscape, wait-time tolerance steadily decreases with age, as older patients feel the need to speak with doctors sooner.
Your Virtual Care Toolbox should clearly consider the demographics of the patients you serve.
Remote Patient Monitoring
Remote Patient Monitoring is a family of tools that enable patients to aggregate, process, and transmit health data to their healthcare providers using personal health technologies. The most common virtual care tools in this category include wearables, monitors, smart watches, and mobile phone applications. These tools aid in the management of chronic diseases, the tracking of symptoms, and behavioral health monitoring.
When optimally integrated as a component of a Virtual Care program, Remote Patient Monitoring can deliver massive benefits. For instance, a recent study conducted by the US Department of Veterans’ Affairs showed that proactive symptom monitoring through a telehealth platform led to 57% fewer unplanned hospitalizations and 97% fewer unplanned clinic visits, among prostate cancer patients.
While Remote Patient Monitoring can be an effective supplement to aggregating and reporting data, other store-and-forward tools can capture a patient’s prior health record for case management.
The third category of virtual care tools is Asynchronous Store-and-Forward (asynchronous being the operative word). This category is also known as Store and Forward Telehealth (SFT) and the US Department of Veterans Affairs defines it as, “the use of technologies to asynchronously acquire and store clinical information (e.g. data, image, sound and video) that is then forwarded to or retrieved by a provider at another location for clinical evaluation”.
As opposed to Real-Time Virtual Visits, Asynchronous Store-and-Forward tools don’t require the physician to be present at the time medical information is presented. Advocates of these tools note that asynchronous communication allows doctors to review materials on their own schedule, allowing for improved time efficiency.
Universal Medical Record Uploaders and Remote Second Opinion (RSO) Software are two of the most common Asynchronous Store-and-Forward tools. Universal Medical Record Uploaders enable patients to aggregate and upload medical records of any type or format through a web-based application. Practices can receive and review this information in advance of a patient encounter, whether in-person or virtual. A growing number of practices are beginning to incorporate this tool as part of their new patient intake process.
Remote Second Opinion and Remote Consultation software takes this process one step further. In addition to enabling patients and referring physicians to aggregate and upload records, the software platform organizes this information into a convenient and easily understandable case. This case is then presented to specialist physicians for review and response. Their analysis is shared back to the patient or referring physician who initiated the case, often as part of a virtual real-time consult.
Asynchronous Store-and-Forward technologies have seen growth in adoption and patient preferences over recent years. A 2020 study by the Advisory Board, found that many patients now prefer virtual second opinions over the alternative of driving to see a specialist physician. Additionally, adults over the age of 56 showed a strong preference for virtual second opinions rather than driving to see a physician, even in potentially serious or complex medical situations.
As these patient preferences shift, Asynchronous Store-and-Forward technologies are becoming an important tool to include in your Virtual Care Toolbox.
Choosing Your Virtual Care Tools
In summary, below are some of the most common tools to choose from when filling your Virtual Care Toolbox. Remember, not every practice needs every tool, but a clear understanding of your patient interaction points and patient demographics can help you identify which items to select.
Purview offers Asynchronous Store-and-forward solutions for use by hospitals and subspecialists. If you need help determining if adding these tools to your Virtual Care Toolbox might be right for you, please reach out and we would be happy to have a conversation.