Blending virtual, in-office, at-home, and asynchronous patient care at scale

Virtual care and telehealth use has skyrocketed during the pandemic, accelerating the imperative to build a blended version of virtual, in-person, in-home, and asynchronous care that efficiently delivers quality outcomes, improves satisfaction, and optimizes cost, Here, we answer three questions (1) Do consumers and employers want blended care? (2) Do providers want blended care? (3) How can providers and payers offer blended care at-scale?

Do consumers and employers want blended care options like virtual, in-office, at-home, and asynchronous?

Various surveys over the past year indicate that patients have been very satisfied with virtual care/telemedicine, and many want these options to stay and expand.

  • A Press Ganey survey demonstrated that telemedicine can achieve similar patient experience ratings as face-to-face visits. And, of those visits, 70 percent involved full or mixed virtual medicine, combining video, in-person, telephone, email, or text.
  • The J.D. Power U.S. Telehealth Satisfaction Study found that virtual care scored 860 on a 1,000-point scale, soaring over years past.
  • Nearly 75 percent of patients, who had accessed their first-ever telehealth visit during the first wave of the COVID-19 pandemic, also reported high patient satisfaction with the experience.

Consumers seem ready to embrace blended care.

  • A recent survey found that patients are more likely satisfied with a combination of in-person care and other methods for communicating with healthcare professionals. Satisfaction rates are high for communication channels like video, phone, text and email, combined with in-person visits.
  • In 2020, over 60 percent of patients said that they want to use technology more for communicating with healthcare providers and managing their conditions in the future.
  • In that same survey, 90 percent of those patients who used a new device or app rated the experience good or excellent and want to continue to use them.
  • 47 percent said they received better, more personalized responses.
  • 41 percent received quicker responses using technology.
  • 40 percent said it was more convenient to access through new communications channels.

Employers are moving towards blended care.

  • 51 percent of employers will expand virtual care programs in 2021
  • 60 percent of employers who expanded virtual care options in 2020 said they plan to make the changes permanent
  • 80+ percent of employer health centers added or increased the use of virtual care options in place of in-person visits
  • 95 percent of large US Employers are covering telehealth, which is up from 56% in 2016.

Do providers want blended care options like telemedicine combined with in-office?

Providers have noted that virtual care gave them greater flexibility and improved care coordination throughout the pandemic. In fact, 95% of physicians reported a willingness to use telehealth.

And, critically important, physicians have been satisfied with adding virtual care to delivery channels.

  • 75+ percent said telehealth enabled them to provide quality care for COVID-19-related care, acute care, chronic disease management, hospital/emergency department follow-up, care coordination, preventative care, and mental/behavioral health.
  • 68 percent have increased motivation to integrate telehealth in their practices.
  • 55 percent experienced improved job satisfaction.
  • 80 percent said that telehealth improved the timeliness of care for their patients.

How can healthcare organizations offer blended care that consumers and clinicians want at-scale?

While many patients have high satisfaction with their virtual care/telemedicine experience in 2020, one survey reported that 52 percent of respondents said they faced at least one barrier to telehealth access like providers offering limited services, confusing technology requirements, or lack of awareness of cost.

Although substantial resources have been invested to better leverage telehealth, there is still a long way to go– today only 43% of consumers had adopted video-based telemedicine in 2020.

Lastly, despite consumer and physician satisfaction, surveys and others sources indicate opportunities to improve processes related to telemedicine/virtual care.

Areas for Improvement for Blended Care at Scale

A Harvard Business Review article, “Balancing Virtual and In-Person Health Care” suggested three areas for improvement:

  1. Practices will need to develop criteria to triage and schedule patients for in-person or virtual visits
  2. Once technical functionality is established, virtual care needs to be optimized to meet other core provider and patient needs
  3. Key performance indicators should be designed to assess the effectiveness of virtual care models

“Our success will depend on reducing the digital divide as much as we can, and making sure that these visits are provided equitably, particularly to patients with social determinants that can limit access to care.”

A survey conducted by Wakefield Research, uncovered two, key desires consumers had after their virtual care experiences:

  • Online appointment scheduling was suggested across several consumer surveys considering that during this first COVID-19 surge, only 30 percent of patients said they booked their telehealth visits online.
  • Virtual post-discharge and follow-up plans reflected in fewer than 50 percent of respondents felt they understood the next steps in their care after a telehealth visit.

Developing rapport and trust between physician and patient was also a indicated as a concern. One report suggested ways for providers to enhance the patient experience during virtual visits:

  • “Be genuine and conscious of the warmth conveyed during the opening and closing of each session. Confirm that the patient can hear and see you clearly and avoid interruptions.”
  • “Set an agenda at the outset. Identify and confirm the patient’s priorities and communicate how they will be addressed.”
  • “Consistently convey empathy through language. Deliberately check in about patients’ worries or concerns throughout the visit and especially at the end of the session.”
  • “Bring structure to officially closing out the session. Summarize the post-visit plan, reinforcing patient and provider actions. Review questions and answers. Offer instructions for follow-up concerns.”

Despite concerns around trust, patients’ top five concerns are reflected in J.D. Power’s 2020 Telehealth Satisfaction Study, placing quality and outcomes over convenience or ease of use:

  1. Spend enough time to provide quality care
  2. Completely resolve medical concern(s) on visit
  3. Follow up after visit
  4. Online: Question/problem is resolved on first contact
  5. Phone: Question/problem is resolved on first contact

“The second five KPIs, according to J.D. Power, are used by fewer than two-thirds of survey respondents…”

  1. Consultation: Treat me with courtesy and respect
  2. Consultation: Listen carefully
  3. Consultation: Explain things clearly
  4. Consultation: Cost-effective for the service I receive
  5. Consultation: Gave easy-to-understand information on health questions or concerns

Blended Care is the Healthcare Imperative

Analysis suggests that, for many specialties, at least 50 percent of appointments and care could move to virtual modalities, including video visits, asynchronous communication, and remote monitoring. A blended care model holds promise for risk-based care, specialty care, chronic care, disease management, as well as primary and routine care. Key will be creating a frictionless, integrated, and data-driven patient journey and provider workflow built upon robust technology, scalable operations, and a shift in professional training.

Our Healthcare Services team is experienced in equipping teams with the right technology and tools while establishing optimized processes and data-driven performance management.

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