Contributed: Patients deserve virtual care that better integrates, and doesn’t compete with, in-person care

By Dr. Patrick Carroll

By now everyone knows that virtual care usage exploded over the last year, forging a new competitive era of telehealth. While more choice and greater access are generally good things for consumers in any industry (and this is also true for healthcare where patients, our “consumers,” have historically had neither) the growing virtual care market also has the potential to lead to a more fragmented experience.

This will only happen if virtual care entities do not integrate and coordinate patient care by working across the industry with brick-and-mortar and other traditional healthcare provider partners.

First, let me be clear: Americans still need much more care access, and telemedicine is helping to fill some of the many gaps people face today in seeking care. A recent survey found that more than half of U.S. adults have now tried telemedicine, yet a majority indicated they still face significant barriers, such as cost and broadband access –  problems that were more pronounced in minority and other underserved communities. 

Telemedicine is not a panacea for solving the U.S. healthcare shortage, but it certainly can help to reach more people, fill care gaps and add resources to the woefully overwhelmed healthcare system. Ultimately though, what patients also need from virtual care providers are more serious efforts to create increasingly sophisticated and coordinated integrations with brick-and-mortar healthcare partners.

While the relationship between virtual care platforms and traditional healthcare providers has been sometimes characterized as competitive or adversarial, judging the success of the telehealth revolution should be contingent on the success of these partnerships. 

While there are types of conditions that will always be better managed by in-person healthcare, virtual care providers are becoming more experienced at identifying health issues in patients who might not have physically visited a doctor in person otherwise. However, what good is that ability if that patient never follows up?

Many times the reason a patient lands on a virtual care provider’s doorstep is that they didn’t like the friction that seeing a provider in person can entail, including taking time off to get to an appointment and long waits to see a provider. So we shouldn’t expect a patient who prefers to see only a doctor conveniently from home to suddenly take the initiative to go to a healthcare provider in person because their virtual doctor recommended they do so.

For instance, consider a patient who sees a virtual care provider for sexual health. Part of that visit many times includes screening for cardiovascular health issues – screenings that this patient might not have ever gotten elsewhere. If a problem is detected, the patient is then frequently advised to seek specialty care in person.

But then what? We assume the patient that didn’t want the “hassle” of seeing a doctor in person suddenly is ready to jump through the hoops they’ve been avoiding? That patient deserves a virtual care provider that’s willing to forge community-level partnerships that identify and remove as many points of friction as possible. Otherwise, that patient is likely left with more health silos and fragmented care.

Clinical lab testing is another critical point between in-person and virtual care providers where patients deserve much better integration. A patient who can’t as easily make it to a doctor’s office might find the same issues with visiting a clinical testing location. So, virtual care providers likewise need to pursue ways to more deeply integrate with the testing industry to reduce patient pain points in seeking care.

Ironically, the COVID-19 pandemic did some good on this front, sparking incremental changes. In the early days of the pandemic, testing was a major problem, and many virtual care providers partnered with testing operations to bring COVID-19 screening into the home. These partnerships, born out of a national emergency, provided the “testing” grounds that have opened the door to greater – and smarter – telehealth opportunities.

If primary care medical professionals can consult with a patient online, order tests that are delivered to patients’ homes and monitor their progress with subsequent virtual visits, then virtual care is an effective modality for bringing down costs and reducing patient friction – all while still ensuring high-quality care. 

But, those providers still need integrations with brick-and-mortar healthcare providers who can take on more complex cases that may require in-person care.

Consider a regular virtual care patient with medication-managed diabetes who begins to present with increasing levels of lightheadedness and fatigue. While these are not uncommon side effects of some diabetes medications, a subsequent at-home blood test uncovers B12-deficiency anemia, which has been linked to long-term use of certain diabetes medications.

Even though both conditions – diabetes and B12 deficiency anemia – can technically be treated via telehealth as separate conditions, a virtual care provider may be able to recognize that the two could be linked – an instance that would likely cause the virtual care provider to recommend a specialist.

That’s where deep integrations between virtual care and traditional healthcare providers lead to better outcomes by creating a seamless transition for the patient and their data.

However, it shouldn’t stop there. We are entering a brave new world of possibilities as the remote patient monitoring technology market matures. A whole ecosystem of connected smart devices opens the door for virtual care providers to not only treat more conditions, but also work with health systems in communities across the nation to address population-level health.

Virtual care providers have the potential to bring more patients into the system – especially in harder-to-reach communities – and then, via partnerships with health systems and remote patient monitoring technologies, collectively work to bring more relevant care to patients.

As one expert pointed out, remote patient monitoring technologies enable a swifter migration to “truly personalized care,” and both virtual and brick-and-mortar providers should consider a strategy to leverage them in order to better serve patient populations.

Ultimately, it’s not just in the expansion of telehealth as a care-delivery modality where virtual care providers have the greatest opportunity to evolve. It’s also through the innovative partnerships they strike with traditional brick-and-mortar healthcare providers – integrations that ensure patients get easy access to comprehensive, integrated care.

While we’ve seen some of this already happen, which has led to greater care access overall, we’re only scratching the surface. Patients deserve more, better and deeper integrations between virtual and in-person care providers.

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