Virtual care that works

How to get convenient, high-quality, and coordinated care


June 21, 2021

Population Health Team at Embright 


Virtual healthcare, telemedicine, or telehealth, catapulted in popularity over the last year due to the COVID-19 pandemic. This dramatic increase in utilization was because in-person simply was not an option for acute medical needs. Before the pandemic, adoption was low and remained low for years... why? And, has the pandemic forever changed how people receive medical care? 

Incentive alignment for providers and patients

Providers have lacked the infrastructure and incentive to develop reliable, accessible virtual care options for their patients. Patients shied away from virtual care due to a variety of reasons, including technology inefficiencies and availability. All that has now changed. 

With the urgent need to provide care safely to patients, the Centers for Medicare and Medicaid Services (CMS) used its waiver authority to establish payment parity for in-person, video, and audio-only care visits 1. This allowed providers to charge equal rates for all types of aforementioned visits. This change made virtual healthcare a viable care delivery model for medical practices 2. With this payment change and the growing demand from providers and patients, Silicon Valley came calling. Venture capitalists (VCs) began investing in start-ups spinning up virtual healthcare platforms as the demand continued across the country and the world. 

So many options --- too many options? 

Now, there are hundreds of virtual healthcare or telehealth companies in the United States alone. Becker's Hospital Review published an article in September 2021 titled 260+ telehealth companies to know | 2020 3. That is a lot of new options in the market. The new telehealth "wild west" continues to grow to this day as there are predictions that virtual healthcare or telehealth will stay as a viable option for the long term. 

Many of these new virtual healthcare options tout features including great member experiences and clinical efficacy. Yet, these new, VC-backed technology companies have little to no experience in delivering care to patients. Begging the question - what is the quality of care being delivered? With so many options in the market, you could spend your entire planning cycle simply evaluating virtual healthcare options quality, cost, experience, appropriateness, coordination, implementation, etc. for your employee population. 

Proven health systems adopting new technology or technology driving healthcare delivery? 

Delivering quality, coordinated healthcare is complicated. Great virtual healthcare must consider the following: 

  • quality
  • appropriateness
  • coordination
  • cost

This same list applies to quality healthcare overall. Health systems and physicians across the country have worked on ensuring quality, appropriateness, coordination, and costs are embedded in the way care is delivered to all patients for decades. In this virtual healthcare boom, why wouldn't employers look to trusted health systems to enhance their virtual care options rather than technology companies who are diving into medical care delivery for the first time? Many patients want to see their normal doctor in a virtual setting, and this is possible when a health system leads the effort to add quality virtual healthcare options to their service offerings. One great example of this is MultiCare Health System's Indigo Urgent Care 4. MultiCare designed this application from the ground up in 2016. Members using MultiCare's Indigo virtual care application combines the convenience of an easy-to-navigate platform with quality, local, and vetted clinicians. The care provided is integrated and coordinated with the rest of the member's medical care, and the virtual visit can be with a member's existing provider. 

Clinically integrated networks and virtual care 

You may be asking, how does a clinically integrated network (CIN), like Embright for example, fit in with virtual healthcare? MultiCare Health System is part of Embright's clinically integrated network along with UW Medicine and LifePoint Health. Embright members have access to virtual healthcare like MultiCare's Indigo virtual care and UW Medicine's eConsults. eConsults is embedded in every electronic medical record (EMR) allowing primary care providers (PCP) to confer with specialists and provide personalized treatment plans. These technologies funnel the member's visits, treatment plans, history, etc. into a single source powered by Embright. Embright collects and coordinates the member's data across all the health systems part of its network. 

When a member's  holistic record is available to the providers delivering care, it allows quality, appropriate, coordinated care to occur at a reasonable cost. 

Virtual Care Evaluation Checklist 

Types

  1. Does the technology support video calls?
  2. Does the technology support audio-only calls?
  3. Does the technology support text message?
  4. Is the service available 24/7?
  5. What medical specialties are available to members? 

Quality

  1. How are the clinicians vetted? 
  2. Where are the clinicians located? 

Appropriateness

  1. How are the clinicians trained?
  2. What guidelines are in place to ensure appropriate care is delivered?

Coordination

  1. Can a member choose to communicate with their existing doctor/provider? 
  2. Will the virtual visit be coordinated/integrated with the member's current health record?

Cost

  1. What is the implementation/setup  and maintenance costs?  
  2. Are there additional costs?
  3. How is my organization billed ? 

Implementation

  1. How long is the implementation process? 
  2. Do I have the necessary staff to evaluate and implement this program?

1 - MedPAC to Congress: Change MA Benchmarks, Slow Down on APMs. https://www.ajmc.com/view/medpac-change-ma-benchmarks-slow-down-on-apms 

2- Understanding The Case For Telehealth Payment Parity. https://www.healthaffairs.org/do/10.1377/hblog20210503.625394/full/ 

3 - 260 Telehealth Companies to Know. https://www.beckershospitalreview.com/lists/260-telehealth-companies-to-know-2020.html 

4 - Indigo Online Care. https://www.indigourgentcare.com/onlinecare