Enabling Virtual Care: Forms, Appointments, and More

In recent months healthcare leaders’ perception of telehealth has shifted. It seems that the realization finally hit that this form of care delivery is definitely “here to stay” and that a healthcare organization ought to do something about it, if they wanted to stay competitive — and give their patients what they want most: convenient access to high-quality care.

What’s important to realize at this point is that telehealth (a.k.a. virtual care) is so much more than “telephonic” care or even video visits.

To truly deliver “care at a distance” (our definition of “telehealth”) care teams must offer more than just a replacement of the “in person” conversation. To truly deliver care virtually, healthcare organizations must recreate the complete care experience (and more!) to make this an efficient and effective way to practice medicine.

Beyond the Visit

Telehealth is about “Delivering Care at a Distance” with Telemedicine as a subset of telehealth being focused on “Practicing Medicine at a Distance” , i.e., the interactions between clinicians and patients.

While there are multiple modalities to interact with patients (such as these 9 ways to deliver extraordinary care), today, we’ll venture “beyond the visit”. There’s this whole other world of activities that happen before a visit, after a visit, and in between visits. Here are just a few of these activities:

• Patients must complete administrative forms (such as consent) and complete clinical assessments (such as depression screening).
• Clinics prefer to collect co-pays and payments prior to the visit.
• Patients prefer to schedule appointments and appreciate personalized reminders.
• Some patients may want to share clinical data and studies from other providers – or share their data from their health and wellness tracking apps.
• Patients would like to learn more about their diagnosis or their treatment – preferably from a source endorsed and provided by their physician.
• Patients would like to access their test results, the physician notes, their immunization records and other clinical data in a self-serve fashion.
• etc.

But beyond these administrative and logistical challenges, there are even greater opportunities to leverage the new world of virtual care to improve health outcomes.

Participatory Wellness “At a Distance”

Getting patients to actively and properly participate in their care has long been the “holy grail” of healthcare, especially in the treatment of so-called “lifestyle diseases” which are caused by or exacerbated by the patient’s style of life — sleep, food, stress, exercise.

In the 1990s and before there was mostly talk of “patient compliance” (or the lack thereof) and patient’s “adherence” to the protocols set forth by the doctor. Over the past decades this slowly evolved into a focus on patient engagement and, most recently, into participatory medicine, involving patients into the care management decision making process.

In the traditional care model centered around in-person care interactions between clinicians and patients were limited to pre-scheduled, periodic appointments that required patients to travel to the doctor.

Fortunately the virtual care model — or “care at a distance” model — provides many more communication options for more frequent interactions, facilitated by the “telecommunications technology” (a term frequently used by the governmental definitions of telehealth).

A strong contributor to good patient engagement is the strength of the relationship of patients with their doctor. As human beings, we build trusting relationships over time and through multiple interactions.

Since virtual care does not require the logistical overhead of patients having to come into the office, the technology offers numerous ways to elegantly “be in touch” with patients – from brief “live” interactions, to asynchronous messaging, pre-recorded video messages, review of remotely measured vital signs, electronic links to more information, etc.

Convenience: The Vitamin C of life in the 21st Century

But patient engagement is also about convenience. The ubiquitous availability of technology that brought us SmartPhones, same-day deliveries, online trading, online travel booking, electronic books, streaming movies, etc. have accustomed us patients to even more “instant gratification” that we’d like to experience in healthcare as well.

If it is too cumbersome for patients to jump through the hoops that healthcare (currently) requires, it’s much easier to just “give up”, especially if the patient’s condition is not that severe (yet).

If as a patient I need to create another account, remember another password, give my date of birth for the umpteenth time, it’s easy to get frustrated and overwhelmed. E.g., virtually no physician has ever tried to create an account on their EHR’s patient portal to experience what patients have to go through.

Under these conditions — oftentimes created by poorly designed and poorly implemented technology — patients seize to engage between visits and the relationship can get lost.

The biggest threat, however, are the new players that offer a convenient, easy care experience, though they also often do not address the more complex conditions. But many patients do not know that or, in the moment of clinical need, do not care, and they will choose the more convenient option over what may be the better, more high-quality option.

But “traditional” care providers don’t have to throw in the towel quite yet. Beyond the design of smooth virtual care workflows that create a great user experience for patients and physicians alike, the selection of the right tool to deliver extraordinary virtual care can make all the difference.

Virtual Care Point Solutions are Precision Tools

Today’s “virtual care” point solutions can help significantly in the delivery of extraordinary virtual care. There are now numerous virtual care point solutions readily available that are specifically and carefully designed to create an extraordinarily positive experience for patients and clinicians.

To point to the noisy elephant in the room, unfortunately, most EHRs have not been designed for that extraordinary patient or physician user experience, especially when it comes to “delivering care at a distance”. For most EHRs, the addition of telehealth was an afterthought, a haphazard response to the Covid-19 health crisis. Video chat features were quickly added to satisfy the requests for telehealth functionality within the EHR.

EHRs were originally designed (and are still relentlessly optimized) to provide accurate and especially comprehensive billing support to maximize billability of patient care. The primary stakeholder is thus the CFO, not the CMO, the CNO, or the Chief Patient Experience Officer (which many organizations don’t yet have, anyway).

Over time — much at the behest of Health IT leaders who prefer not to deal with yet another vendor, yet another integration and yet another implementation project — the EHR has grown from a point solution (maximize billing) to an all-around tool that can do many things, though not necessarily all of them well.

On the other end of the spectrum are point solutions, focused on doing a few things extremely well, especially to provide a great patient experience and to provide a great experience for the clinicians.

These companies were there before Covid made telehealth a household name. They have worked for years on optimizing their solution to facilitate the provision of excellent care via video, or through remote physiological monitoring. They’ve been designed with the input of many clinicians who thought of better ways to serve and to engage their patients.

One such company started with a focus on video-telemedicine and over time, based on the feedback from early adopters, now offers a suite of features that make it super easy for patients to engage with their doctor and vice versa. From intake forms and co-pay collection to appointment scheduling and appointment reminders all the way to supporting the design of customizable workflows to fully mirror the in-person care experience.

Another company started in the world of patient engagement decades ago and now seamlessly added telehealth functionality into its suite of features.

Optimizing Virtual Care Beyond the Visit

The first step that healthcare organizations must undertake is to create a clear vision in their mind of what they would like the patient and the physician experience to be when it comes to virtual care.

This is followed by an analysis of the current workflows for inpatient care as well the current practices for virtual care: “What’s working well? Where are the gaps? What needs to be fixed? What should be retained? What should the future workflows look like?”

Armed with this knowledge, teams can now intelligently and educatedly evaluate a variety of technical solutions to select those that can support their vision of smooth, delightful, efficient, and effective virtual care: “Where is our current technology serving us well and where does it create unacceptable barriers? What other solutions are available that can help us with virtual care, with patient engagement, with extraordinary care delivery?”

Once the workflows and most-suitable technologies are implemented you can now serve your patients conveniently “at a distance”, increasing the chances for a high degree of patient engagement leading to better outcomes, lower cost, and a high degree of patient and clinician satisfaction — which happens to be definition of healthcare’s quadruple aim.

Would you like to talk through what it would take to create a vision, analyze your workflows or which vendors you should consider, you can schedule a brief video chat with Christian.