Electronic Health Reporter

By Sandeep Pulim, MD, chief medical officer, Bluesteam Health.

Telehealth, telemedicine, and virtual care are often used interchangeably to describe remote healthcare visits. But virtual care means something much more than just telehealth or telemedicine. In fact, virtual care is in a category all its own. It is the logical, necessary next step in providing access to healthcare for all.

Telemedicine is Evolving

Remote monitoring and telehealth are nothing new. For decades, doctors have been able to monitor patients remotely or provide medical consults over the phone. Anxious parents have called in to 24-7 nurse hotlines to get advice about childhood illnesses and accidents. More recently, with the advancement of smart phones and web cams, new business models were created to connect patients with doctors over the internet.

However, most people still preferred to visit their doctors in person, and most doctors and healthcare centers weren’t considering a major shift to video any time soon.

Then COVID hit. It accelerated peoples’ desire for virtual healthcare visits and helped them feel more comfortable using video conferencing technology. Zoom, FaceTime, Google Meet and Skype became the go-to solutions for clinics large and small that didn’t yet have telehealth in place.

Video conferencing did good things for healthcare:

• Prevented even higher rates of delayed care
• Enabled providers to triage patients from a distance
• Gave quarantined providers a way to treat patients remotely
• Kept more clinics open and providers working
• Improved access to care for more patients

And while these video conference technologies solved an immediate problem, they quickly showed their limitations. These bandage solutions solved one issue while encountering (and even creating) many more problems.

Rapid expansion of video conferencing for healthcare exposed its weaknesses from HIPAA compliance issues, non-secure connections, the inability to bring a third party onto the call, wasted time as patients and/or doctors wait for the other party to join, limited number of users, concurrent calls, and call minutes and even the limited length of calls. The pandemic accelerated everything, even the “bad habits” of telemedicine.

Some might say that the problems people faced with healthcare video conferencing set telemedicine back by limiting the expectation of telemedicine to its modality: tele-. Even the word telehealth implies that it is simply a means to an end: the virtual delivery of a single healthcare session, often with a focus of a specific number of sessions per day. The current expectation of telemedicine is that it is best suited for ambulatory care or outpatient care. But with the shift toward more value-based care, telehealth must shift to one that considers a more holistic approach to patient engagement beyond a single transaction.

That’s why we need to move the understanding of telemedicine forward again. Beyond video calls. Beyond ambulatory visits. Beyond seeing telemedicine as just another form of transactional care. To do this requires reframing our thinking and our vocabulary to talk about providing virtual care rather than telehealth or telemedicine. So what really is virtual care?

• Virtual Care Enables Value-Based Care: Clinics and healthcare organizations must shift from providing a limited style of telehealth that only focuses on a video visit or telephone call to providing a full-service virtual care model.

• Virtual Care Mirrors In-Person Workflows: A full-service virtual care model is possible when it uses an integrated, flexible platform that can mesh with established workflows. Technology shouldn’t get in the way of a successful virtual visit but should appear seamless for both patient and provider.

• Virtual Care Nurtures Patients Through the pre-encounter, the encounter and the post-encounter: This means that the physicians knows whether this patient should be seen virtually or in-person and makes the appointment easy for the patient to use and access, mirrors the in-person appointment and provides a consistent follow up by automating future visits.

• Virtual Care Strengthens the Patient-Doctor Relationship: We know that a strong patient-doctor relationship drives better outcomes. By moving from a single-use, transactional version of telemedicine and into a holistic virtual care model, patients can connect with known doctors. Providers can access patients’ health records before, during, and after their virtual care sessions. Clinicians can schedule the patient’s preventative and follow-up care, determining whether a virtual visit or in-person visit would best suit the patient at that time.

Advance from Video Conferencing or Telemedicine to Provide Virtual Care

It isn’t as hard as it may seem. In fact, many organizations have gone virtual in as little as two weeks. Those who want full EHR integration can even get online in about 6-8 weeks, depending on the complexity of the solution required.

Let’s move forward together. Let’s make virtual care accessible to everyone. And let’s provide real care that spans the care continuum to sustain and improve public health. To do this, we must continue to hold health care delivery systems and payers accountable for delivering health outcomes.

Virtual care is that way forward.