Where virtual care meets value-based care

Where virtual care meets value-based care Bill Siwicki

Gary Hamilton, CEO of patient engagement technology vendor InteliChart, believes three things about virtual care that, he says, deserve more attention:

• Telehealth services can offer healthcare providers the opportunity and capability to reach broader populations – and they can serve as disease prevention tools for these populations.
• Telemedicine tools can help ensure physicians and their care teams better manage patient care, and the associated workflow, to help their patients stay their healthiest.
• Telehealth, through improved patient engagement technology, can be the key to creating successful preventative care programs – ones that boost value-based care reimbursement models.

We spoke with Hamilton to discuss how telemedicine can relate directly to disease prevention, preventative care and value-based care.

Q: You say telemedicine can serve as a "disease prevention tool" via enhanced patient engagement. Please elaborate on this notion.

A. From a disease prevention perspective, the more people who have access to healthcare, the more people with chronic conditions are going to be well-managed, so that means more diseases can be prevented. Telehealth can help us reach a population of chronic-disease patients who simply don’t have adequate access to providers, for any number of reasons including cost, transportation and time.

Further, telehealth brings the potential to significantly increase access to care for rural patients, and patients experiencing social determinants of health issues. Telehealth enables patients to see providers at times that are more convenient for their own busy schedules and generally costs less than an in-person visit.

Increasing accessibility to care for patients represents the first step to managing chronic conditions. For many groups of patients, they only see their providers once a health issue arises, and that approach sometimes results in costly visits to the emergency department for these patients.

Additionally, telehealth brings the potential to promote greater health equity among underserved communities through broader access to care. Telehealth can serve as an ongoing access point to care for those in the beginning stages of chronic conditions.

Q: You suggest telehealth through improved patient engagement technology can be the key to creating successful preventative care programs. How so?

A. It is ultimately the provider’s responsibility to initiate interest and engagement from patients. So, when patient engagement is lacking, it’s because either the patient has not had adequate access to care or there has not been committed involvement from the patient. Either way, providers must get more innovative in their approaches to managing those patients.

If the provider can manage one group of patients digitally with automation in a way that they are engaged and can stay on track, the provider can focus more time on in-office visits for patients who need more human interaction. It’s about identifying opportunities for interventions that don’t need to be performed within the four walls of the organization.

In this respect, virtual providers are identifying additional opportunities for intervention that are teed up and supported by the communication, management and engagement that has occurred up to that point in time. Telehealth is what creates that opportunity in the first place.

Q: With these two angles in mind, how can telehealth fit into the importance of preventative care in value-based care reimbursement models?

A. As it relates to value-based care, there are a lot of opportunities to involve group settings where patients are being managed collectively and there are group discussions with providers. One example is group counseling for nutrition and diabetes management.

For someone who just received the diagnosis of diabetes, there is so much to unpack because the disease cannot simply be fixed with a pill. Medications may help, but patients generally still must make significant modifications to lifestyle, activity levels, weight management and diet. Additionally, there are numerous implications associated with diabetes, such as high cholesterol and other cardiovascular diseases.

People are patients for such a small component of their lives, in terms of face-to-face time with providers, so being able to manage people via telehealth on their own time in a way that is convenient for them can foster substantially greater engagement.

Taking a step outside the healthcare industry for a moment, if we look at the growing use and popularity of food services like Uber Eats, DoorDash and Instacart, that speaks to the lengths that people will go to for the simple factor of convenience. They no longer want to go to the restaurant; they want the restaurant to come to them.

Healthcare is no different. If we can’t come to patients in a way that is convenient for them, we are going to deal with the same access and engagement issues that we’ve historically seen. That means telehealth represents an amazing opportunity. If we can manage patients on the front side of their diagnoses, and continue that management longitudinally, it's going to have a significant impact on the escalation of patients’ chronic conditions and whether they're kept in check.

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