Virtual health kept patients connected during COVID…where does it go from here?

By Jen Radin, MBA., MPH., principal and Eileen Radis, MBA., principal, Deloitte Consulting LLP

Virtual health was critical for helping patients stay connected to their physicians and care teams during the COVID-19 pandemic. But virtual health has the potential to be more than a substitute for in-person visits. It could help transform care delivery models, increase patient access, and drive better health outcomes.

Many of our clients are now trying to determine the next steps in their virtual health journey. Deloitte expects that the Future of Health^TM will be focused on well-being and prevention rather than treatment. Growth of virtual health could be a key factor in that future. Health care organizations that opt not to embrace virtual health could risk losing business to tech-savvy, consumer-centric organizations that are quickly moving into the health care space.

How can organizations embrace virtual health? Consider these four models

Virtual health visits have plateaued and even declined from last year’s spike as many patients now feel safer returning to medical facilities for in-person visits. And many clinicians prefer in-person visits due to the higher reimbursement rate. While certain medical procedures must take place in an exam room, payment models are evolving, and some routine care can easily be done remotely. Why would a parent drive their sick child to a doctor’s office for a common condition—such as pink-eye—that could be diagnosed during a video visit? 

In many cases, virtual health can help improve health care quality and access. It can reduce costs, improve patient satisfaction, and increase connectivity between clinicians and patients and their families. We have outlined four care-delivery models that health care organizations should consider as they look to solidify or expand their virtual health offerings:

1. Standalone virtual health services: These visits (e.g., video, call, chat, etc.) were a lifeline during the early months of the pandemic and are typically a substitute for in-person care. The most common virtual health services are for behavioral health, urgent care, primary care, and specialty care.¹ During the pandemic, many health care organizations increased their use of virtual visits out of necessity. This helped to improve access while also boosting patient satisfaction.² Technology investments tend to be low and usually require a minimal operating model because most of the day-to-day responsibilities for leaders, clinicians, and other employees stay the same. However, as organizations look to mature their care-delivery model, they will likely need to evolve and expand not just technology but also the maturity of their operations that enable virtual health services and capabilities.
2. Virtual-health programs: Some health care organizations are developing a virtually enhanced continuum of care for specific diseases, illnesses, or syndromes. Tele-stroke programs, for example, provide services for acute stroke patients in a variety of settings where there might not be access to on-site stroke physician services. Such settings might include mobile stroke units, emergency departments, intensive care units, and medical surgical units.³ Virtual-health programs can also help health care organizations improve access to care by limiting the need for in-person services. This can be particularly beneficial to rural patients who might not be able to travel to a medical facility. In addition, continuous patient monitoring can help health care organizations prevent complications and curtail long-term care costs. Health care organizations that want to develop or expand virtual-health programs should consider an operating-model transformation that focuses on clinical and operational capabilities. Additional investments in technology might be needed, and dedicated virtual health leaders will likely oversee these programs.
   
3. Virtual health center: This dedicated entity oversees all virtual clinical services and operations. The virtual health-support center identifies opportunities to incorporate virtual health and to transform care delivery across all clinical disciplines. During the pandemic, virtual health centers focused on ensuring safe, high-quality care for chronic and acute patients. Health care organizations interested in launching a virtual health center will likely need to develop a dedicated entity that includes operational and clinical capabilities. A comprehensive governance structure could help connect the appropriate decision-makers across the organization to ensure virtual health decisions are not made in a silo.
   
4. Integrated care delivery model: This model seamlessly integrates virtual and in-person care to provide comprehensive care to patients across different specialties. It allows clinicians and care teams to use continuous monitoring to focus on the patient’s health status and adherence to a care plan. Through the influx of real-time data and observation, clinicians and care teams can intervene early to address or prevent complications. This operating model is the most aspirational and future-facing, and few, if any, health care organizations have one in place. But that is likely to change. A transformed care delivery model that incorporates virtual health into its everyday care model will likely drive greater access to care, improve quality outcomes, and contain costs. This model will require a large transformation of the health care organization’s operating model and culture. New ways of working will likely need to be implemented with a focus on integrating processes, services, and experience for all clinical and operational roles. Continuous investments in technology will likely be needed to maintain the integrated care delivery model.

Decision framework overview

What key questions need to be answered as health care organizations assess their virtual health aspirations? Here’s a decision framework to determine which virtual health care delivery model is most feasible today and in the future. Consider these questions in each decision category:

Strategy

• How can virtual health help the organization deepen connectivity to the consumer?
• How can virtual health support the aspirations for clinicians?
• How is the payer environment evolving? Is the organization transitioning from a fee-for-service model to value-based care?
  
• How is the organization trying to improve access to care for specific populations?
  

Infrastructure/technology

• In what ways can existing technology and infrastructure investments be scaled to support future virtual health aspirations?
  
• Where can virtual health fit into the organization’s overall technology modernization effort?
  
• How mature are the organization’s current cloud and AI capabilities?
  
• What is the level of interoperability across the organization’s platforms?
  

Operational readiness

• How is the organization tracking metrics that can be used to evaluate the performance of leaders and business units?
• In what ways are existing processes and policies supporting virtual health?
  
• How will evolving federal and state regulations enable the organization’s care delivery?
  
• What organizational capabilities need to be built or changed given virtual health needs?
  

Workforce readiness

• How prepared is the organization’s clinical and administrative staff to deliver virtual health?
• Does the organization already have clinical and administrative virtual health leaders?
  
• How can the organization enable an innovation-focused culture?
  
• How will remote working options and virtual care delivery impact career paths and employee retention?
  

Financial

• How much money is the organization willing to invest in virtual health? 
• What is the potential profitability?
  
• How will virtual health help the organization achieve its margin targets?
  
• Are there long-term opportunities to commercialize virtual care?
  

As health care organizations look to solidify, streamline, or expand their virtual health capabilities, they should try to be decisive about their overall aspiration and existing capabilities. We expect the way organizations deliver care will continue to evolve. Organizations that take the time to design and implement the right care delivery model should be positioned to contain costs, drive quality, and enable access while enhancing patient satisfaction.  

Acknowledgements: Maureen Medlock, Urvi Shah, Kendell Anders, Sonal Purohit, Lissandra Ilcyn 

Endnotes:

1. Monthly Telehealth Regional Tracker, FairHealth, March 2021

2. Deloitte Study of Health Care Consumer Response to COVID-19, April 2020

3. American Telemedicine Association: Telestroke Guidelines, Telemedicine Journal and E-Health, May 2017

Return to the Health Forward home page to discover more insights from our leaders.