Virtual care: primed to solve healthcare’s cost and quality challenges
Brian Jack, MD, professor and chair of the Department of Family Medicine at Boston University School of Medicine and Boston Medical Center, discusses how virtual health can support clinicians by providing solutions in the home.
As the population ages, the demand for clinical care is rising rapidly. At the same time, the healthcare industry is dealing with a shortage of physicians and nurses. It’s a difficult equation, at best.
“How can healthcare organizations provide the right clinical resources to a larger patient population while maintaining or improving the quality of care? It’s not easy to bend the cost curve when there are so many challenges in the healthcare delivery environment,” said Tom Foley, director, global health solutions strategy at LenovoHealth.
Thought leaders gathered at The Health Innovation Think Tank, Adoption and Policy at a Crossroads, held at the UPMC Center for Connected Medicine in Pittsburgh on October 10th, pointed to the fact that virtual care just might be the factor that can help to solve healthcare’s current conundrum. Co-hosted by Lenovo Health, Justin Barnes Advisors, Center for Connected Medicine (CCM), Inventiv Health and HIMSS Media, the event brought some 50 healthcare delivery system, payer organization and healthcare IT vendor thought leaders together to offer their insights on myriad industry issues.
Indeed, virtual health solutions can help to extend provider’s reach and close the care gap that is currently making it difficult to meet value-based care’s call to improve outcomes while simultaneously reducing costs. For example, as part of its Re-engineered Discharge (RED) program, Boston Medical Center is using “Louise,” a virtual patient advocate to deliver discharge instructions and education at the bedside. Louise communicates directly with patients, teaching them about components of their care, such as their prescribed medications, follow-up appointments and diagnoses.
“We know that nurses don’t really want or have a lot of time to do patient discharge,” said Brian Jack, MD, professor and chair of the Department of Family Medicine at Boston University School of Medicine and Boston Medical Center. Yet, properly conducting thorough patient discharge sessions can significantly help to improve quality and reduce costs. In fact, some 20 percent of patients experience post-discharge adverse events and about 20 percent of Medicare patients are readmitted to the hospital, according to Jack. A virtual solution could help providers offer a better discharge experience and, in turn, improve quality and reduce costs.
“Peter Drucker would have said that this is an enormous problem with billions of dollars on the table and the solution is to just teach the patients what to do when they come home from the hospital,” he pointed out. Through the RED program, Boston Medical is doing just that and, as a result, has experienced a 20-percent reduction in readmissions and 25-percent reduction in emergency department (ED) visits, according to Jack.
Considering the fact that 75 percent of homes are expected to have smart speakers by 2020, the potential for virtual solutions to close the care gap in a variety of scenarios is great, according to Bill Rogers, CEO of Orbita. Because everyone is accustomed to using voice, virtual assistants can engage patients in a natural way and “lower the friction” when used to teach patients about diseases such as diabetes; act as a personal assistant to help patients book appointments or record symptoms; or serve as a lifestyle coach to help people track fitness goals and stick to diet plans, Rogers said.
While virtual solutions can be used in many ways, Sylvan Waller, MD, principal at Waller MD, pointed out that healthcare organizations must rely on virtual care and telehealth best practices that “have been developed over the past 30 years. This is not just an overnight success,” he said.
For example, telehealth solutions work best when they are integrated into the “fabric of care delivery,” not when they are used as a stand-alone solution. In addition, organizations must implement change management programs that secure the physician and care team buy-in needed to support virtual health initiatives.
While interest in virtual care is on the rise and its potential is great, Jack suggested that more widespread adoption might not be realized until value-based care actually becomes the dominant payment model. In fact, despite the fact that value-based care is gaining ground, many health organizations are still operating under predominantly fee-for-service models. As such, Jack noted, some leaders want to learn how to use virtual technologies to improve care and reduce readmissions but don’t want to “actually flip the switch” until they have stronger value-based incentives to do so.
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