It took a few years and a pandemic for the concept of “telehealth” to evolve into comprehensive digital pathways for the delivery of patient care. From initial contact to triage, consults with physicians and specialists, and even diagnosis and monitoring with digital devices, integrated health care delivery systems now offer these end-to-end journeys.
An in-depth look at how integrated multispecialty medical groups and systems have charted and built true virtual care pathways was presented at the World Health Care Congress June 8 – 10 event, in “Virtual Care: Furthering Consumer-Centric Health Care Transformation.”
“Our goal in deepening and expanding our digital patient care pathways is to create value for all of the Quadruple Aim goals: better quality health outcomes, affordability, customer experience and clinician experience,” says Courtney Stevens, Director of Virtual Care for Henry Ford Health System, Detroit, Michigan, who presented on the health system’s telemedicine experience during the pandemic. “We are better able to deliver proactive care when people need it, increase touchpoints, lower costs, and simplify interactions for both patients and providers with a deeply integrated, end-to-end digital delivery option. We can attract, engage and retain customers by providing an exceptional digital experience that allows them to engage with our health system where, when and how they prefer.”
Henry Ford’s goal to provide 1.5% of outpatient visits virtually in 2020 exploded exponentially due to the pandemic; in all 10% of total outpatient visits were virtual in that year. Fortunately, staff had been engaged in building its digital capabilities for 10 years, and already had in place a strategic plan, standards and supports, and communication tactics to gain customer engagement and train providers in this new delivery modality.
In 2020 alone, HFHS implemented more than 160 virtual program implementations and expansions, adding video post-operative visits, group video sessions, multispecialty video visits, and comprehensive video exams conducted with digitally enabled devices to support a sub-set of physical exam components in real time. The latter capability also enables video exams in the worksite, in schools and in the home, as well as post-discharge evaluations by mobile paramedics.
What is the patient experience with digital care delivery? According to Henry Ford surveys, three out of four patients rated their experience as “very good,” with 16% rating it as “good.” The major barrier to video-visit use was the preference to see the doctor in person, which was voiced by three out of four patients surveyed. Other barriers given were lack of comfort with the technology (16%); video visits did not meet the patient’s specific health care needs (14%); it was confusing (8%); and the initial trial didn’t work well (7%). More than half (56%) have not experienced any problems with video visits. Of the problems cited, connection issues were the most common (17%). Younger patients were more likely to use digital options than older adults, with about a 10-percentage point difference in “likelihood of future use” between 25- to 44-year-olds and those 65 and older.
Ongoing challenges to maintaining and refining the digital care delivery system include constantly upgrading technology, protecting privacy, training the care team, and overcoming the digital divide among patients that exists due to various degrees of digital literacy, accessibility, compatibility, and technology support.
Henry Ford is targeting a 15% annual average for digital care delivery in 2021 with a 77% satisfaction rating. Other goals include identifying “telehealth-eligible” encounters by service line and accelerated development of the digital “front door” that guides patients on their initial contacts with the health system.
Finally, the presentation noted that the keys to success in a digital system’s delivery should drive value in five key areas:
– Enhances care coordination
– Expands consumer and clinical access
– Improves clinical outcomes
– Improves efficiency
– Enhances consumer experience
Henry Ford is a member of the Council of Accountable Physician Practices (CAPP), a coalition of leading multispecialty medical and health systems involving more than 30 organizations and 80,000 physicians. To learn more about the pioneering work of these organizations to foster integrated, connected and coordinated health care delivery, read the blog “CAPP Cites Six Key Findings from COVID-19 That Will Improve America’s Health Care System”.
About the Council of Accountable Physician Practices
The Council of Accountable Physician Practices (CAPP), an affiliate of the AMGA Foundation, is a coalition of visionary medical group and health system leaders. We believe that physicians working together, backed by integrated services, systems and data and technology, can best shape and guide the way care is delivered so that the welfare of the patient is always the primary focus. www.accountablecaredoctors.org