From ZOOM to Zip! Supercharging your virtual care program

By: Mike Rhoades, CEO

As of this writing, the U.S. has more than 800,000 COVID 19 cases with 44,000+ deaths and trillions of dollars in economic losses.  Despite this, our job as executives is to find the silver linings of opportunity in a sea of despair. Ready or not, the virtualization of care will be a brass ring for those bold enough to grasp it early.

In my spare time, I teach Health Information Technology at the University of Texas to health executives pursuing their MBA/MHA.  After class one day, I joined a fellow professor for a drink and was slightly annoyed that he continuously checked his smartphone while we conversed.  Exasperated, I asked him if he needed to attend to the “siren’s call” of his smartphone.  Apologetic, he explained that he was actually conducting an asynchronous class, a lab to be precise, where his students were working on a case study in which they sent the professor questions via a chat function.  The app they all used included the case study, key questions and a field for responses, tracking of team communications (showing your work), hints that unlocked as questions were answered, and timers.

Once I got over my frustration with the distraction, I admired the brutal efficiency of this new mode of teaching.  While foreign to my traditional “lecture and test” style of educating, I had to admit that his students were likely more actively engaged than mine, and attaining knowledge with progressive efforts for better retention. The app “gamified” learning while simultaneously acting as a force magnifier for the professor.  You see, he was not only managing one asynchronous virtual class..he was managing three!

Now, apply this concept to our industry, which is moribund to traditional office-based therapies scheduled on the hour (with 10 minutes to document, potty, and transition to a new patient!).  Facilities, administration, marketing, recruitment, and operating systems are wrapped around this familiar mode of care.  Imagine, however, that a new patient visits an office for the first face-to-face visit with their care team leader, who follows a script to ensure the patient has a connected device and that virtual health apps and tools are downloaded and functioning.  The care team leader (who could be a clinician or a care manager) then helps the patient construct a care plan and schedules a 15-minute virtual session between the patient and their integrated care team (including behavioral health, primary care, and other applicable specialties). The care team leader empowers the patient to present their care plan to their integrated care team and then schedules the follow up visits (most of which may be virtual).  Much of the care going forward is now virtual, with periodic F2F sessions based on the risk of the patient for an adverse outcome.

Speaking of risk, the virtual health program deployed by the integrated care team includes asynchronous tools that conduct regular pre-scheduled automated screenings and check-ins with patients. This could include formal tools like a PHQ-9 or GAD-7 and/or a simple “How are you feeling today on a scale of 1-5?”  While seemingly innocuous, the data gathered from these check-ins provide patient-level baseline and trending.  When benchmarked to other patients with similar conditions at a similar stage in treatment, the virtual health tools can easily alert adverse trending and risk to the care team leader for immediate outreach or even to schedule a F2F visit.  Operationally, the virtual integrated care team can manage two to three times the volume of a traditional clinic to the same effective outcomes. In this model, the virtual health technology is blended with F2F to extend the impact and effectiveness of the care team.

Since primary care is now being forced into virtual models (Blaze Advisors is hearing that as many as 30-40 percent of primary care clinics may consolidate to virtual models in 2020 – 21), a window has opened to invite new partners into your integrated care team.