Lessons Learned in Virtual Care

By: Jill Lineberger, Senior Vice President

The shift to almost 100%  virtual care, or tele-health, happened quickly as the Coronavirus pandemic moved across our nation. Many care providers jumped in with a “let’s try everything and seeing what works” strategy. Now, with time and experience behind us, we can assess our progress and apply lessons learned to help continuously improve access, engagement and outcomes.

It’s also valuable to recognize that many of these virtual care steps can and should remain in place after the pandemic has passed, to help us better reach patients who may find it difficult – if not impossible – to attend in-person care sessions.

Here are a few lessons to consider.

Hang the welcome sign on your virtual front door by considering these approaches.

• Concierge services can help patients navigate virtual care. A virtual set-up checklist and decision aids help ensure patients and providers have all the tools they need for a successful virtual session. Remember virtual care, like in person care, is a continuum. For guidance, reference the Blaze tip sheets Patient Readiness Checklist and Virtual Health Patient Decision Aids.

• Broaden your net of influence. Rotate clinical staff to expand access hours. Deepen relationships with and provider much needed support to your community’s first responders by offering accelerated access appointments, brief on-scene telephonic care provider introductions and morning rounds collaboration. Support healthcare workers and partners by helping them explore opportunities for therapeutic decompression groups and staff resiliency programs.

• Consider systems for virtual bedside assessments. Remember that rapid activation is key, even while the patient is in an in-patient or ED setting. And don’t give up on open access; it to can go virtual. Make sure clinician schedules are visible and on-demand consults are quickly assigned. Establish a QA metric and monitor virtual access time. Ensure intake clinicians can activate treatment immediately by having access to therapeutic schedules for direct admission into basic sessions.

Look for ways to improve clinic efficiency.

• Transition low value tasks, such as vital sign collection, medication list collection and medical history collection, from prescribers to administrative or nursing staff. Examine clinic workflows and re-task to ensure all staff are working at the top of their license.

• Boost nursing pre-planning visits by leveraging a virtual nursing visit to complete medication reconciliation, collect medical history and prepare the patient for the appointment with the prescriber.

Offering a nurse advice line.

You can assist not only with medication questions and refills, but find ways to support when patients are unsure whether to visit their doctor, the urgent care or the ER. Encourage preventive care by promoting nursing consultation with your agency’s clinical team when working with patients in the field. During a time of medical uncertainty, real-time consultation can identify rising risks and prevent defaulting to a high level of care because the patient and staff did not know what else to do.

Connection and education are vital.

• Leverage all that technology offers. Mental health and substance use apps promote self-care and boost patient and caregiver support, and offer a number of advantages:

  An introduction to care: Apps may be a good first step for those new to care. Support can take place anytime, anywhere and at a self-guided pace.

  Low resource investment: Technology can help mental health providers offer support to many between therapeutic sessions by reinforcing new skills and providing support and monitoring. Some apps are free or cost less than traditional care.

  Appeal: Some find these apps appealing so are more engaged with the content outside of therapy sessions.

  Objective data collection: Technology can quantitatively collect information and assist with objective reporting of progress towards outcome (at a population and patient level) and remote patient monitoring.

Adjust your outcomes.

While some outcomes may still be the same – show rates, clinical improvements, etc. – you may want to consider other outcomes, such as patient engagement in apps and patient satisfaction. Elevating the patient experience and increasing engagement is the competitive norm. Be sure to include patient feedback in the virtual care offer. For additional guidance, see the Blaze tip sheet Tele-health Survey.

We will all live in a new normal after the current pandemic passes, so now is the time to look at what we’ve learned and how we can maximize care in the future.