Virtual care strategies for primary care

The trend toward telehealth during COVID-19 is expected to continue after the pandemic is over. Patients and providers are making appropriate adjustments and are accepting this alternative method of healthcare delivery as a safe and effective way to provide quality care. Some virtual care strategies for primary care practices include a shift in a digital-ready mindset as well as restructured communications strategies.

Research conducted by Gallup before and during the pandemic shows a significant increase in virtual care, both in terms of usage and preferences. In 2019, a survey of more than 30,000 people in the US showed that only 14% had used telemedicine in the past year. 17% anticipated that they would use telehealth in 2020. A similar survey conducted in March 2020 showed a significant increase, with 34% of people in the US having used telemedicine and 46% saying they would be likely to use it in the future.

Healthcare providers have also tracked data that has reinforced the trend. One example has been Cleveland Clinic, which had anticipated over 60,000 telemedicine visits in March 2020, compared to an average of 3,400 virtual care sessions each month before the start of the pandemic.

Patients who are starting to use telehealth in greater numbers are doing so because of the convenient access and because of the value they see in virtual care. Gallup also found that people who use telehealth are more than 1.3 times more likely to rate the overall quality of their virtual healthcare as “excellent,” over those who had not experienced telehealth.

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How can primary care physicians put in place and maintain virtual care strategies beyond the pandemic? COVID-19 has required that providers rethink their care models to ensure the health and safety of their patients as well as their clinical staff. Virtual care must adapt to meet the capacity and needs of diverse patient populations. Of particular need are those patients with chronic conditions, who make up about 60% of Americans, and those underserved and in rural areas.

Fortunately, many of the barriers to accessing virtual care have been suspended or removed, including alleviating some HIPAA rules and increasing reimbursement parameters for telehealth services. However, managing patient populations remotely will require the primary care physician to:

  • Communicate virtually with patients and with the entire health team
  • Create appropriate staffing models
  • Conduct outreach and protection for vulnerable populations
  • Conduct telehealth visits using technology that can be accessed by patients
  • Integrate behavioral health as an added value, especially during times of crisis
  • Humanize the digital experience, continuing to nurture the patient-physician relationship through appropriate communications channels.

The Centers for Disease Control and Prevention (CDC) recommends additional virtual care strategies to increase the primary care practice’s telehealth uptake:

  • Promote and optimize the use of telehealth services for the safety of healthcare personnel and patients while using the Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care to determine when in-person care is appropriate. Include options for language interpretation, as needed.
  • Communicate with insurers and payers to understand availability of covered telehealth, telemedicine, or nurse advice line services.
  • Use tele-triage methods for assessing and caring for all patients to decrease the volume of persons seeking care in facilities, especially during times of high transmission of contagious diseases such as COVID-19.
  • Provide outreach to patients with limited technology and connectivity and offer flexibility in platforms that can be used for video consultation, or non-video options, when possible.