A view from the Center

Deloitte's Life Sciences & Health Care Blog

Once a vision for the future, virtual health is a reality of the present

Virtual health stretches beyond the use of digital tools, or mobile devices that connect patients to physicians. It combines digital and telecommunication technologies to create a continuous connection between patients, physicians, and other caregivers. By combining technologies, health care stakeholders are able to more effectively coordinate patient care.

The idea of virtual health goes back decades. So why now? I think there are several reasons. First, technology has finally caught up with our vision for the future. Secondly, consumer expectations are higher, and demands for improved convenience and availability have increased. At the same time, many of the financial, behavioral, and policy barriers that have hindered adoption are starting to crumble.

As the health care sector transitions from a volume-based fee-for-service model to one that rewards value, virtual health could have a significant return on investment. For hospitals, physicians, and other caregivers, virtual health could enhance the ability to improve care, outcomes, convenience, and patient engagement while reducing costs.

Four reasons the time has arrived for virtual health

There is clearly tremendous interest in this topic. Here are four reasons I think the time has come for virtual health:

  1. Improved technology: Internet speed and connectivity are light years beyond where they were a few years ago. In addition, most everyone seems to have a smartphone within arm’s reach at all times (maybe not always a good thing!). Flip phones and dial-up have given way to smart devices (with exceptional camera lenses). Better technology has helped make telehealth more user-friendly and accessible for patients and providers. More than 90 percent of American adults use the internet,1 which means physicians have the ability to answer non-urgent questions from patients online. In addition, the vendor landscape has broadened significantly, and interoperability continues to improve. Patients, health systems, doctors, and health plans can connect with each other through a variety of devices.
  2. Evolving state laws: Over the past several years, some state laws have been modified to allow wider use of telehealth. Until recently, for example, some states did not allow providers to write prescriptions after a telehealth visit. Other laws required physicians to meet first with patients in person before telehealth visits were allowed. At least 34 states now have laws that require coverage for telehealth services.2
  3. More covered services: A growing number of state laws require commercial health plans and Medicaid to cover certain services through telehealth. Medicaid programs in 49 states and the District of Columbia now offer some telehealth coverage.3 A growing number of private health plans now pay for telehealth visits. As of 2016, 74 percent of large employer-sponsored plans had incorporated telehealth into their benefits (up from 48 percent in 2015).4
  4. Payment parity: Several states have enacted laws that require health plans to put payments for telehealth visits on par with face-to-face visits. At least 23 states and the District of Columbia now require full parity.5 Some states are exploring legislation that would let physicians use telehealth to meet with patients in other states. At least 18 states have enacted a compact streamlining licensing.6

We still have hurdles to overcome. Before the industry can fully benefit from virtual health, our care-delivery and payment models likely need to change (see Deloitte’s report, Realizing the potential of telehealth). This includes governance, workflow, training, and development. We also have to convince people to try it.

The vast majority of people (74 percent) say they are willing to try telehealth visits, according to the American Hospital Association.7 However, just over 20 percent have taken that first step and had a virtual visit. While most people are willing to try telehealth, it might not yet be offered by their physician. (While 26 percent of group practices offer a telehealth option, another 15 percent intend to start this year.)8 Or, patients might not be aware that it is available. In a 2016 Deloitte survey of health care consumers, most of the interest in telehealth was related to post-surgical care and chronic-disease monitoring.

Here are three areas where I think virtual health could improve the value of health care:

  • Outcomes: Virtual health led to a 15 percent reduction in length of patient stays, and improved the experience of chronically ill patients, and remote monitoring of patients once they leave the hospital can cut readmission rates.9 It is estimated that $7 billion a year (average of $126 per visit) would be saved if annual face-to-face doctor visits moved to virtual visits.10
  • Access: There are now about 200 telemedicine networks and 3,500 service sites in the US, according to the American Telemedicine Association. Adoption of virtual health could extend the reach of physicians and other care providers, and improve convenience for patients. Getting into a car and driving to see a doctor can be a burden for patients. Improving convenience and keeping patients out of waiting rooms can translate to a better patient experience.
  • Adherence: Virtual health can help improve medication adherence, health tracking, and patient accountability. It also can help patients better understand their treatment plans. Telehealth and remote monitoring can give physicians real-time insight into their patients’ health and medical data. For patients with chronic conditions, it can improve disease monitoring and alerts.

For virtual health to succeed, health systems should be thoughtful in how they integrate it. Many health care organizations have already implemented some type of virtual health. The organizations that can seamlessly integrate the technologies into their care delivery model—and create a fluid experience for patients whether care is virtual or in-person—can lead the way.

It is clear that virtual health is no longer just an idea. It is beginning to infiltrate hospitals and health systems, and patients, employers, and physicians are growing more comfortable with the idea. Virtual health, however, is in its infancy, and it is important that health systems have the right infrastructure and strategies in place as they move forward. To stay relevant, hospitals and health systems should prepare for this future, which seems to have already arrived.

1 Pew Research Center, 2018
2 Health Data Management, 2017
3 Health Affairs, 2016
4 https://www.medscape.com/viewarticle/849971
5 Health Affairs, 2016
6 Interstate Medical Licensure Compact, 2018
7 https://www.aha.org/system/files/research/reports/tw/15jan-tw-telehealth.pdf
8 https://www.hhnmag.com/articles/8350-telehealth-adoption-to-double-by-2018
9 The Wall Street Journal, 2016
10 http://www.healthcareitnews.com/blog/virtual-visits-cutting-healthcare-costs

Author bio

Steve serves as the National Health Care Providers Marketplace Leader & the National Advisory Leader. He leads a focused team who provide risk and regulatory, technology, and strategy & operations consulting services. During his career, Steve’s focus has been on operational improvement, specifically revenue cycle. He has led large transformational projects involving acute care hospitals, ambulatory operations, clinics and physician practices.