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Health systems: Here’s an enterprise-wide approach to virtual health

Some of the biggest thinkers and innovators in health care are in Orlando next week for the annual HIMSS19 Conference. Virtual health— a method of enabling continuous, connected care via digital and telecommunication technologies—is one topic that is certain to generate a lot of buzz during this year’s sessions. While virtual health certainly seems to be the hot topic du jour in health care, adoption rates still aren’t what they could be, according to our 2018 survey of US health care consumers and physicians.

Only 23 percent of surveyed consumers have had a virtual visit, but more than half (57 percent) of the others said they are willing to try it. On the physician side, only 14 percent have implemented virtual visits, and 44 percent have not implemented any of the seven virtual health technologies listed in the survey. A majority of physicians agreed that interoperability was essential for increased adoption. While adoption rates could be improved, physicians and consumers alike agree on the potential benefits: virtual health can improve access and offers greater convenience. Virtual health goes beyond simply enabling video visits. It has the capability to act as a complement or, in some applicable cases, a complete substitute for in-person care.

Questions to consider when building a virtual health strategy

As health systems begin to see these benefits of virtual health, they should define an enterprise-wide strategy before thinking about specific technologies and tools. This will help ensure that investments address short-term goals and allow for future scalability. Here are some questions that should be considered when defining a virtual health strategy:

  • What is the overarching objective?
  • Which areas of the health system are particularly suited for virtual health?
  • Which patient populations should be targeted?
  • Which technologies should be pursued, and in what order?
  • Which measures can be used to evaluate success in virtual health?
  • What are the potential risks, and how can those risks be mitigated?

Virtual health technology approaches

Once a virtual health strategy has been established, the next step is to find the right technology. Here are three common approaches health systems have used to launch their virtual health strategies. It is worth noting that these approaches represent the current state. We expect that these technologies will become more robust over time.

    1. Partner with an electronic health record (EHR) vendor: Under this approach, a health system can turn on virtual health capabilities within the EHR. One advantage to this approach is that it leverages the EHR, a system with which providers are already familiar. Furthermore, since virtual health capabilities are integrated into the EHR, there is generally less concern over losing patient data or having to manually enter virtual health encounter data into the EHR1. An additional benefit is on the cost side. Since a health system has already paid for EHR implementation and licensing, the incremental cost to enable virtual health capabilities is typically low. One downside is that EHR vendors might not offer a full suite of virtual health capabilities. As a result, health systems may need to turn to other vendors as their virtual health needs evolve, in order to meet consumer demand. Additionally, EHR vendors have typically focused on provider workflows and experience rather than patient-facing processes and interfaces. This can lead to varying levels of user-friendliness on the patient side, which can be a barrier to adoption.
    2. Partner with a virtual health vendor: Some vendors that specialize in virtual health offer set services, while others let health systems select from a menu of services to create a white-label platform2. A further distinction is between vendors that offer single, point solutions (e.g., virtual visits only) and those that offer platforms that allow customers to opt in to multiple solutions. These solutions generally provide more robust virtual health capabilities because they are not tied to EHR technology, and often have application programming interfaces (APIs) that allow for interoperability with other systems, such as scheduling and EHRs3. However, interoperability between virtual health technologies can be a challenge if providers need to navigate technologies offered by multiple vendors. Working with multiple vendors can also lead to increased maintenance costs for health systems.
    3. Build a customized internal platform: A health system might opt to design and builds its own virtual health platform, either in-house or contracted. While this approach allows for complete customization, the health system must have advanced technology capabilities to be successful. Additionally, customized platforms can be difficult to keep current because the health system, rather than the vendor, is responsible for developing and deploying updates. Due in part to these limitations, this approach might be the least common among health systems.

We often see health systems move between or combine these approaches as their needs and consumer demand evolve. This can result in technologies that are not interoperable and do not support scalability. At this point, it can be valuable for a health system to revisit its virtual health strategy, with the goal of evaluating which technologies and vendors enable an enterprise-wide approach to virtual health.

Our vision for virtual health technology is a comprehensive, enterprise-wide platform that seamlessly integrates a health system’s virtual health solutions, EHRs, and billing – agnostic of vendor. The platform vendor would not necessarily provide a full suite of virtual health capabilities, but rather serve as a backbone that links multiple capabilities. This platform could be designed for strong interoperability among technologies and with multiple users in mind (e.g., provider, patient, caregiver). The platform could also be designed for modularity, allowing health systems to add new capabilities to the platform over time.

By addressing physician demand for interoperability, the future state platform could help health systems increase physician adoption of virtual health. On the consumer side, a patient-friendly platform can help encourage consumers to use it. And by providing a solution that can grow with a health system, the platform aims to make virtual health technology investments future ready. While the right virtual health technology depends on each health system’s specific goals, being strategic from the outset can help ensure that the selected path supports an enterprise-wide approach to virtual health.

1 https://mhealthintelligence.com/news/virtual-care-within-the-ehr-may-be-a-game-changer
2 https://mhealthintelligence.com/features/picking-the-right-telehealth-platform-for-a-small-or-solo-practice
3 https://www.healthcareitnews.com/news/comparing-11-top-telehealth-platforms-company-execs-tout-quality-safety-ehr-integrations

Author bio

Chris Shudes is a principal in Deloitte Consulting’s Provider practice and the technology leader of Deloitte’s Virtual Health practice, responsible for building out technology platform infrastructure to support enterprise Virtual Health capabilities. Chris has over 20 years of IT and strategy consulting experience including leading business and technology strategies, IT transformation, shared services, IT operating model, enterprise architecture, and cost reduction initiatives. Chris specializes in shaping and delivering large-scale business and IT transformation programs. Chris has extensive experience across the health care industry including national health provider systems, regional and community systems, AMCs, ASCs, and commercial payers.