Industry Voices—Virtual care should address transition points in our fragmented system

For a triathlete, every transition between athletic events has to go smoothly. If your bike tires are flat when you get out of the water or your running gear is missing, you just won’t perform your best. The same is true for a patient navigating the healthcare system: If at any point in your journey you miss a step or take a wrong turn, you risk falling through the cracks.

On top of that, each athlete’s knowledge of the course, access to a support team and ability to afford premium gear combine to shape their individual experience of the race long before the starting pistol. Similarly, an individual’s unique medical and social experiences, ability to access care and engagement with their health make a big difference in how they experience the healthcare system.

Just as early preparation, careful planning and the right support team empower athletes to reach peak performance, a successful healthcare model should do the same for patients. It’s clear that patients are demanding more accessible care options: Telehealth usage is currently 38 times pre-pandemic levels, and some estimates predict that 70.6 million Americans will use remote patient monitoring tools by 2025. With healthcare facing a pivotal moment of digital transition and the Biden administration recently announcing investments in high-speed internet to power that shift, we have maybe the biggest opportunity of our lifetimes to transform the care ecosystem.

But we are squandering this moment if we only focus on siloed, add-on telehealth or remote monitoring solutions that mirror the fragmentation and unreliable care transitions of our existing system. As the healthcare industry adapts, we must thoughtfully implement digital technology at every step and every transition in the care journey to create the connective tissue that makes patient-centered, team-based care a reality.

This is especially important for patients with complex, chronic care needs, for whom even a simple weekend trip away, let alone a triathlon, can be daunting. Imagine a grandfather traveling alone across the country for his grandson’s high school graduation while managing chronic obstructive pulmonary disease (COPD). Leaving his support network of providers and pulmonologists at home, he may experience shallow breathing as he makes the 15-minute walk from airport security to his gate. If his shortness of breath worsens, his only option would be to seek help from a local urgent care clinic or emergency department on arrival. But this care would be entirely incongruent with his care plan at home and is likely to come with a high payment out-of-pocket. Even if he feels okay for a little while, his primary providers aren’t aware of his symptoms, and he feels uneasy about getting home safely.

Now reimagine the scenario with virtual care thoughtfully integrated.

Virtual-first care models designed with individual patients at the center enable more frequent and personalized touch points, offer access to support in moments of need and provide the support for individuals to become more active participants in their health, which has been shown to drive meaningful outcomes. Take our grandfather, for example. In a virtual-first model, he records his daily symptoms using a smartphone app, allowing his care team to provide personalized, proactive recommendations to try and stay ahead of an exacerbation.

If he does have a flare-up while traveling, a virtual coach assesses his symptoms and either walks him through self-management or escalates him to an in-network provider in the area, all while communicating with his primary care team. Through virtual-first care, his experience shifts from unpredictable and reactive emergency medicine to engaging and proactive self-managed care. 

Like a training team setting up a triathlete’s equipment perfectly at each transition point in the race, virtual-first care can also optimize handoffs between care settings. If our grandfather experiences an exacerbation and is hospitalized, the status quo discharge process is often abrupt. There may be a line buried in paperwork that simply instructs, “follow up with primary care provider,” leaving the burden on the patient. This is one reason that up to 20% of patients are readmitted to the hospital within 30 days of being hospitalized for COPD. Instead, by integrating connective technology, a discharge planner can confidently send him home knowing that the virtual care team will help him reconcile and adapt to his new medication regimen, monitor his vital signs and begin a pulmonary rehabilitation program. Overall, he has a better understanding of his care plan and a clear path forward as he transitions from the hospital to his home.

Even though most of us are not training for an elite athletic competition, we all deserve access to the resources we need to stay healthy throughout the winding courses of our lives. As healthcare moves to a hybrid care model that supersedes physical infrastructure, every part of the ecosystem—providers, payers, innovators and investors— must proactively cooperate to enable seamless, high-value virtual care. That work includes creating new performance standards and incentive structures that enable and reward incumbent systems and networks to keep pace with care innovations and creating better information-sharing pathways between all entities involved in a person’s care. If we as an industry don’t do this from the outset of this transformation, we will be left with a fragmented digital version of our current status quo.

Linette Demers serves as a program director for the Digital Medicine Society, a nonprofit working to advance the safe, effective, ethical, and equitable use of digital technologies to optimize health.

Geoff Matous is the president and chief commercial officer of Wellinks, a healthcare company offering the first-ever integrated, virtual chronic obstructive pulmonary disease (COPD) management system.