After years of holdout, healthcare organizations are coming around to treating individuals less like patients and more like consumers.
On the provider side, that’s meant expanding beyond traditional services and into new primary, specialty and acute care delivery approaches enabled by new virtual care technologies. Particularly as the COVID-19 pandemic upended in-person services, organizations have needed to adopt strategies that emphasize care on the patient’s terms.
“With COVID, we’ve seen a tremendous reduction in the number of patients that are showing up for care in brick and mortar facilities—our emergency department line saw a 40% drop at its nadir in our ED volume, and we’re still at 10% to 20% under where we were about two years ago nationwide,” Gregg Miller, M.D., chief medical officer at acute care management and healthcare staffing company Vituity, said this week during a panel hosted by Fierce Healthcare.
“We need to provide care in place. We need to reach out to patients where they’re at and get them the care they need in their own four walls, whether it’s their home, whether it’s the nursing home they’re at, whether it’s providing more specialty services to an urgent care clinic or to a rural remote area,” he said.
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Payer groups are feeling that shift in the atmosphere as well. When the pandemic hit and people were anxiously seeking out virtual healthcare services, Oscar Health Vice President and General Manager of Virtual Care Marianna Spanos said it was brandlike relationships between the company and its members that helped drive a spike in utilization.
“We had that trust, we had those relationships with them,” Spanos said during the panel. “So that’s been what we’ve been really focused on: it’s how do we build that relationship [and] engage our members actively throughout so we can be there for them with a direct care relationship when they really need us.”
The transformation of healthcare interactions toward something more akin to a retail purchase has brought immediate gains to businesses that have pounced on the shift, if the rise of consumer-facing telehealth brands such as Hims & Hers or Ro is any indication. Still, patients need these services to deliver care that is of appropriate quality.
There is a concern that patients’ desire for convenient services may have an outsized impact on their decision-making when seeking care, said Sarah Pletcher, M.D., vice president and executive medical director of Houston Methodist.
“I liken it to Amazon,” she said during the panel. “I love the local bookstore, and I have relationships with them and I trust that they’re going to recommend great books for me. But to be honest I’m just going to go the easy route of ‘buy it now’ and trust whatever Amazon tells me. And yes, Amazon has to meet me halfway and be a little bit personalized with the recommendations, but convenience is going to overcome quality. I struggle with that sometimes with what we design for patients.”
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The answer, panel members agreed, is ensuring a balance between the two.
Kyu Rhee, M.D., senior vice president and chief medical officer at CVS Health’s Aetna, noted that consumer-friendly approaches around efficiency, effectiveness and patient-centered design have always been among the aims of healthcare quality.
Spanos and Pletcher said the key is for organizations to realize that delivering quality care through telehealth or another convenient medium isn’t just a "copy and paste" of the traditional approach to care. Providers, payers and other services must find ways to communicate to patients that the care they’re receiving still checks all of the boxes in terms of quality.
“There’s a perception historically amongst users, members, patients that quality means time,” Spanos said. “It means a long interaction, an hour-long visit. It means certain things happen a certain way, usually in person.”
“I think it’s more about shifting that dynamic because I don’t think we would ever compromise with quality,” she continued. “It has to be efficient, but it can be high quality and efficient. It’s about what triggers a sense of perceived and actual quality.”
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But for all the talk of patients’ preference for convenience, Miller noted that most in-person services have resumed in the months since the pandemic struck.
Patients are still aware of the trade-offs in care delivery inherent to telehealth, he said, although more can be done to shorten the perception gap and thereby increase the number of touch points between healthcare and patients.
“We’re seeing the pendulum shift back towards brick and mortar,” he said. “Patients are voting to a certain extent with their feet, and they do recognize that convenience doesn’t necessarily equal quality. I think it’s up to all of us working in the telehealth space to make sure that we are able to demonstrate true quality care via our telehealth platforms and make sure patients understand that.”