How virtual-first can improve outcomes and make healthcare more affordable

The “virtual-first” approach to healthcare that some hospitals and healthcare systems are taking is helping to reshape the way patients receive care. And virtual healthcare providers – online companies that specialize in telemedicine, also known as “payviders” – are offering consumers a “virtual first” approach to healthcare.

(Payvider in this context should not be confused with payvider means large healthcare systems that handle both healthcare delivery and claims processing, such as UPMC, Kaiser, and Geisinger.)

But many healthcare organizations have yet to embrace a “virtual first” approach, eschewing the front door of telemedicine for traditional, in-person care.

Avihai Sodri is CEO of Antidote Health, a provider of telehealth services. He has extensive experience with the virtual-first approach. We spoke with him to learn more about the benefits of virtual-first. He points to greater accessibility, data integrity and consistency, improving healthcare outcomes and greater affordability.

Q. How does a virtual first approach to healthcare help hospitals and healthcare systems enable greater access to care?

A. A virtual-first approach significantly improves healthcare accessibility by removing geographic and socioeconomic barriers. Using telehealth and telemedicine technologies, patients can receive primary care or specialty consultations virtually regardless of location.

This is invaluable for everyone in the US, especially for people living in rural areas of the country, who often suffer from chronic conditions such as high blood pressure, diabetes and heart disease at higher rates than their urban counterparts.

They no longer have to travel long distances for essential care. Additionally, this approach increases access to mental health care and counseling for individuals who would not normally seek or access such services, expanding the reach of critical health care support.

The American healthcare system has serious accessibility problems. Fortunately, a “virtual first” approach to healthcare is delivering benefits telehealth and other telemedicine technologies remove geographic barriers, allowing members to receive primary care or specialty consultations virtually regardless of where they live.

Q. How does a ‘virtual first’ approach to healthcare help enable data integrity and consistency? Why is this important?

A. A virtual-first approach improves data integrity and consistency by seamlessly integrating patient data across all points of care. In today’s fragmented healthcare ecosystem, slow information exchange leads to dual diagnoses, redundant tests and delayed treatments. Virtual-first “payviders” – companies that act as both payers and providers – are eliminating these data silos.

They ensure accurate and consistent collection of patient data, from telehealth consultations and online checkups to laboratory results and insurance claims. Maintaining data integrity is crucial for effective patient management, enabling better treatment plans, accurate health monitoring and informed decision-making. It also reduces errors in the patient journey, which can increase costs, improving the quality and affordability of care.

Payment providers using the virtual-first approach do not experience the same problems because they act as both a provider and a payer. This model and approach removes data silos, ensuring accurate and consistent collection of patient data across points of care, from telehealth consultations and online checkups to lab results and insurance claims.

By maintaining data integrity and consistency, virtual-first payers can provide several unique benefits to their members. For example, they can provide members with personalized and cohesive experiences access to various virtual services. Likewise, data integrity and consistency help reduce errors in the patient journey. If these errors are left unchecked, costs can mount, increasing the cost of coverage.

Q. How exactly can a virtual-first approach improve health outcomes?

A. A virtual-first approach improves health outcomes by providing holistic care and ensuring continuity of care. Traditional telehealth models often address only one short-term illness per visit and cannot adequately treat patients with multiple interrelated conditions such as diabetes and hypertension.

Virtual-first payers, on the other hand, assign dedicated primary care physicians to patients, facilitating the management of multiple conditions simultaneously.

This continuity promotes stronger relationships between patient and healthcare provider, increasing the likelihood of treatment compliance. Additionally, improved data integrity and consistency enable early identification of risk factors, enabling proactive rather than reactive treatment. This proactive care helps patients stay ahead of their medical problems, reducing the risk of hospital admissions and expensive surgeries.

Today is the design of Many telehealth models are intended to address one short-term illness or disease per visit. This model sometimes works; but it cannot account for people who have multiple, interconnected conditions, such as diabetes and high blood pressure.

However, a payer that uses a virtual-first approach is well positioned to provide holistic care that accommodates patients with multiple conditions, significantly improving health outcomes.

A virtual-first approach also supports continuity of care; However, those telehealth providers who view virtual visits as isolated, one-time events cannot. By operating no differently than online urgent care, these other telehealth providers cannot maintain continuity of care between visits because the patient meets a different doctor each time. Research shows that this inconsistency is not ideal because patients are less likely to adhere to treatments, reducing the quality of outcomes.

Payviders using the virtual-first approach will assign a dedicated primary care physician to patients to ensure continuity of care and ultimately improve health outcomes. Likewise, the data integrity and consistency possible through the virtual-first approach allows payers to identify risk factors earlier, allowing them to recommend treatment proactively rather than reactively.

The patient stays one step ahead of his or her medical circumstances, reducing the chance of hospitalization and expensive surgery.

Q. How exactly can a virtual-first approach lead to greater healthcare affordability?

A. By offering proactive and efficient care, a virtual-first approach leads to greater healthcare affordability. Virtual-first payers can offer their members affordable premiums through cost savings realized through reduced hospital visits and medical bills.

Proactive care – supported by real-time data collection and consistent data integrity – allows patients to avoid expensive treatments by managing conditions early.

Additionally, this approach helps members make timely and cost-conscious healthcare decisions, such as avoiding unnecessary out-of-pocket expenses through appropriate referrals. By simultaneously reducing the overall burden on the healthcare system and providing patients with cost-effective choices, the virtual-first model makes healthcare more affordable for everyone involved.

A payer that uses a virtual-first approach – because of the benefits I mentioned – can offer its members more affordable premiums. For example, proactive care through greater data integrity and consistency leads to greater cost savings for members as they have fewer hospital visits and expensive medical bills, simultaneously reducing the overall burden on the healthcare system.

Additionally, a virtual-first approach promotes real-time data collection, allowing members to make timely and cost-conscious decisions when purchasing healthcare services, such as avoiding unnecessary out-of-pocket expenses through referrals.

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication