People of a certain age speak wistfully of a time when doctors made house calls. The in-home visit had advantages for patient and physician alike.
“House calls” eliminated the need for ill patients to get to the doctor’s office—along with the risks of coming into contact with other health-compromised people.
For doctors, it was a break in routine, an opportunity to observe patients in their own home environment—and, sometimes, to gain insight beyond what was possible during an office exam, particularly insights relating to social and environmental determinants that significantly impact health and wellness.
Patients and physicians have long been expressing concerns about less personal relationships. Many have worried that using telehealth tools would diminish patient engagement even further. But there is growing evidence that, when implemented thoughtfully as part of the care continuum, remote care builds and solidifies relationships.
I know you
Regular, consistent check-in over distance creates a bond between patient and clinician. Elderly and chronically ill patients quickly come to prefer in-home visits to trips to the doctor’s office.
Frequent face-to-face interaction and monitoring provide caregivers with a baseline for a more nuanced understanding of the individual’s health and response to treatment than the 3- or 6-month checkup. The CDC reports that chronic diseases such as heart disease, cancer, and diabetes can be “largely preventable through close partnership with your healthcare team, or can be detected through appropriate screenings when treatment works best.” Human and machine analysis of monitoring data leads to earlier detection and treatment of problems that improve health and reduce hospitalizations and costs.
A new model of virtual care
Although the path forward has not been straight, telehealth has come a long way in just a relatively short time. In fact, data is showing a clear connection between virtual care and positive outcomes. The early days of one-off trials for telehealth where ROI was hard to measure are quickly fading.
Part of the past issue was of course that the reimbursement models were not clear. In contrast, today, telehealth is making critical inroads due in large part to the expansion in reimbursement options, a growing aging population, higher incidence of chronic diseases, and an expensive medical system. Some compelling statistics have been compiled by Mercy Hospitals, a nonprofit healthcare system with operations in Missouri, Kansas, Arkansas, and Oklahoma. Over the last decade, Mercy has invested much thought and significant capital in a new model of care that leverages telehealth technologies. In 2015, it opened the Mercy Virtual Care Center (VCC), a four-story facility without a single patient bed. Inside, physicians and nurses back up local care teams with remote care for patients in their homes or in the hospital.
Monitoring of chronically ill patients by clinicians at the VCC has shown that Mercy Virtual has reduced costs, and reported lower mortality with fewer days spent in the hospital.
In other units, virtual clinicians can respond to patient calls in less than a minute, communicate with the patient, assess their condition visually and via instrumentations, and facilitate the right response—reducing stress for both patients and floor nurses.
Let doctors be doctors
Physicians are finding that virtual capabilities make it easier to coordinate care across the continuum. Multiple specialists participating in a virtual visit, for example, can help patients get the right care, faster.
With a shocking 42% physicians reporting symptoms of burnout in 2018, Connected Health can offload and eliminate many of the tasks physicians say takes them away from patients and extends their workday.
Rather than feeling displaced by technology, doctors report greater peace of mind knowing that a highly qualified virtual team is continuously monitoring their patients. A majority of clinicians say they want to provide some portion of care virtually. The ability to remotely assess a patient’s vitals and consult with patient and nursing staff, for example, could eliminate unnecessary trips to the hospital.
Collaborating in the digital care network requires workflow integration and workforce transformation
Connected Health is evolving with the expansion of virtual care, AI-driven digital assistants, IoT, and anywhere-anytime consults. As a result, every healthcare organization needs to prepare itself to be part of the collaborative, digital care network. This means plugging into a modernized architecture of secure, interoperable, smart technologies connecting users, applications, and devices.
But technology is not what’s keeping us back. As telehealth pioneer Kristi Henderson, Seton Health, pointed out in a recent interview regarding telehealth trends: “Technology has been there. This was never an issue around technology. It’s definitely gotten better and less expensive, so we can scale it. It’s really been around integration and workflow transformation and a trust that has it coming. So, it’s exciting to think about where we’re going from there.”
The first step in building out a Connected Health environment is to bring people together to identify gaps in the care continuum, redefine roles and workflow, and care plan transitions.
While making house calls isn’t a new concept, doing so virtually certainly is. There are people, processes, and technologies involved in making this transformation a reality. Care teams can learn a lot from the failures and successes of health systems who have made this transition, and apply those lessons learned to their own telehealth initiatives.
Looking ahead, healthcare organizations need to be prepared to answer the question that is becoming more popular among patients: ‘Do you make house calls?’
Susmit Pal is the Director for Connected Health Solutions within Dell EMC Global Alliances. With over 16 years of experience in business development, marketing, IT consulting and strategy/planning, he is focused on helping customers create a digital strategy and select the right tools and processes to transform the clinical workforce, improve patient experience and deliver better patient care at a lower cost. Follow him on Twitter: @SusmitPalAtDell