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How Is Virtual Healthcare Different from Telehealth?
Virtual healthcare (aka remote patient management) is closely interlinked with telehealth, or telemedicine, but not interchangeable.
Virtual care is a broader term that defines the wholesome of remote tech-driven healthcare
Marcus Grindstaff, COO of Care Innovations , describes the entirety of terms for different distance healthcare operations in the following manner:
“Telehealth is a very broad category of solutions that service patients at a distance — so it could be doctor visits at a distance, it could be chronic condition management, it could be managing high-risk pregnancy. But doing that at a distance, doing it remotely.”
According to McKinsey’s report, the definitions in the area are the following:
However, challenges remain. Our research indicates providers’ concerns about telehealth include security, workflow integration, effectiveness compared with in-person visits, and the future for reimbursement. Similarly, there is a gap between consumers’ interest in telehealth (76 percent) and actual usage (46 percent). Factors such as lack of awareness of telehealth offerings, education on types of care needs that could be met virtually, and understanding of insurance coverage are some of the drivers of this gap.
What is the full potential for telehealth and virtual care?
Action Plan for Entrepreneurs in the Virtual Care Industry
What actions should healthcare stakeholders take in the near term to shape this opportunity?
Actions payers could consider:
Define a value-backed virtual health roadmap , taking a data-driven view to prioritize interventions that will improve outcomes for priority populations, and develop strategies to digitally enable end-to-care care journeys.
Optimize provider networks and accelerate value-based contracting to incentivize telehealth.
Define approaches (beyond the immediate COVID-19 response measures) to reimbursement and covered services, embed in contracting, and optimize networks and value-based models to include virtual health. Align incentives for using telehealth, particularly for chronic patients, with the shift to risk-based payment models.
Build virtual health into new product designs to meet changing consumer preferences and demand for lower-cost plans. This new design may include virtual-first networks, digital front-door features (for example, e-triage), seamless “plug and play” capabilities to offer innovative digital solutions, and benefit coverage for at-home diagnostic kits.
Integrate virtual health solutions into the care delivery approach. Given the significant disruptions to providers, payers are reassessing their role in care delivery—from ownership of care delivery assets, value-based contracting, or anything in between. Consider options in virtual health (for example, platforms, digital-first providers) as a critical element of this approach.
Reinforce the technology and analytics foundation that will be required to achieve the full potential of virtual healthcare solutions.
Actions health systems could consider:
Accelerate development of an overall consumer-integrated “front door.” Consider what the integrated product will initially cover beyond what currently exists and integrate with what may have been put in place in response to COVID-19 (for example, e-triage, scheduling, clinic visits, record access).
Segment the patient populations (for example, with specific chronic disease) and specialties whose remote interactions could be scaled with home-based diagnostics and equipment.
Build the capabilities and incentives of the provider workforce to support virtual care (for example, workflow design, centralized scheduling, and continuing education); align benefit structure to drive adoption in line with the health system and/or physician practice economics.
Measure the value of virtual care by quantifying clinical outcomes, access improvement, and patient/provider satisfaction to drive advocacy and contracting for continued expanded coverage. Include the potential value from telehealth when contracting with payers for risk models to manage chronic patients.
Consider strategies and rationale to go beyond “telehealth”/clinic visit replacement to drive growth in new markets and populations and scale other applications (for example, teleICU, post-acute care integration).
Actions Investors, Health Services and Technology Firms Should Consider
Conclusion
Virtual Healthcare Solutions: Terms Explained
Telemedicine
Telehealth
Remote Patient Monitoring (RPM)
EHR/EMR Integration
mHealth (Mobile Health)
Virtual Care Platform
AI-Driven Diagnostics