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

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

(Payvider in this context not to be confused with payvider meaning large health systems that handle both care delivery and claims processing, such as UPMC, Kaiser and Geisinger.)

But many provider organizations have yet to embrace a virtual-first approach, eschewing a telemedicine front door for traditional, in-person care first.

Avihai Sodri is CEO of Antidote Health, a telehealth services provider. He has extensive experience in the virtual-first approach. We spoke with him to get the lowdown on 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 health systems enable greater accessibility to care?

A. A virtual-first approach significantly enhances healthcare accessibility by removing geographical and socioeconomic barriers. Leveraging telehealth and telemedicine technologies, patients can receive primary care or specialized consultations virtually, regardless of location.

This is invaluable for everyone in the U.S., primarily for people living in rural regions of the country, who often suffer from chronic conditions like hypertension, diabetes and heart disease at higher rates than their urban counterparts.

They no longer need to travel long distances for essential care. Additionally, this approach increases access to mental health resources and counseling for individuals who might not typically seek or have access to such services, broadening the reach of crucial healthcare support.

The U.S. healthcare system has serious accessibility issues. Thankfully, a virtual-first approach to healthcare, which leverages telehealth and other telemedicine technologies, removes geography barriers, allowing members to receive primary care or specialized 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 enhances data integrity and consistency by seamlessly integrating patient data across all points of care. In the current fragmented healthcare ecosystem, slow information exchanges lead to duplicated diagnoses, redundant testing and delayed treatments. Virtual-first “payviders” – companies that act as both payer and provider – eliminate these data silos.

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

Payviders using the virtual-first approach do not encounter these same issues since they act as both the provider and payer. This model and approach remove data silos, ensuring accurate and consistent patient data collection across various care points, from telehealth consultations and online check-ups to lab results and insurance claims.

By maintaining data integrity and consistency, virtual-first payviders can provide several unique benefits to their members. For example, they can offer personalized and coherent experiences for members to access different virtual services. Likewise, data integrity and consistency help reduce errors in the patient journey. These errors, if unchecked, can run up costs, 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 manage patients with multiple interconnected conditions like diabetes and high blood pressure.

In contrast, virtual-first payviders assign dedicated primary care physicians to patients, simultaneously facilitating managing multiple conditions.

This continuity fosters stronger patient-provider relationships, increasing the likelihood of treatment adherence. Furthermore, enhanced data integrity and consistency allow for early identification of risk factors, enabling proactive rather than reactive treatment. This proactive care helps patients stay ahead of their medical conditions, reducing the likelihood of hospitalizations and expensive surgeries.

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

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

A virtual-first approach also supports care continuity; however, those telehealth providers that treat virtual visits as isolated, one-time events cannot. By operating no differently than an online urgent care, these other telehealth providers cannot maintain care continuity between visits since the patient meets with a different physician each time. Research shows this inconsistency is not ideal, as patients are less likely to comply with treatments, decreasing the quality of outcomes.

Payviders that use the virtual-first approach will assign a dedicated primary care physician to patients to ensure continuity of care and, ultimately, improved health outcomes. Similarly, the data integrity and consistency possible through the virtual-first approach enable payviders to identify risk factors earlier, allowing them to recommend treatment proactively rather than reactively.

The patient stays one step ahead of their medical conditions, reducing the likelihood of hospitalization and expensive surgeries.

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

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

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

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

A payvider using a virtual-first approach – because of the benefits I mentioned – can offer more affordable premiums to their members. Proactive care through greater data integrity and consistency, for example, leads to more cost savings for the member since 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, permitting members to make timely and cost-conscious decisions when consuming 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



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