Issue link: https://beckershealthcare.uberflip.com/i/759111
30 Executive Briefing The Transformative Virtualization of Care Delivery By Sanjay Patil, Executive Vice President and General Manager, Health Systems, MDLIVE, Lauren Weigand, Associate Director of Product Management, Health Systems, MDLIVE, and Bryan Brewer, Vice-President, Professional Services and Implementations, Health Systems, MDLIVE A dvances in telehealth technology coupled with EHR in- frastructure investment and value-based care incentive programs have created new opportunities for deploying virtual care services. On-demand, low acuity telehealth services are just one of many high-value, telehealth-based, virtual care options for healthcare organizations. Broadening the Telemedicine and Telehealth Paradigms Telemedicine has traditionally been used in a provider-to-pro- vider context with limited reimbursement options in the fee- for-service environment. Telehealth expands telemedicine to include direct engagement of the consumer in a virtual care en- vironment. In an era of high-deductible health plans, telehealth also provides a low-cost alternative to urgent care and emergen- cy department visits for clearly defined low-acuity conditions. Low-acuity telehealth services provided by a third party are a low risk, virtual care entry point for healthcare organizations with a plan to offer consumerized healthcare products and services. Expanded use of EHRs coupled with integrated telehealth ser- vices elevates telehealth from an external third-party service that addresses a limited range of low-acuity patient encounters to full service virtual care that is a seamless part of workflow for primary and specialty care, as well as the revenue cycle. Health systems can also position fully integrated telehealth services as a patient engagement, market and loyalty differentiator. Requir- ing patient portal enrollment and registration for use of health system telehealth services, including on-demand and sched- uled visits, will drive patient portal utilization. Real-time claims and clinical data analytics coupled with virtual care services enables health systems and plans to close gaps in care and ensure continuity of care at an affordable cost. Time- ly gap closure can help healthcare organizations avoid nega- tive CMS audits resulting in lowered star ratings, especially for health plans with sizeable Medicare Advantage insured lives. We Predict Virtualists will Emerge Alongside the Hospitalist and Intensivist Oakland, Calif.-based Kaiser Permanente has reported 13 mil- lion virtual visits in 2015 and forecasts 16 million virtual visits by 2018, including visits conducted using voice, video, secure email and secure text. By 2018, Kaiser forecasts that provider virtual visits with patients will exceed provider 'bricks and mor- tar' encounters. What are the key elements of a successful, inte- grated telehealth solution to deliver virtual care? • Telehealth services must be incorporated in every provider toolset at every level of care, including the need to: • Fully integrate EHR workflow including scheduling, best prac- tices, documentation and patient portal registration/utilization • Integrate analytics to identify optimal telehealth treatment scenarios and options • Identify value-based care metrics that are addressable with telehealth services • Focus on the scalable telehealth services that deliver value and achieve target outcomes • Enable timely care communication among and between acute and ambulatory providers as well as intermediate care providers including skilled nursing facilities, long- term acute care, rehab and in-home providers Just as the provider designations and certifications for hospital- ists and intensivists were created to meet a renewed focus on improving quality and patient outcomes in the fee-for-service reimbursement environment, we predict the designation and eventual certification of providers as Virtualists will emerge to support cost effective virtual care delivery, improve patient out- comes and meet value-based care performance targets. Next-Generation Medicine via Telehealth 2.0 The next generation for telehealth — Telehealth 2.0 — will be integrated with EHR and analytics infrastructure, act as a core driver of value-based care and facilitate higher levels of patient engagement around target outcomes. Telehealth 2.0 will drive cost savings, enable balanced utilization of provider time and skills for in-person patient encounters, as well as virtual encoun- ters, and drive quality results that meet or exceed value-based care program targets. Telehealth 2.0 will be focused in eight areas of virtual care: 1. Informed on-demand and scheduled patient history for virtual care: EHR and analytics infrastructure will give pro- viders on-demand patient history, including information for patients with chronic conditions who may see multiple providers, have labs ordered by multiple providers and/or have prescriptions ordered by multiple providers and filled by different pharmacies. 2. Timely, coordinated transitions in care: Integrated virtual care will give providers more options for confirming referrals, orders and appointments for specialist visits — including man- dated behavioral care — after primary care encounters. It will simplify communication for verifying receipt of notifications at time of discharge, confirming 48-hour follow up visits to check recovery, verify medication adherence progress and provide reminders to drive compliance with scheduled follow-up pri- mary care or specialist visits within 15 days after discharge. 3. Identify and close gaps in care: EHR and analytics infra- structure coupled with telehealth services gives providers Sponsored by: