HR Professionals Support Digital Transformation And Virtual Care As Future Proof Opportunities

Why a coordinated approach to care is crucial for better outcomes

By Michael Gorton, and Michael Brombach, Recuro Health

As the pandemic taught us to more efficiently work from anywhere, it also created circumstance where medical delivery focused on location of the patient, rather than the provider. With mounting pressures to design and implement health benefits programs that meet the needs of geographically and culturally diverse populations, HR professionals increasingly turn to digital solutions with capabilities to deliver a more personalized approach. Now recognized as telehealth or virtual care, this remarkable technology is the channel for providing patient-centric, on-demand care. The next generation to this digital solution is focused on preventative health and wellness.

Throughout the healthcare ecosystem, industry leaders recognize virtual care as ‘future proof” because it leverages the most advanced information technologies and digital health innovations to realize new and emerging value opportunities. As a solution strategy, integrated virtual care applications are successfully meeting today’s challenges in complex clinical, economic and workforce environments.

● Addressing healthcare needs of an exploding population coupled with a shortage of primary care physicians and scarcity of behavioral health clinicians

● Responding to the demand for more affordable and convenient access

● Resolving patient barriers to accessing care, issues associated with health equity

● Realizing time and cost efficiencies, reducing hospital, payer and patient expenses

● Improving overall experience of healthcare and outcomes

Nearly three-quarters (74%) of the 135 large employers surveyed by the Business Group on Health said virtual care will have a major impact on care delivery in the future. With greater adoption and acceptance of virtual care, HR decision-makers welcome opportunities to reshape the design of employer-sponsored health plans and include digital care options. What is most appealing for companies of all sizes is access to a one-stop resource that integrates all their vendor solutions in one central location for a “complete care” experience.

Bringing together the best of preventative care, with a coordinated model that includes primary care and behavioral health, select virtual care solutions are designed to improve health outcomes, reduce medical spending and deliver top-tier member satisfaction.

Virtual care solutions can be scaled to the size and needs of the employee population, customized from a suite of integrated digital health. On-demand access to in-demand health services is enabled in real-time through computing and mobile technologies across multiple communication channels. This capability provides a seamless, single point experience, delivering health services whenever care is needed and wherever the patient is located. By removing the boundaries of a physician office visit, or making hybrid virtual and physical arrangements available, virtual care provides greater access tied to convenience and affordability compared to in-person visits.

For human resource executives and benefit administrators, a “virtual first” strategy optimizes health plan performance and enhances employee engagement and experience. This can lead to an organization-wide change focused on catching medical issues before they become expensive and dangerous,

Virtual Primary Care Transforms Healthcare Access, Delivery and Utilization

The introduction of Virtual Primary Care (VPC) is dramatically reshaping how healthcare is accessed, delivered and utilized. Connecting employee health plan participants and their dependents with virtual providers through a virtual-first approach to primary care is proving to positively impact the triad of cost, quality and access to care with an added benefit of employee satisfaction with benefits.

A well-designed VPC solution provides employees with convenient access to a top primary care physician (PCP) of their choosing, Because as studies claim, one in three millennials do not have a relationship with a PCP and are less likely to seek preventative care on a regular basis, VPC is especially important as a solution to generational healthcare needs. The virtual solution is effective because it combines simplicity with the ability to catch things early on. As Ben Franklin has said: “an ounce of prevention is worth a pound of cure.”

A designated VPC physician provides routine health and wellness screenings and preventative care along the employee’s healthcare journey – and refer patients to the appropriate specialists. VPC can also cover access to comprehensive risk assessments that cover physical and behavioral health treatments.

One caveat: many HR administrators embrace narrow provider networks since they perceive opportunities for better quality and cost savings. With optimized VPC models, changing networks may not be an issue since they do not force participants to identify a new primary care physician and reestablish a personal, dedicated relationship.

Genomics will Play a Significant Role in Virtual Primary Care

As part of an uptick in virtual primary care adoption, integrated genomics will become a significant disruptive force and value proposition differentiator as an integrated benefit. The ability to transform genomic information into effective diagnostics and therapies with greater precision represents the future of personalized and preventative medicine as it embraces genomic tools to enable more precise prediction and treatment of disease.

The fundamentals of genomics will require the development, standardization and integration of several important tools into health systems and clinical workflows. These genetic tools include health risk assessment, family health history, clinical decision support for complex risk and predictive information.

Together with in-home diagnostics, genomic information and the efficacious application of Artificial Intelligence (AI) tools will enable a paradigm shift to a comprehensive approach. It will be possible to identify individual risks and guide clinical management and clinical decision making -- all of which form the basis for a more informed and effective approach to patient care.

A New Breed of Virtual Care Aligned with Coordinated Care

With healthcare and workplaces facing a pivotal moment of digital transition, integrated virtual care is poised for higher utilization and significant growth, as well as refinement. There is becoming greater emphasis on “care coordination” and diminished focus on siloed, add-on remote monitoring solutions that simply mirror the fragmentation and unreliable care transitions of the existing system.

Care coordination is a natural extension of the remote care model that integrates both digital and virtual care. It accesses healthcare services in a cogent way that dives better outcomes and provides a new moniker for the ‘care gatekeeper,’ such as a patient’s virtual primary care physician. Integrated into one central platform, comprehensive “complete care” services include virtual primary and urgent care, behavioral health, at-home lab testing, genomics testing, as well as a suite of supplemental benefits, such as chronic care management, pharmacy and care navigation.

What’s New, Next and Beyond

This next generation of virtual care is part of a greater seismic shift toward delivering the full spectrum of care wherever patients are located, whether at home or in the workplace. With the Digital Medical Home, patient data and records are securely stored and accessible by any provider, anytime, anywhere. It is an objective that is both consumer and payer centric, serving the care access needs of employees and all segments of the healthcare ecosystem. Continued advancements in wireless communications and data technologies are enabling remote patient screenings and diagnostics in a way not previously thought possible – and forging a digitally connected relationship between patients and providers by way of virtual care.

As virtual care becomes more accessible, HR professionals can look forward to increased coverage by insurance companies and Plan Sponsors. Cost reduction and affordability will be significant drivers of virtual-first adoption. Today, several insurance products—such as this Kaiser Permanente plan— cover all virtual and telehealth services in a "virtual first" format.

Telehealth, VPC and the Digital Medical Home will begin to ameliorate concerns about rising healthcare costs by improving access to mental health services as well as primary care, genomics and labs.

The goal is to build and operationalize an entirely new engine that improves upon the virtual care model with the next generation of digital health innovation. The best tech-enabled telemedicine engine is founded on the principle to prevent first and treat when necessary. Given its current popularity and progress, virtual care will increasingly demonstrate its value and scalability to become the preferred healthcare delivery method for providing employee healthcare.

Michael Brombach is a contributing author to The Digital Medical Home and has published multiple thought leadership articles on topics including, how to solve healthcare’s complexity, future applications of virtual care models, the growth potential of consumerism in health care, and provider transformation. As Chief Operating Officer of Recuro Health , he leads strategy and development of Recuro’s digital health platform and products, overseeing integration, go-to-market strategy, and future product innovation.

Michael Gorton is a quintessential entrepreneur and company builder. As CEO of Recuro Health he leads a team which includes several leaders from Teladoc, where he served as the founding CEO and pioneered an industry-changing health care model that created a new efficiency paradigm in healthcare. Gorton co-authored and published The Digital Medical Home : a compendium of stories, personal anecdotes and true accounts of how telemedicine was born and how it grew into the industry we know today.

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