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The Virtual Care Revolution?

Contributors

Carl H. Kennedy, FACHE - Managing Director, Outcomes Delivery, GE Healthcare

Are Detractors Holding the Future of Virtual Care from Reaching its Potential?

Virtual care continues to mean a lot of different things to different people. Everyone appears to agree in the COVID-19 era that Telemedicine is somehow engrossed in the framework of Virtual Care. Whether or not this is true, there are some fighting back against the “Virtual Care Revolution.” Virtual Care promises extreme benefit to patients, clinicians, and organizations. But, it has its detractors who are quietly, and sometimes loudly, pushing back against what many have come to believe is the next normal.


Clinical Optics

Like pilots once believing the autopilot advancement would steal their jobs, could clinicians be seeing Virtual Care as ‘big brother’? Or an entity that will eventually relieve them of their positions? This could not be further from the truth, but let us first discover the origins of this thought process.

Whether it is in the operating room, patient room or post-acute setting, the practice of medicine has been largely left to meander at a local level. Changes to new systems, protocols or platforms have seen resistance. Visionaries such as Dr. Brent James have pushed the envelope and standardized care at a more regional level. His reception was not always welcomed by the medical staff just as the advent of Virtual Care has been shrugged off. i

Change is hard. Change in healthcare is well recognized as a herculean task. Dr. Ignaz Semmelweis discovered hand washing in the 1840s. Yet today we still struggle to appropriately wash our hands. Now, imagine something measuring your success every single time you wash your hands. Imagine that something keeps providing tips and insights while you are mid-suds in real-time. The practice of medicine begins to look a bit more cookie cutter – albeit reliable and with outcomes that are predictable.

Healthcare has shied away from “cookie cutter” medicine. It is beginning to break with tradition and develop the ability to create immense variation. Herein lies the clinical dilemma: do we conform and realize better outcomes? Or do we maintain our current path without the aid of Virtual Care tools? On our current path, predictions from ‘To Err is Human’ are to be expected for the foreseeable future.

“To Err Is Human asserts that the problem is not bad people in health care–it is that good people are working in bad systems that need to be made safer.”ii

If Virtual Care is not the shepherd and a giant leap towards this, what is?

Administrative Optics

Leadership has historically shied away from conflict with medical staff, cherishing high producers rather than high performers. That mentality has seemed to sway more in the past few years as a Just Culture is explored and implemented. The days of disruptive physicians are not entirely behind us, but organizations have looked across their employees and the overall health of the organizations. iii With this in mind, leadership should be thinking about the greater good and how Virtual Care presents a use case beyond the status quo of how ‘1+1=2’ and instead ‘1+1=3’.

With the shift away from fee for service, the benefits of a virtual aid and/or extender of care become obvious. Leadership across organizations will need to shepherd these technologies into play and ensure their appropriate use. This will be no easy feat as the culture that once prevented conflict may now have to be turned upside down and reinvented. The end goal is better outcomes for patients. This also translates into better margins and an annuity with positive patient feedback. The alternative is not desirable, as we see thin margins almost evaporating before our eyes. With Federal funding related to COVID-19 finite, organizations will need to become better stewards of their funds or face financial ruin.

Virtual + Cloud Computing

In the year 2020, a global pandemic shook the world. Without knowing it, COVID-19 forced organizations to innovate faster than ever before. Suddenly, cloud-based Virtual Care became the talk of healthcare circles. Few understood this technology. For that reason, many would immediately discount its security and efficacy.

For those that have embraced cloud infrastructures, limits once imposed on Virtual Care are being broken down. Enabling clinicians to securely take part in patient care from their homes, with a plethora of patient data in real-time, is changing how Virtual Care has been sold to the industry. It has become a force multiplier and has enabled clinicians to see the correct patients, at the correct time, making the correct interventions. Over time this could turn into the next Virtual Care Revolution.

Conclusion

Whether you believe in Virtual Care or not, it has arrived on our doorstep. Similar to how video conferencing came into vogue so quickly, Virtual Care is taking on many forms in this day and age. There are benefits yet to be unlocked and discovered. The question is, are you onboard and willing to participate in the Virtual Care Revolution?


References

i: https://www.nytimes.com/2009/11/08/magazine/08Healthcare-t.html

ii: https://pubmed.ncbi.nlm.nih.gov/25077248/

iii: https://www.psqh.com/julaug06/disruptive.html