Cleveland Clinic leader: Telehealth now a 'permanent mode' of care delivery

Photo: The Clinic by Cleveland Clinic

Telehealth encounters have the potential to save $250 billion in healthcare expenditures annually across covered populations, a McKinsey & Company analysis has found.

But creating true value from virtual care demands that healthcare providers and health plans design their digital trajectory with intention, says the top exec at The Clinic by Cleveland Clinic, a joint venture combining clinical expertise (Cleveland Clinic) with digital technology (from telehealth vendor Amwell) to give patients expanded access to care (virtual second opinions).

Telemedicine demands personalized care at scale for complex conditions, ramping up the move toward concierge care, and increasing access to the best medical expertise, The Clinic by Cleveland Clinic continues.

Healthcare IT News sat down with Frank McGillin, CEO of The Clinic by Cleveland Clinic, to get his considerably expert views on where telehealth needs to be headed in 2022 and beyond.

Q. You’ve said that creating true value from virtual care demands that healthcare providers and health plans design their digital trajectory with intention. What exactly do you mean by this?

A. It’s clear that virtual care is now a permanent mode of healthcare access and delivery. When the pandemic emerged, healthcare organizations had to ramp up their telehealth investments in just a matter of days to meet the sudden surge in demand. That meant relying on the quickest options available. Often, this resulted in “platform sprawl.”

We’re still feeling the effects of less-than-intentional digital investments made during a crisis. Today, one in four hospitals, health systems and health plans rely on five or more telehealth platforms, according to a survey by Amwell and HIMSS Analytics.

This presents significant obstacles in delivering seamless digital care. It also increases the potential for breakdowns in care. That’s especially true, given that 25% of clinicians say virtual care systems and clinical workflows are still not integrated in their organization, according to the survey.

Now, creating true value from virtual care demands that leaders determine the types of digital investments needed to deliver superior care across the continuum of care. Leaders also must consider: “Which digital investments will position our organization to remain competitive in a disruptive landscape?”

This means doubling down on investments that match patients with experts in their specific condition, engage patients in a thorough review of their diagnosis and treatment plan, and provide a seamless, highly coordinated care experience.

Unless healthcare leaders design their digital trajectory with intention, they risk losing patients, clinicians and market share to disruptors with well-defined digital capabilities.

Q. Aligning clinical expertise with digital technologies for a more personalized approach to care is a smart growth strategy for virtual care in 2022. This is what you believe. Please explain.

A. “Smart growth” in digital care means future-proofing digital investments to enable a more seamless, tightly integrated experience for patients and clinicians alike. It’s an approach that is conducive to delivering highly personalized care experiences. It’s also essential to achieving sustained engagement that improves health outcomes and reduces care costs.

Consider that virtual encounters have the potential to save $250 billion in healthcare expenditures annually across covered populations. One way that clinical expertise can be aligned with digital technologies to deliver more personalized care is through multidisciplinary virtual visits for patients with complex conditions.

Our Virtual Second Opinions program includes multidisciplinary case analysis conditions, such as for brain tumors and prostate cancer. This ensures patient cases are reviewed from all angles. It also provides a higher level of confidence for patients around the medical advice they receive.

Pairing patients with virtual support from a multidisciplinary team of experts reduces the risk of suboptimal treatment plans. Just as important: virtual multidisciplinary visits eliminate long travel times and exposure to COVID-19 for vulnerable patients. For employers and health plans, the right diagnosis and treatment equates to better member outcomes and reduced costs of care.

Similarly, intelligent remote monitoring that alerts clinicians to the need for intervention in real time is a vital tool for ensuring patients receive the right care when and where it is needed. At a time when care teams are short-staffed and under tremendous pressure from all sides, investments in intelligent remote monitoring give clinicians the tools they need to make the right decisions in times of stress.

It also reduces the potential for mistakes in clinical judgment, including misdiagnosis. That’s critical, given that 20% of people with serious illnesses are misdiagnosed.

Q. Why should healthcare provider organizations be ramping up the move toward concierge care – virtually and on-demand?

A. Interest in concierge care surged during the pandemic. For some consumers, concierge care holds appeal as a means for avoiding in-office wait times and potential COVID-19 exposure. For others, it’s a way of ensuring direct access to physicians, with in-person home visits a popular option. Visits with a luxury component also are not uncommon.

At The Clinic by Cleveland Clinic, we believe virtual concierge care presents a much less expensive option for concierge-level access and service. It also positions healthcare organizations and health plans to deliver better care to complex patients at reduced cost – with better outcomes.

For example, Anthem rolled out a concierge cancer care program in 2020 that enables members to receive a virtual second opinion from physicians at Cleveland Clinic, including from world-renowned oncologists.

Our data underscores the value of this approach. When patients receive a second opinion for life-altering diagnoses, such as cancer, 28% of patients receive a change in diagnosis. Additionally, 72% of treatment plans are modified after expert analysis.

We’re also seeing health plans explore models for concierge care that help eliminate inequities in care by strengthening access to care for marginalized populations. In our view, the best concierge care models include tightly integrated support – including digital record collection on behalf of patients – as well as dedicated care managers and fast insight.

Q. What do you think should happen with the pandemic’s relaxation of state licensure requirements that expanded access to medical experts who are highly experienced in patients’ specific conditions? And what does this mean for the future of telehealth?

A. When patients are about to make a major decision in their health journey, they need fast access to experts who can provide appropriate guidance. Relaxed state licensure requirements expanded access to medical experts who are highly experienced in a patient’s specific condition. This level of access is critical to providing the right diagnosis and ensuring the best outcomes for patients, regardless of where they live.

Today, 64% of primary care clinicians believe telehealth has made a major impact on their ability to serve patients. Now, many fear that if pre-pandemic payment regulations around telehealth are restored, their practices won’t be able to afford to continue virtual care.

For physicians and clinicians, the loss of this adaptive tool could contribute to already high rates of burnout in the profession, since patient visits already are more complex and take more time than they did before the pandemic.

For patients who fear exposing themselves to the virus during in-office visits, relaxed telehealth regulations could mean the difference between maintaining needed care or struggling to manage chronic or complex conditions on their own. It could also increase the risk that an emerging condition would go undetected, threatening Americans’ health on a scale the industry has never seen before.

In 2022 and beyond, continued access to virtual care across state lines will be vital to protecting health on a broad scale. It’s a measure that supports continued, consistent access to care regardless of geography, economic circumstance or social determinants of health.

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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