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Waiting for Godot: My first experience with virtual care

May 3, 2017

    One holiday morning my wife, Michele, had an earache, which persisted until the afternoon, when it was too late to make a doctor's appointment. She decided to try the virtual care option on our health plan. Unfortunately, I couldn't even remember the name of the company, so I emailed some colleagues for help.

    My colleague responded with information about our company's virtual care option and our benefits hotline, which I promptly called. They directed us to our health plan website's "virtual care" link to schedule a visit for a $10 co-payment.

    Getting started

    On her phone, Michele couldn't find any reference to virtual care via the link provided. I opened my Mac and located the virtual care link, which led to a page that showed two providers. I clicked on one, and was directed to another site that showed the price was $49 per visit. I called our benefits hot line back to confirm we'd only pay $10 once our insurance information was recognized.

    The first virtual visit attempt

    After registration, Michele went through the menus to select her symptoms, fill out a patient history form, and enter her payment information. But then a window popped up to download new video software. After installation the original screen had frozen, along with all her information. She tried again—and again the screen froze. We called the virtual care company and they told us to try Google Chrome instead of Safari.

    We tried Chrome, and happily Michele's medical history had been saved. She entered the payment info again and was assigned a doctor, with a message that stated, "There are two patients ahead of you in line." Meanwhile, a video explained that the doctor was reading Michele's history. Unfortunately the waiting period took longer than expected and we had other plans, so we cancelled the visit.

    The second attempt

    Several hours later we tried again and she got right into the queue. By now it was time to go see Christmas lights with our kids, so she downloaded the virtual care app on her phone and logged in.

    Now there were three patients ahead of Michele, and after 20 minutes she was still second in line. Half an hour later the doctor told Michele it was impossible to diagnose an earache virtually, and suggested she go to urgent care. We weren't charged for the virtual consultation.

    Virtual care opportunities and challenges

    Although Michele did not get the care she needed, there were some positive aspects to this experience. We received helpful information provided online and by telephone. The virtual care platform had some useful functionality that prevented a duplicate log in, and I appreciated not paying for a visit that was not completed.

    But on the whole it wasn't quite the experience we had imagined. Virtual care is not something you can do on a whim. Once you've set up an account, ensured your browser works, and entered the required information, it could still take some time to see a doctor; in Michele's case, it took longer than it would have taken her to see our doctor in person.

    Action items for providers

    Here are eight things providers can do to help your patients have a better virtual care experience:

    • Advise consumers to set up their virtual care accounts before they need them.

    • Publicize which common conditions can and cannot be handled virtually.

    • Avoid frustration with automated feedback to consumers that their problem is not a good candidate for virtual care. Ensure your medical staff agree with these guidelines.

    • Send consumers physical sources of contact information, web addresses, and suggestions for using virtual care.

    • If you contract for a virtual care service on behalf of your customers, ask vendors how long their typical wait times are (along with other service issues). If you provide your own service, benchmark these metrics against peers.

    • "Secret shop" the virtual care experience before you select a vendor—focus on setup convenience; help line timeliness, accuracy, and attitude; wait times and the waiting room experience; provider friendliness, professionalism, and follow-up.

    • Continue regular evaluations for your contracted provider or for your own service, and give actionable feedback to the providers.

    • Conduct follow-up customer experience surveys after virtual visits and regularly review and evaluate the feedback you receive.

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