The Growth Channel

Why providers are dragging their feet with virtual care

by Tom Cassels and Emily Zuehlke

Recently, health technology investor Malay Gandhi said, "Telehealth is a runaway, unassailable trend that will become the predominant way people receive care." If that could be the future, then why does today look so different?

One important reason: Despite the well-documented benefits of virtual access to care—improved access to providers, greater efficiency and flexibility, comparable care outcomes—hundreds of interviews with health care leaders reveal a common roadblock to growing a mature program: physician resistance.

According to many physicians, their patients are only interested in having an in-person relationship with their doctor, especially when it comes to specialty services. Additionally, we increasingly hear about pushback related to uneven reimbursement for virtual services.

New survey findings, however, tell a different story. It's not one many physicians are ready to swallow. Not only are patients interested in virtual care—many may actually prefer it.

According to a new Advisory Board survey, up to 77% of consumers would consider seeing a provider virtually, and 19% already have. The results suggest that the health care industry has largely underestimated and, to date, failed to meet consumer interest in virtual care. The Virtual Visits Consumer Choice Survey is Advisory Board's ninth nationwide consumer choice survey designed to better understand the tradeoffs that consumers make when they need different types of care.

Consumers' appetite for virtual care therefore presents significant opportunities and challenges for legacy medical groups and health systems:

  • Provider organizations, many of whom have been hesitant to launch or grow their virtual offerings beyond on-demand primary care, may quickly find their patients are switching to other providers or third parties for virtual access.
  • Nimble entrepreneurs may be able to partner or compete with providers for patients' virtual business.
  • Insurance companies looking to expand access to care for their members and manage costs—a virtual visit for an acute condition represents an average $126 in cost savings over in-person care for commercial payers — may prioritize providers with telehealth platforms for network inclusion, according to results of a recent study by the Alliance for Connected Care.
  • The trend of employers moving toward virtual visits as a way to curb absenteeism and costs is likely to continue. Already, 90% of large employers plan to offer telehealth services in 2017, according to data from the National Business Group on Health.
  • And health care consumers soon may have more options to skip germy waiting rooms or long waits to see a specialist, leading to increased shopping for care.

The key to responding to this opportunity is to realize that consumer interest in virtual options isn't limited to primary care. The market for on-demand virtual primary care is significant—an estimated 20% of primary care and urgent care visits are clinically appropriate to shift to a virtual care platform, and this survey shows there is consumer demand to match. But direct-to-consumer virtual specialty and chronic care are largely untapped frontiers.

In particular, the most popular types of virtual visits tested in Advisory Board's survey interested more than 70% of respondents, including seeking a prescription question or refill; receiving ongoing results from an oncologist; pre-surgery and select post-op appointments; and ongoing care for chronic condition management. Select pregnancy checkups, weight loss or smoking cessation coaching, dermatology consults and psychologist consults were among other top offerings.

Caregivers were also surprisingly receptive to connecting virtually with a provider to get direction on caring for a loved one, such as an aging parent or a sick child.

With the expansion of both real-time and asynchronous virtual technology, patients are finally able to act like consumers. Driving to an office to access medical expertise is a relic of provider-centric design that's organized around the providers' convenience. Consumer demand and willingness to pay for their own convenience is untethering access to such expertise from bricks and mortar to mobile and flexible.

Overall, most of the nearly 5,000 survey respondents reported that they would be willing to consider a virtual visit in each of the 21 primary and specialty care scenarios tested.

Why is creating patient loyalty so hard?

However, it's important to note that although consumers' interest in virtual visits is high, they still have concerns. Specifically, 21% of survey respondents reported that care quality was their top concern with a virtual visit. Some 19% said they were worried a provider would not be able diagnose or treat them virtually, meaning they would have to go to the physical clinic anyway. Only 9% of respondents said they had no concerns about virtual visits. Industry players will need to respond to consumers' top concerns to actually convert interested prospects into virtual patients.

While these survey results should provide a wake-up call, the industry must realize that virtual visits are not a panacea and not appropriate for all providers or appealing to all patients. For starters, reimbursement and regulations vary by state and an integration strategy is critical to connecting virtual patients with future in-person care.

Additionally, population demographics may affect market readiness. Respondents older than 50, for example, were predictably more resistant to consulting with a care provider over the phone or via a digital channel than were younger respondents, and urban respondents were generally more interested than their rural peers.

However, as consumers increasingly shop for convenient, affordable health care, and as payers' interest in low-cost access continues to grow, this survey suggests that consumers are likely to reward those who offer virtual visits for specialty and chronic care.

This post originally appeared on Health Data Management's "IT Think"

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