Beyond telemedicine: When was the last time you placed an Amazon.com order by phone or video?

Value-based care is driving the evolution from traditional telemedicine models to virtual healthcare

Say the word telemedicine, and most people think of patient encounters that start with live, direct-to-video or phone visits between patient and provider. However, with value-based care driving new reimbursement models, quality, efficiency and cost are more important than ever. As a result, the market is rapidly moving away from traditional telemedicine and embracing virtual healthcare—a more modern, innovative approach that connects the online experience with the brick-and-mortar and benefits health systems, providers and patients.

The digital delivery of modern virtual healthcare, done correctly, uses structured data in the form of online, adaptive interviews to guide patients through their healthcare encounters. Providers, following evidence-based pathways, leverage this structured data to create an online diagnosis and treatment plan with high rates of clinical guideline adherence. While these encounters always include online, adaptive interviews as their foundation, they allow for appropriate escalation of care, including supplemental photos, videos and/or phone calls (ONLY when needed)—and/or referrals for in-person care.

The Evolution from Telemedicine to Virtual Care

Sophisticated mobile and digital standards from other industries have supplied a proven roadmap for this evolution from telemedicine to virtual care. To understand this evolution, one might start with a simple question, such as: When was the last time you placed an Amazon.com order by phone or video?

I have never ordered anything on Amazon—or Uber or eBay—by initiating a videoconference or phone call. Video and phone are simply not the standard entry point in any modern digital industry. Instead, I have, at some point, entered my demographic data (shipping and billing addresses, payment information), areas of interest (wish lists) and key words as I search for information on an item or service of interest. Then, I decide whether I wish to proceed with the online exchange of information to fulfill my product or service request, and select my preferred delivery option.

Likewise, the modern virtual care model—and the one of the future—rely upon a foundation of innovative digital technology that enables the comprehensive collection of crucial patient data before reaching the final exchange of information with a provider as part of this virtual delivery of patient care. This is a much more efficient and quality-driven approach to diagnosis and treatment than encounters that start with live video or phone calls, which can be expensive, cumbersome and often not convenient.

Let's look at the best practice models in other industries, such as Amazon's ecommerce business, which launched a new, disruptive retail experience—providing products to consumers whenever and wherever desired. In the same vein, health systems must address patients' demand for anytime, anywhere access to quality care, delivered via a secure online platform.

To understand how and why the transformation from telemedicine to virtual care needs to happen, we will examine a couple of things that Amazon did to revolutionize the retail shopping experience.

Sears Roebuck to Amazon

When I was a kid, my parents received catalogs in the mail from Sears Roebuck & Co. In one well-bound catalog, they could shop for clothes, washing machines and all types of household items. When ready to purchase an item, they would pick up the phone and place an order. Compared to the previous experience of having to visit individual stores, sometimes hundreds of miles apart, Sears vastly improved the convenience of furnishing people's homes.

Fast-forward 30 years. Amazon has all but made shopping via the Sears catalog obsolete. Given the mounds of articles about Amazon's rise to success, I won't belabor this discussion with an in-depth analysis of the "why." Instead, let's focus on two key innovations that Amazon implemented that are pertinent to healthcare's evolution from telemedicine to virtual care.

The Disruption of the Digital Experience

Shopping on Amazon today is surreal. Through the ecommerce website, we have access to millions of products, many with reviews from buyers, competitive pricing information and multiple delivery date options. All of this requires petabytes of data whizzing around the globe. But it didn't start out this way. Amazon launched its site with a handful of products, carefully organized to create a simple but reliable retail experience. It was fast, it was cheap—and it was digital.

By digitizing every aspect of the buying process, Amazon created the opportunity to innovate and ultimately dominate. In making this commitment, Amazon leaders learned that if they could digitize the retail experience for digital books, they could do the same for TVs, DVD players and other products in a way that would be cheaper, faster and more personalized than any analog option.

Today, that small kernel of data has mushroomed, but the principle remains the same. A digital experience—even a simple one—can revolutionize an industry if it is applied methodically across products and services.

On My Time

Consider where and when you shop on Amazon: For many people, it's at home on the couch with your spouse or other family members. You buy anywhere, anytime—and more importantly, on YOUR time. Amazon disintermediated the buying and fulfillment process by using a robust technology platform. In doing so, Amazon tapped into the marginal shopping capacity of our daily lives. This digitally driven retail experience has allowed Amazon to offer cheaper products in a more personalized and convenient fashion than any other retailer on the planet.

Amazon's powerful platform unlocked the reliance on a single method of contact, the phone. Instead of dialing a number to place an order, we can visit a website, use a mobile app, interact via SMS, or email to buy the things we want or need.

The Origin of Virtual Care

If we look at how Amazon changed the retail paradigm by digitizing the buying and ordering process to improve upon the old retail models, we can see some parallels in the initial evolutionary shift from telemedicine to virtual care.

The traditional telemedicine models use analog tools such as phone or video to initiate patient visits. But in today's emerging value-based care environment, where documentation and outcomes matter more than ever, that's not enough. Virtual care platforms, like Amazon.com, use data to drive care delivery. In the same fashion that Amazon can pull from a broad data set of products and reviews, virtual care platforms integrate a broad set of clinical protocols/guidelines and metadata to personalize and streamline the clinical experience for patients AND providers.

Virtual care platforms have digitized the treatment of simple acute conditions such as sinus infections and urinary tract infections. Now that success can serve as a foundation for applying the same digital paradigm to more complex care such as hypertension and other chronic conditions, post-surgical discharge, mental health and even oncology—faster and more profoundly than analog telemedicine services.

Healthcare cannot achieve personalization, nor can we take advantage of big data sets, without digital care delivery platforms to connect patients and providers. Outsourced, siloed telemedicine services served as a stepping-stone to modern virtual care platforms that were designed from the outset to digitize care. Beyond using data as the foundation, innovative virtual care models embrace device-agnostic platforms that allow patients and providers to connect anywhere, anytime—without the necessity of real-time interactions.

Amazon has proven that analog does not scale. Only digital virtual care platforms will unlock the tremendous power of clinical data sets and apply them to improve patient access and provider efficiency for simple and complex healthcare needs. While Amazon is not delivering products that one couldn't obtain prior to the ecommerce giant's entry into the market, they are making it more convenient, efficient and cost-effective to do so. Virtual care provides the same type of value proposition through the innovative delivery of mainstream medicine.

Ah - le Cart

Some who embrace the old, waning telemedicine models say that the care model should not be more "retail"-ized. At one time, there was a belief that 20+-minute video visits were the markers of great care delivery (which is akin to thinking a larger saddle will make your horse faster than a car). However, there's not a shred of data to support this stance, mostly because collecting data in an analog world is nearly impossible. Not so for digital platforms, where highly structured data sets and analytics tools can prove and improve quality of care in near real-time. Healthcare should not be deprived of the same convenience and cost-reducing tools enjoyed by other industries.

The tar pit of telemedicine has the potential to trap many companies, mammoth or microscopic, that do not evolve. Amazon serves as an important example for healthcare's much-needed transformation to virtual care.

Analog, synchronous telemedicine services are being replaced by innovative, data-driven digital platforms that create the opportunity for transformative change in healthcare. This change, like many revolutions before it, starts with a simple question: When will be the first time you'll use a digital virtual care platform?

Jon Pearce is the CEO of Zipnosis, the first virtual care company empowering health systems to launch virtual care services staffed by their own clinicians. Pearce is a healthcare entrepreneur focused on leveraging the power of technology to improve the way healthcare systems engage and treat their patients. He developed his bold vision for the industry based on experience with med-tech startups and as a venture analyst. He has parlayed that experience into a virtual model that enables healthcare organizations to enhance patient engagement without sacrificing quality.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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