Why 2 health systems created a virtual care startup

Two health systems were a "match made in heaven" when they collaborated to form a virtual care company that has already been a hit with patients.

Cleveland-based MetroHealth System and Charleston, S.C.-based MUSC Health came together in 2022 to form Ovatient, a virtual care nonprofit with a dedicated staff of virtual-first providers. Ovatient has since launched for MetroHealth patients with plans to roll out to MUSC Health later this year.

"There are a lot of large organizations that have entered this space and exited as quick as they went in," MetroHealth Chief Clinical Transformation Officer Nabil Chehade, MD, told Becker's. "I strongly believe this is different."

MetroHealth, for instance, previously partnered with a third-party vendor for virtual care. "The medical director called us saying, 'We have a patient suspected of COVID, please take care of them," Dr. Chehade recalled. "It's like, 'What kind of service is this that is not going to take care of the patient?' So very quickly, overnight, we decided that's not going to work."

His health system connected with MUSC Health through America's Essential Hospitals, the trade group for safety-net hospitals. Both systems wanted to create a more cohesive virtual care experience.

"Telehealth in the future is actually combining and coordinating telehealth services in traditional bricks and mortar," said MUSC Health CEO Patrick Cawley, MD. "So if you see a patient via telehealth, but they need to be seen in person or they need lab work or they need X-rays, then we would facilitate that. And that should be seamless to the patient, and the patient should be able to easily go back and forth from a telehealth visit to an in-person visit and vice versa."

It helped that MetroHealth and MUSC Health weren't competitors. One is an urban, public health system, while the other is an academic network that serves a largely rural patient population in a completely different region of the country.

"That's why it was almost a match made in heaven, and we did not have prior relationships," Dr. Chehade said.

Most importantly, they would provide the virtual care to their own patients. "We didn't want to parachute into a market and offer virtual because that's disconnected care," Dr. Chehade said.

Ovatient is also embedded into Epic and MyChart. "Being built on Epic, and having the integration with it, allows for seamless care coordination across our regions and the health systems that we serve," said Ovatient CEO Michael Dalton, the former vice president of virtual care at MetroHealth.

The startup is also focused on quality, making sure its patients are appropriate for virtual care and scrutinizing visits via a peer review process and biweekly quality huddle.

"I want to be able to demonstrate that it is not 'as good as' but actually, if you design it well, adding value," Dr. Chehade said. "Am I able to close more care gaps because patients are more engaged with this technology? With this digital Ovatient offering, is the total cost of care actually lower in a patient with comorbidities?"

"What do we need to do to be able to provide a high-quality virtual assessment?" Mr. Dalton added. "How can we meet that patient's needs virtually and not have to escalate them to in-person care?"

The demand and response for Ovatient have already surpassed expectations. Virtual primary care is booked more than a week out, while the platform's net promoter score has exceeded 80.

Ovatient's 18 staffers, who are located across a dozen states, include nine full-time providers credentialed at the health systems and two nurses. The nonprofit is also looking to hire clinical social workers, psychologists and health coaches as it expands into virtual behavioral health.

The providers are effectively "virtualists," delivering virtual care exclusively. "For a provider in a hybrid model of care, there can be inefficiency, where I'm seeing one patient virtually, the next patient in person, and there becomes this tension," Mr. Dalton said.

Virtual urgent care is offered 7 a.m. to 10 p.m. seven days a week, while virtual primary care is 7 a.m. to 7 p.m. weekdays.

Ovatient, funded by the two health systems' venture capital arms, cost "several million dollars," Dr. Chehade said, declining to get into specifics.

The startup could seek more health system members. An emphasis on seamless, coordinated care would need to be a prerequisite of any future Ovatient partners, officials said.

It also plans to stay a nonprofit for now, fitting the mission of its safety-net health system founders and allowing it to offer student-loan forgiveness to providers. Ovatient, unlike some virtual care platforms, is available for patients with Medicaid and Medicare. Out-of-pocket costs also don't exceed $65 a visit and are eligible for financial assistance and sliding-scale charges.

One do-over for Dr. Chehade would have been engaging MetroHealth providers earlier in the process to assure them that this platform complements rather than replaces their ability to deliver virtual care. Mr. Dalton said he didn't foresee the amount of legal work needed to provide care across state lines.

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