The COVID-19 pandemic has dramatically accelerated the adoption of telehealth, transforming the patient and practitioner experience. While mostly positive, this transformation has created growing pains as patients and doctors adapt to new technologies and workflows.
According to AMA digital health research, telehealth adoption had already doubled between 2016 and 2019 — from 14% to 28%. With the pandemic, and aided by the removal of regulatory barriers, the AMA estimates current telehealth adoption to be between 60% to 90%.
This trend won’t last forever. As the pandemic subsides, patients will once again want to see their doctors face-to-face. The challenge for healthcare providers is to combine the best aspects of both virtual and in-person medicine to deliver hybrid healthcare that proves more efficient while creating a more rewarding patient experience.
What Is A Hybrid Patient Care Model?
Hybrid healthcare brings together the best of telehealth and in-person treatment. It relies heavily on technology for video conferencing, patient monitoring, appointment scheduling, and follow-up. Individual circumstances should determine if a patient should be managed remotely, face-to-face, or both.
Example of Hybrid Healthcare
A dermatology practice has reopened in-office appointments following a temporary shutdown due to COVID-19. However, some patients aren’t yet comfortable venturing into the office in-person. The practice offers patients both options, so long as their conditions meet the criteria to be evaluated via video conferencing/telehealth. For patients with minor conditions like psoriasis and acne, telehealth visits remain a good option. For patients who may need biopsies or surgery, telehealth isn’t an option but the clinic remains at low capacity thanks to the patients who are utilizing telehealth—making the patient journey safer and more comfortable for everyone.
Why a Hybrid Patient Care Model is Important
While telehealth and in-person care each offer unique benefits and drawbacks, combined they create a synergistic model that delivers better, more cost-effective healthcare and more satisfied patients.
Telehealth promises to transform healthcare practices in many ways, from extending available hours and reducing facility costs to improving patient engagement. Telehealth can help address doctor shortages, extend healthcare into geographically isolated areas, and deliver compelling patient education.
However, physicians may not be able to properly diagnose and treat many medical conditions (especially severe ones) virtually. And some patients may not be comfortable with an online appointment or have the technical knowledge to participate successfully.
Traditional, in-person patient care, while slower and more expensive to deliver, remains at the core of healthcare because it is reimbursed at higher rates, is preferred by many patients and offers physicians and advanced practitioners a more comprehensive view of the patient’s health and wellbeing during an exam.
Finally, COVID-19 introduced a historical crisis to healthcare in America, but one that we can learn from and use to be better prepared for future disruptions. Because no medical specialty can be completely replaced by telehealth, a combination of the two, delivered simultaneously to different patients within the same medical practice, means healthcare providers can both meet the needs of their patients now and be prepared to continue caring for patients in the event that they need to temporarily close in-person office visits again in the future.
Rushing to Adopt Telehealth — Challenges and Lessons Learned
With the accelerated adoption of telehealth, consulting firm McKinsey estimates that up to $250 billion of current US healthcare spend could become virtualized. This rapid expansion, however, has created concerns for both providers and patients.
McKinsey found that besides technology and security requirements, telehealth providers were uneasy about workflow integration, reimbursement, and overall effectiveness compared to in-person care. In turn, patients reported a lack of awareness of telehealth offerings and what type of care needs could be met virtually.
Patient scheduling has proven to be a particularly challenging issue for providers. Efficient patient scheduling is critical for healthcare providers to maximize revenue and patient satisfaction. But widespread use of telehealth has uncovered several scheduling shortfalls like the ability to identify visit type and limited integration with telehealth solutions—particularly those that weren’t originally designed and optimized for healthcare.
Upon implementing telehealth, many providers found themselves with a new challenge in keeping patient flow moving and reducing confusion for patients as they navigated a now-completely-digital patient journey. For this reason, virtual waiting rooms are essential to powering a hybrid care model, helping in-office patients avoid the traditional ‘waiting room’ experience and speed patient flow while also offering medical office staff a useful tool for managing the flow of telehealth patients.
Lack of Training
Patients may not know how to establish, modify, or cancel appointments. Providers must look for ways to educate patients on how to use online scheduling tools effectively.
Gaps in Patient Communication
Medical providers who turned to telehealth rapidly later struggled to keep their patients informed about the changes in their offices and how to access care. Medical providers reached for telehealth but also needed tools to communicate which locations were seeing patients in-person and which ones had closed, how to request a telehealth appointment, which providers were available, and what to do if your condition was more acute than what was appropriate for telehealth.
Generic Appointment Reminders
Medical providers who were already utilizing automated appointment reminders found they needed customization and directions for patients who would be receiving care via telehealth. Telehealth providers need a robust patient reminder system that includes automated text, email, and phone call reminder notifications and that can include a patients’ unique telehealth link or be customized with directions for telehealth appointments.
Incomplete Patient Information
Patient information that would have been collected by front desk staff at a patient’s in-person visit became a sudden challenge when telehealth adoption skyrocketed in early 2020. Without a digital way for patients to complete forms and update their payer information, medical office staff were left scrambling for workarounds that were powered mostly by manual processes and patient outreach.
What Kind of Workflows Do You Need for Success in a Hybrid Care Model
While virtual appointments often represent just one of many patient touchpoints, it’s critical for healthcare providers to establish comprehensive, interconnected patient workflows to support the combination of telehealth and in-office appointments. These include:
Appointment scheduling. It should be easy for patients to schedule appointments, whether over the telephone or using a computer or smartphone.
Digital patient registration and check-in. Patient registration is important for capturing a range of data that aids in both patient care and the billing process that follows (e.g., basic health history, medications, insurance details). Modern best practice is to collect this information prior to a patient appointment, regardless of whether a patient is being seen in-person or via telehealth, taking the registration process digital is the best way to do this. Online forms should be clear, easy to use, and have a common interface across all platforms.
Automated appointment reminders to keep patients on the schedule and minimize no-shows. Patient no-shows can Providers need the ability to push multiple reminders in a range of formats, including text, voice, and email. Reminders should allow for 2-way communication so patients can confirm, cancel, or reschedule from the reminder and where possible, be bi-directionally integrated to the scheduling system for automated workflows and easier access to patient responses.
2-way patient text communication. In today’s healthcare environment where patients can interact with most consumer industries via their mobile devices, medical providers and their staff need the ability to communicate with patients 1-to-1 via text. When it comes to powering hybrid care, 2-way patient text is even more important so as patients navigate new processes and have questions along the way, medical office staff can answer their questions quickly without playing phone tag or asking patients to navigate the clinic phone tree.
Follow-up. Proactively connecting with the patient post-appointment is not just critical for managing aftercare and booking follow-up appointments. Follow-up is also essential for capturing patient feedback on the process, identifying issues, and gauging their overall satisfaction.
Can a Hybrid Patient Care Model Scale to all Healthcare Settings?
While the speed of telehealth adoption is likely to slow, most experts believe there is still a significant capacity for growth. McKinsey’s research suggests that “approximately 20% of all emergency room visits could potentially be avoided via virtual urgent care offerings, 24% of healthcare office visits and outpatient volume could be delivered virtually, and an additional 9% “near-virtually.”
Can hybrid healthcare scale across all geographies and demographics? Technology barriers are being swept away — high-speed internet is ubiquitous, and almost everyone has a smartphone. Removing these barriers makes it easier for all patients, regardless of age or economic status, to transition to hybrid healthcare. Hybrid care helps solve many of the barriers to access that can affect patients in rural areas, without transportation, challenging work schedules, or who may have a hard time leaving someone they care for. These patients can often be seen via telehealth, freeing up exam rooms and clinic space for patients the prefer or require in-person care.
The tools that help power hybrid care are widely available to medical practices, hospitals, and health systems regardless of size, geographic location, specialty, or organization type. Tools like patient self-scheduling, appointment reminders, digital registration and check-in, patient surveys, 2-way patient text, and mobile billing are helping organizations from single-provider practices to large health systems, FQHC’s, tribal care organizations, and more reach their patients more effectively, expand patient access, avoid the delays and frustrations associated with playing phone tag with patients, and power optimized provider schedules that meet the unique needs of their patients.
The Future of Hybrid Healthcare
COVID-19 has proven to be the catalyst for long-overdue changes to healthcare. Patients find hybrid healthcare more convenient, proactive, and less time-consuming, while providers see the opportunity to deliver more effective healthcare at reduced costs. While both patients and healthcare providers may struggle with the speed and complexity of healthcare’s digital transformation, telehealth’s rapid expansion indicates there’s no going back. As KPMG states about technology and hybrid healthcare: “Digital front doors are here to stay.”