Consumers' reliance on technology to answer ordinary questions is a driving force in healthcare, and physicians at Virginia's Bon Secours Health System are giving the initiative to provide virtual visits high marks.
In less than three months, more than 4,000 patients in Virginia have signed up for virtual visits with primary care providers at Bon Secours Health System.
Telemedicine isn't new for the nonprofit Catholic health system headquartered in Maryland. It's been in the system's hospitals, but the new service was specifically developed to address the rise in consumerism, says Louise Edwards, senior manager for business development and planning for BSHSI.
A total of 15 BSHSI primary care providers, which include a combination of physicians, medical assistants, and certified nurse practitioners, provide virtual care to patients during regular office hours, 7AM to 8AM. After hours and on the weekend calls are handled by American Well, a third-party telemedicine provider.
The health system's employees were the first group to test the platform, and Edwards says about 2,000 employees signed up in the first two weeks. Within 11 days, virtual visits were available to residents in Virginia, one of six states where the health system operates.
By April 1, the $49 virtual visits will expand to Kentucky and portions of West Virginia and Ohio. "It's in our strategic plan; that's how important it is," she says. "The future of healthcare is going there."
Virginia is one of eight states the American Telemedicine Association awarded a composite grade of "A" in a report last month. Like most technological innovations, the speed of implementation is outpacing regulation and demand. A major barrier to telemedicine is that each state makes its own regulations, but sheer demand for access may ultimately remove that hurdle.
Identify Physician Champions
Currently, virtual visits are only available with primary care providers, but Herbert Cummings, COO of Bon Secours Medical Virginia Medical Group, says phase two will include specialists.
"We're floating ideas now to cardiologists and neurologists," Cummings says. "Instead of being prescriptive, we're asking, 'How could this assist you?' We believe creativity is going to come from physicians."
The use of telemedicine, whether in emergency departments or in doctors' offices, is growing significantly. The criticism it receives for being merely transactional is hollow. Consumers already flock to retail clinics for minor issues. And patient demand for virtual visits isn't likely to slow down because physicians think it disrupts care coordination.
BSHSI's aggressive schedule to expand to other states signals it is willing to work with the new ways patients engage with technology.
"It's important to make sure we are accessible to patients in many different forms," Cummings says. "We have retail clinics staffed by NPs [and] telemedicine provides another opportunity for patients to see us. We think it's going to resonate with patients who self-seek, let an illness play itself out, or patients who may use the ED for something minor."
Cummings says he strategically thought about which doctors could be the prototype for virtual care. "We identified physicians who were open-minded and tech-savvy," Cummings says. "They weren't afraid of it and they were going to be our best ambassadors. They would also provide a sense of confidence in patients who were also using this for the first time."
The setup for providers is pretty simple. Each one has an iPhone, iPad, and desktop computer
designated for virtual visits. Two to three employed providers are available at all times. Edwards says they log on and off in-between their regular office visits so that someone is always available.
Patient Experience is the Driving Metric
Out of the 4,203 patients who've pre-registered, either by the system's app or the desktop version, 300 have used it. That might seem like a low number, but both Edwards and Cummings say that's because the service is so new. Plus, they aren't looking to increase volume—yet—instead, they are measuring the program's success based on patient experience.
"We had a couple of hiccups in the beginning," says Edwards. "The Internet connection that the provider has is critical. You don't want something slow because video feed can be affected."
BSHSI also had to train physicians about small details that can make a big difference, such as where to look in the camera, and how to set volume control. The technical bumps were quickly alleviated, says Edwards.
"So far, patients rate the visits a 4.94 out of 5 and they rate providers just as high, a 4.74 out of 5," she says.
While Cummings says the goal is not "visit volume," he does believe that virtual visits will eventually a new normal at BSHSI.
"Our focus is on patient experience," he says. "A future goal is one of every four visits to be performed virtually. For new physicians, I think this will be a standard part of their onboarding."
Jacqueline Fellows is a contributing writer at HealthLeaders Media.