Health Systems Are Moving Beyond the Video Visit

Propelled by more engaged consumers and available digital health devices, healthcare providers are taking that next step and replicating the physical exam at home.

Healthcare organizations are starting to look beyond the video visit to connect with patients at home, with new programs that pull in smart devices, wearables, and other digital health technology to make the experience more than just a video chat.

At MemorialCare, a health system in southern California, administrators have expanded their Virtual Urgent Care platform to include technology that allows patients to conduct guided physicals at home. In a partnership with New York-based TytoCare, the health system is sending handheld examination kits that allow users to conduct examinations of the heart, skin, ears, throat, abdomen, and lungs, and measures, among other things, heart rate and temperature.

"We can actually allow a physical exam to take place in the patient's home," says Mark Schafer, MD, CEO of the MemorialCare Medical Foundation, which comprises more than 300 primary care physicians and 2,000 specialists.

The typical definition of a telehealth visit is an audio-visual platform accessed through a computer, laptop, tablet, or even a smartphone, which allows a consumer to get in front of a healthcare provider when and where needed. That concept was pushed into overdrive during the pandemic, when telehealth use soared and healthcare organizations embraced whatever platform they could find to deliver a virtual visit in place of in-person care.

But many health systems are eager to move beyond that platform. Prodded by consumers who are adopting health and wellness technology and intrigued by digital health tools that capture more relevant data at the point of care, they're moving into remote patient monitoring and direct-to-consumer services that turn the healthcare experience into more than just a conversation.

To that end, health systems like MemorialCare are using technology to enhance collaboration between provider and patient.

"We already had the framework in place around video as one of our first virtual health tools," says Schafer. "That's a nice core capability, but digital and virtual care isn't just video. There are a lot of different ways to access healthcare."

With companies like TytoCare offering products that allow the user to collect more physiological data, health systems are looking to make digital health devices as ubiquitous in the home as the vacuum cleaner or toaster oven. These kits are now showing up in retail stores like Best Buy, Target, and WalMart, as well as in pharmacies and on Amazon. Pick one up, store it in the bathroom closet or cupboard, and pull it out when there's a health concern that would normally necessitate a trip to the doctor's office or ER.

"It changes the way we think about care," says Anne LaNova, MemorialCare's director of virtual care, who tested out the device when she was home dealing with COVID-19.

"MemorialCare is committed to finding ways to enable patients to manage their health through a personalized healthcare experience and ensure that no matter their circumstance, they have easy access to clinic-quality examinations from the comfort of home," Barry Arbuckle, PhD, MemorialCare's president and CEO, said in a press release. "TytoCare enables us to do just that."

Schafer says the challenge will lie in getting the devices into the right homes.

"There is a definite benefit to certain populations," he says, such as expectant and new mothers, families with young children, and people living with chronic conditions who have mobility issues.

While patients can choose to buy their own devices, to get those tools into the right hands, the preferred course of action is to have a care provider recommend that a patient get one (in certain instances the health system can give one to the patient). To help push this program forward, Schafer says MemorialCare started with a dedicated team of physicians and nurse practitioners, to help both patients and other care providers understand the benefits of the technology. Many new programs or strategies begin with physician champions, who help illustrate the benefits and smooth over the rough edges before a certain program is scaled outwards.

"We had to convince [our physicians], but once they tried this out, they were really impressed," says Schafer, who plans on rolling the program out to primary care physicians soon.

The next step, he says, will be collecting data from these encounters, to understand how these devices are used in virtual visits, and whether they improve the experience for patients and give providers the data they need to boost clinical outcomes. This information will enable administrators to fine-tune the program, make plans to expand its reach and— more importantly—convince payers to make this a standard of care.

"This offers a more rich physical exam and gives us more data than a video visit," he says. "We don’t think that video visits are going to go away, but it's good to have more options. The big thing is that we'll be able to try out different use cases," such as patients who often visit the doctor's office or ER for a variety of concerns.

"There's so much more that we want to do in this space," says LaNova, who envisions sending these devices to schools, businesses, urgent care clinics, and other locations to facilitate telehealth services with MemorialCare. They could also become part of the standard of care for health plans, employers, and population health programs looking to monitor and improve urgent care costs.

The devices coming onto the market now "have a lot of different capabilities," says Schafer. "We need to measure benchmarks to find out what works and what doesn't."