Virtual Visits and Beyond: The Next “Pandemic Pivot”

By Florian Otto, MD

While the COVID-19 pandemic continues to wreak havoc across humanitarian and economic fronts, it also may be giving the US health system a much-needed wake-up call to truly prioritize and adapt to patient needs. Almost overnight, our healthcare leaders have realized, and subsequently proved, that it doesn’t have to take years to adopt new technologies that can make a real impact on the health and experience of patients. Take telemedicine platforms; according to a recent McKinsey Survey, consumer adoption of telehealth has skyrocketed, with 46% of consumers now using telehealth, compared to just 11% in 2019. And, this shift is not occurring in isolation. Several previously slow-moving technology trends have seen exponential spikes in market penetration and adoption since the pandemic began. But what’s really here to stay for the long-term? 

As the founder of a health-tech company, COVID-19 has further cemented my belief that patient needs should always be top priority, and we as industry professionals must be able to pivot quickly and nimbly to meet those ever-changing needs. New digital-health technologies have been adopted at record-speed to address the pandemic in the short-term, but these types of developments — including virtual care visits, modernized patient financial engagement platforms and at-home diagnostics, to name a few — have already shifted the paradigm of where and how we interact with healthcare providers and will be here to stay as we pivot to our post-COVID-19 future. 

Virtual Visits for Pre-Qualification (and More)

Why physically go to a doctor’s office or hospital if not required? It’s typically both inefficient and inconvenient for patients, and as it turns out, more than 30% of doctor’s appointments are actually unnecessary. However, in order to enable virtual visits, healthcare providers need to have the appropriate technical infrastructure, staffing and processes in place. At ChristianaCare in Delaware, one of the most dynamic health care providers in the mid-Atlantic, there was a virtual system used to engage with targeted populations of patients at the beginning of the COVID-19 pandemic, but it was kicked into high gear as the situation began to escalate in March 2020. Patients were then able to interact first with their care teams virtually and were only directed to a physical facility for specific tests or treatments. This new model of care kept patients safer in the early days of the pandemic, and it also made more efficient use of resources while focusing on patient needs.  

During a recent virtual event for hospital leaders, ChristianaCare President and CEO Dr. Janice E. Nevin, MPH, said that while they had plans and infrastructure in place for introducing virtual care, it was supposed to be a longer term roll out: “We thought it was a two to three year plan. We did it in two to three weeks,” she said. She went on to state her goal of creating a future healthcare experience that is ‘radically convenient’ and patient-centric. To Nevin, that radical convenience includes the entire patient care journey — virtual visits being just one aspect. Despite the regulatory and reimbursement challenges that remain, Nevin is not alone in her bullishness around the widespread adoption of telemedicine and the transformation of the health care experience to become more data- and technology-driven, and built around the needs of each patient. 

Financial Engagement, Reimagined

Even pre-pandemic, patients reported confusion and frustration after receiving the medical bills associated with a typical hospital visit. However, the situation is further exaggerated in the wake of COVID-19. With unemployment widespread as cases spread across new parts of the country, the financial strain and stress of health issues on top of that is overwhelming for families. Meanwhile, many hospitals and health systems are struggling to stay solvent amid increased COVID-related expenses and lost revenue due to postponed elective procedures. Patients need a better healthcare financial experience now more than ever and healthcare providers deserve to get paid for the valuable treatment they provide. 

Financial engagement platforms like Cedar bridge this gap between patients and providers and we’ve seen a spike in demand for our platform as health system leaders prioritize the need to offer empathy, transparency and convenience to patients throughout their entire healthcare experience — from pre-visit planning and administration through post-visit payment and bill resolution — not just during the clinical interaction itself. 

With the ability to understand costs ahead of time (pre-visit pricing estimates), engage with administrative tasks via the channels most convenient (i.e. mobile) and resolve bills in more flexible and empathetic ways (easy access to payment plans and resolution options), patients are happier and healthcare providers benefit from increased patient engagement and loyalty, not to mention higher rates of payment collection. 

At Home Testing: DIY Becomes BAU (Business as Usual)

At home testing is not a new concept as we’ve been able to buy home pregnancy tests since the late 1970s. More recently, genetic testing kits like those from 23andMe allowed consumers to trace their health predispositions and DNA ancestry from the comfort of their homes. That ushered in at-home health testing for not only genes that might indicate a higher risk for certain conditions, but also for home health lab testing for infectious diseases like lyme disease and certain STDs.

That foundation set the stage for the entry of more sophisticated in-home testing such as we are now seeing with things like at home rapid COVID-19 tests, and a wearable device currently being tested to monitor temperature, cough and breathing and transmit results to physicians. Remote Patient Monitoring Systems (RPMs) had been gaining traction pre-pandemic, but they became a necessity for patients who couldn’t visit in person due to shelter-in-place mandates. At home testing also makes telemedicine more effective in many cases because it helps give healthcare providers the valuable information they need to make a diagnosis or rule out afflictions from a distance. 

A “Contactless” Future Requires Proactive Patients

Beyond the regulatory and reimbursement hurdles, which have eased during the pandemic, one additional requirement of this digital health paradigm shift is a higher level of engagement and self-direction from the patient. Trends indicate that most patients eagerly welcome this responsibility, but it can require overcoming a learning curve and required behavioral adjustments, so can’t be taken for granted, especially with under-represented or at-risk populations without the same access to technology.

The pandemic shift to digital health was born of necessity and may yet suffer some growing pains. However, that pain will be worth it for the patient who gets more control of their physical, mental and financial health from pre-visit testing to post-visit payment. And for the physician who can focus on the medicine, in order to provide their patients with the best possible outcomes. 

Florian Otto, MD PhD, is CEO of Cedar, a healthcare financial engagement platform for hospitals, health systems and medical groups that clarifies and simplifies the financial experience for patients, improving bill resolution and payment outcomes for providers. Prior to founding Cedar, Florian was an executive at Zocdoc where he drove the commercial adoption of the platform. Florian began his business career as a strategy consultant at McKinsey & Company within their healthcare practice.