Pros and Cons of Virtual Care Solutions

AS NEW HEALTH dangers and dilemmas emerge seemingly every year — if not every week — the healthcare industry continues to adapt to meet evolving demands via virtual care. Exploding in popularity out of necessity during the worst of the COVID-19 pandemic, virtual care bridged the gap between in-person office visits and restrictions prohibiting them. Fears of spreading and/or catching the SARS-CoV-2 virus during in-person medical visits led to a greater interest in and use of technology to provide and receive healthcare.¹

In 2020 alone, video visits skyrocketed to 40,000 per day, which is 27 times as many as in 2019.² While that number has come down since offices have reopened, 76 percent of hospitals in the United States still use telehealth today, up from 35 percent a decade ago.¹ One in four Americans over age 50 said they’d had a virtual care visit during the first three months of the pandemic, up from just four percent of older adults who’d had a remote visit the previous year, and almost three-quarters of Americans surveyed said the pandemic made them more eager to try virtual care.¹

Though various forms of virtual care have been in existence for some time, the pandemic normalized them. The process continues to be honed, and virtual visits can now be made as easily and frequently as most traditional office visits. In fact, at-home virtual visits were so convenient for patients during 2020, thanks to the decreased travel time, ease of availability, privacy of one’s own home and lowered risk of possible exposure to disease, that virtual visits are here to stay. Patients and providers both now even expect it as standard practice.

Defining Virtual Care

But what is virtual care, exactly? It might seem like defining it should be easy, but the answer isn’t exactly straightforward.

First, “virtual care” is an umbrella term that refers to all the ways patients and healthcare providers deliver care digitally. Second, while “telehealth” and “telemedicine” fall under the umbrella of virtual care, they are not synonymous terms. Telemedicine refers to the practice of medicine at a distance through the use of technology, including video visits to support diagnosis, treatment and prevention; post-op follow-up visits via text messaging, phone calls or video visits; and remote monitoring of patient conditions.³ Telemedicine achieves everything a patient would accomplish during an in-person visit with a provider.⁴ Telehealth refers to the provision of medical services, both clinical and nonclinical, at a distance through the use of telecommunications technology. These technologies include the online platforms and digital tools themselves that facilitate care management, enable patient-provider communication, provide medical training and offer continuing medical education.^1,4

The format of virtual visits bears little difference from traditional visits. The only major difference is location. Patients and providers discuss the same things they would during face-to-face encounters, but simply do so through a different medium, with vitals taken via mobile apps or digital devices and instructions offered through a screen. These media include video visits, phone appointments, email, virtual front doors, wellness apps, remote patient monitoring and online chat services for clinical advice. All forms of virtual care can be administered via a HIPAA-compliant program such as Zoom, Doxy.me or Microsoft Teams.

No matter how these resources are categorized, listed or distributed, healthcare professionals need to know what they are, how to use them and the pros and cons for both patients and providers.

Pros and Cons of Virtual Care

Virtual care offers many benefits, but there are some downsides to consider, too.

Convenience. Patients can access healthcare via a smart phone, tablet, desktop computer or laptop according to their own timetable. While not all conditions can be treated virtually, many can be addressed and monitored through mobile apps and take-home devices such as EKGs, remote blood pressure monitors, blood glucose monitors and other digital devices that make telemedicine feasible. These sophisticated devices save patients the stress of taking time off work, commuting and potential exposure to disease. In fact, nine out of 10 patients say they would cancel an appointment because of workplace stress or lack of sick time.⁵ However, not every type of appointment can be conducted remotely. Patients and providers will always need to meet face-to-face for certain types of hands-on assessments such as reducing fractures or suturing skin lacerations; imaging and blood work must also currently be done on site. Still, in-person visits can be a waste of time and resources, making virtual care a more efficient mode of treatment.⁶

Context. Virtual visits give providers a window into a patient’s home environment, which may help providers better understand patients’ unique situations and implement an improved care plan. For example, during a video visit, an allergist might see triggers such as plants, pets and/or foods in a patient’s home environment that could be causing symptoms; neurologists or physical and occupational therapists might see how well patients are able to navigate their homes by identifying stairs, ergonomic issues and fall risks; and psychiatrists might identify stressors in the home.⁷ Visual clues provide context for patients’ reported symptoms that providers wouldn’t otherwise obtain.

Streamlined care management. Virtual care improves access to and interaction with patient information, which benefits patients and providers alike. Digital tools allow the care team to share and access patient information among themselves, improving communication among primary care providers (PCPs), specialists, nurses, pharmacists and anyone involved in the treatment plan. This includes test results, exam notes, email messages, text reminders and prescription information. By streamlining care management, healthcare providers have greater flexibility, all while lowering costs.⁸ Also, virtual care gives providers the means to monitor patients who need more support, which helps give patients an active role in their own healthcare management, too. However, the security of electronic health records (EHR) is of concern since data breeches are possible.

Access. With virtual care, providers are accessible to rural patients who experience a dearth of healthcare resources. Statistics say there are fewer than 40 doctors for every 100,000 people in rural areas, whereas there are approximately 53 physicians per 100,000 people in urban areas. In rural areas, virtual care provides convenient, crucial access to providers that patients wouldn’t otherwise have.

Beyond PCPs, virtual care also increases access to specialists who may be even further out of reach — not just for patients in rural areas, but even for those who live in small cities or suburbs. Virtual visits are usually available at a lower cost (just $40 or $50 per visit), which makes medical care more affordable.⁶

Provider burnout. Virtual care also helps combat clinician burnout. It increases schedule flexibility and allows providers to consult with each other more quickly regarding crucial situations such as life-and-death decisions. This can lead to timelier and more effective patient care. In addition, virtual care can cut the number of patient no-shows, which saves providers tremendous amounts of time and money.⁶

Cost. The United States spends more than $2.9 trillion on healthcare every year, more than any other developed nation. On top of that, an estimated $200 billion of those costs are avoidable, unnecessary spending. Virtual care has the power to cut healthcare spending by reducing problems such as medication nonadherence, unnecessary emergency department visits and time-consuming in-office visits.6 While some virtual care services are not covered by insurance, telemedicine visits often cost less than in-office visits.

Naturally, every virtual care advantage has a drawback, and both patients and providers have their own perspectives regarding them.

Patient and Provider Preferences

So, who prefers virtual care: patients or providers? The answer isn’t clear-cut.

According to a 2021 RAND Corp. survey, of the 2,080 adult patients surveyed, 66.5 percent indicated they were willing to have at least some video visits in the future. Fifty-three percent of that number preferred in-person visits; nearly 21 percent preferred video visits; and about 26 percent didn’t have a preference or didn’t know.⁹ Forty-five percent of patients surveyed reported having had one or more video visits since March 2020. Of that number, approximately 31 percent preferred video visits, while nearly 44 percent still preferred in-person encounters. Only about two percent said they didn’t want any more video visits in the future.⁹

While patients are at least somewhat willing to use video visits, providers aren’t as eager. Even though patients prefer on-site visits, demand for virtual care continues to grow. Implementing telemedicine services increased provider workload, and they are struggling to keep up. The survey revealed only 45 percent of providers have been able to invest in telehealth technologies so far, and just 16 percent have invested in other digital tools. In addition, only 41 percent of providers believe that they can seamlessly integrate virtual care into their existing workflow because it often requires them to use disparate systems that do not integrate perfectly with EHRs, and other crucial technological errors often occur, including loss of audiovisuals during synchronous remote appointments.²

Further, providers are noticing that their relationships with patients are changing. Fifty-eight percent of providers surveyed reported they lost patients to other physicians or health systems since the beginning of the pandemic, possibly because patient-provider rapport is affected by screens or the fact that telehealth makes health data easier for patients to obtain, making it easier for them to switch healthcare providers.²

Perhaps not surprisingly, while two-thirds of providers and 60 percent of patients agreed that virtual health is more convenient than in-person care for patients, only 36 percent of providers find it more convenient.² Patients and providers clearly see the advantages and disadvantages to virtual care very differently.

Takeaways

Virtual care is almost certainly going to continue to grow and will likely become increasingly normalized as its technologies are fine-tuned and easier to use. While on-site visits will likely be preferred by patients and providers, both can also appreciate the convenience of virtual care while enduring the drawbacks that are inevitably present. Therefore, providers are wise to arm themselves with training and expertise, along with a warm onscreen manner, to be ready and willing to offer quality virtual care.