Beyond Telehealth: Expanding the definition of virtual care

Omar Manejwala, MD

Why the conflation of “telehealth” and “virtual care” is misguided.

Telehealth has gained a lot of attention during the COVID-19 pandemic, and rightly so. It has been incredibly beneficial—critical, really—for enabling patient care while reducing coronavirus exposure risk.

Audio-only communication is the most common form of telehealth being used in physician practices, with video communication used as necessary. This makes sense with respect to patient preferences and practice efficiency. What’s misguided, however, is the continued use of the terms “telehealth” and “virtual care” interchangeably.

With advances in digital health technology, these terms are no longer synonymous, if they ever were. Given recent advances in digitally supported care, we should be much more deliberate in how we define the broader concept of virtual care.

A more comprehensive view

Most telehealth solutions today are essentially “paving a cow path,” so to speak. Typically, they digitize existing workflows rather than address the central question, “What’s the best way to provide a virtual patient care experience that promotes health, value and convenience?” Answering that requires a more expansive view of virtual care that includes not only telehealth, but remote patient monitoring (RPM) and digital therapeutics as well.

Here’s why: time-strapped physicians are under pressure to drive better patient journeys and outcomes without additional operational lift. RPM addresses those needs by balancing synchronous telehealth and in-person visits with asynchronous, digitally enhanced patient support, thereby fueling improved outcomes without adding to physicians’ workloads.

Although it’s a common misperception that RPM is time-intensive, with the correct partner the virtual care enabled by RPM saves time and yields substantial clinical and financial benefits. The key is to use solutions that are clinically validated, have a low operational lift, and demonstrate proven ROI. RPM solutions with these attributes can help practices:

Collect rich, objective, usable data

Gathering data in-between patient visits frees physicians from the traditional limitations of in-office physiological assessments. It ensures a more accurate picture of patient health because it’s not dependent on patient memory, transparency, or context.

While the data itself is beneficial, even greater value should come from the actionable intelligence derived from it. Data can be synthesized into intuitive formats that take seconds to understand rather than precious minutes spent sifting through logbooks. The findings from data often are counterintuitive, which is precisely when they’re most valuable. The gold standard is to arrive at those findings without extra work by physicians or staff.

Take a proactive approach

To improve outcomes, providers need tools that permit proactive decision-making and interventions. RPM gives providers the ability to review real-time trends, insights, and patient data.

Engage patients in healthier behaviors

The impact of patient behavior on outcomes is well established. Tools that leverage behavior science—such as those that use reminders or goal-setting—support providers’ care recommendations by making it far more likely that patients will adhere to them. RPM tools built on sound behavioral science principles guide patients at a personal level to form healthier habits.

Obtain clinical and financial ROI

Solutions should be backed by published outcomes, not just marketing material. The best RPM tools will be part of replicated research published in peer-reviewed journals that indicates they deliver significant clinical advances over time and at scale.

In addition to clinical improvements, solutions should be capable of establishing revenue streams through billable CPT codes (e.g., 99453-99454, 99457-99458), grant funds, and other reimbursement mechanisms including value-based care contracts. By empowering patients during the 99.9% of the time they aren’t in a doctor’s office, RPM tools can help practices gain some influence over the hundreds of daily patient choices that ultimately impact value-based cost and quality metrics.

Why semantics matter

Telehealth plays an important role in patient care, but it’s a mistake to equate it with virtual care. By conflating the two, we set unintended limits around the scope of support we deliver to patients. Telehealth lets us connect with patients wherever they are at any given moment in time, but truly virtual care surrounds patients with support at every moment in time.