By shifting primary care visits by 5 minutes, moving some administrative tasks and self-care duties to patients, the U.S. could conserve billions of dollars which could extend primary care to underserved people and regions, hire more PCPs, and drive quality and patient satisfaction.

Accenture’s report, Virtual Health: The Untapped Opportunity to Get the Most out of Healthcare, highlights the $10 bn opportunity which translates into conserving thousands of primary care providers. PCPs are in short supply, so virtual care represents a way to conserve precious primary care resources and re-deploy them to their highest-and-best-use.

The analysis looks at three scenarios for extending primary care:

  1. Shaving a few minutes off of a typical office visit via consumers’ use of sensors, using patient portals for administrative transactions like completing forms before a visit, and following up via video visits where they can be most appropriately done.
  2. Ongoing patient management using eVisits for people with hypertension.
  3. Patient self-management for chronic conditions such as diabetes.

While the macro numbers for the U.S. health system total nearly $10 billion under these three scenarios (which represent but a few of the total possibilities for virtual health care), the financial and clinical human resource impact for the enterprise — say, an integrated delivery system — are compelling. Accenture calculates that the 5 minutes saved per visits for these three scenarios in a single health system with 1,800 affiliated or employed PCPs could conserve 320 PCPs, equal to about $63 mm of primary care resource.

Medicare value based payments to 2018Health Populi’s Hot Points:  Virtual health care will underpin hospitals’ and health care providers’ ability to move from getting paid based on the volume of patient visits and procedures to being paid on the basis of value — population health outcomes, individual patient diagnostic bundles, episodes of care, among the various flavors of value-based reimbursement evolving in healthcare in America. Remember that Medicare plans to move 50% of fee-for-service payments into value-based funding by 2018. The time between “now” and “then” will fly, in terms of health systems’ ability to shift Medicare workflows into this Brave New Payment Paradigm.

Accenture’s report details but three kinds of encounters that can be shifted, in not-too-dramatic ways, toward the virtual visit paradigm. These models emphasize the paradigm that health care will be both digital AND analog — not one nor the other, mutually exclusively. High-tech can marry appropriately and effectively with high-touch. The art of figuring out the best mix can integrate with the science of what’s best for clinical care, based on clinicians’ coming together with each other and with financial and management staff in delivery systems.

We brainstormed this idea in my meet-up with the Group Practice Improvement Network in San Antonio on 15 October 2015, in the context of the new consumer in the value-based health economy. The theme of the event was “What Matters Most.” In our discussion, a representative from a well-known, respected group practice in the Pacific Northwest commented that her organization has brilliant minds working within — a rich trove of intellectual capital that, if deployed for this kind of discussion, can make these value-based delivery scenarios work toward The Triple Aim.

FYI, my firm, THINK-Health, had the pleasure of collaborating on this Accenture analysis.

For more on the impact of virtual healthcare on hospitals, see Accenture’s Dr. Kaveh Safavi’s essay in U.S. News & World Report’s special coverage for the 2015 Hospital of Tomorrow meeting in Washington, DC.

3 Comments on Virtual Visits Would Conserve Primary Care Resources in US Healthcare

Cameron said : Guest Report 7 years ago

Technology will play a HUGE role in shifting work to those with the greatest incentive to do it: patients and their caregivers. Imagine a would-be patient engaging with sophisticated technology for differential diagnosis - and getting, from home, an idea of: (1) what conditions they might have - and that a clinician should consider (2) how urgent it is and who they should see (3) which labs and tests would be reasonable to pay for (and worth the possible radiation) - and which would not (4) what evidence-based treatments they and their clinician should consider Well. You don't really have to imagine. It's on its way already. Witness the app at Designed for clinicians, it will soon put a team of specialists in the palms of every consumer with a smartphone, tablet, or computer. Cameron Physician Cognition

Ted Eytan said : Guest Report 7 years ago

Jane, Always enlightening and as usual, you continue to be on the right path forward to what people want - more time to enjoy life, enabled by health. I can further extend the analysis for you back-of-napkin style, because imagine that there's a health system that's already doing this routinely. That one (Kaiser Permanente) goes beyond modeling physician time (because what's the goal for health care anyway - not for physicians to have time, for patients to have more time) and into better outcomes. The results speak for themselves: The #1's just keep coming, and if you study/model any one of those measures, especially control of hypertension (#1 in the United States, Kaiser Permanente Mid-Atlantic States), the time saved from not having heart attacks and strokes wallops any physician time saving. And what matters more anyway, patient time is priceless. One side comment I'd made is a slight questioning of the assumption that virtual medicine would reduce a physician visit by 5 minutes. I don't think this future means that people will robotically enter their doctors office and do what needs to get done on paper and leave. Imagine that that 5 minutes will be instead used to discuss the things that are important to patient and physician together - the things not on the checklists, that when discussed, will make sure the checklist things get done. As one of my mentors told me, every one of those measures that we are graded on depends on patient action and engagement. In the end it is not the doctor controlling your blood pressure. So to summarize - from measuring physician time to measuring patient time. Not minutes saved in a doctor visit, minutes added to lives, doctor visit the same length. Picture it. The data is out there, we know the impact. It's happening today, Keep up the great work! Ted

Steve said : Guest Report 7 years ago

I can already see it now; I'm sure there are tons of people who are extremely opposed to the idea of virtual visits. Don't be afraid, people! This is a good thing, and it's not like it's the end of in-person doctor's visits or something. I think those will always be necessary, unless we have some crazy technological breakthrough in the future.

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