MedCity Influencers, Health Tech

Asynchronous virtual health: 3 reasons it’s critical for now and foundational for the future

Health systems should embrace an omni-channel strategy that includes asynchronous virtual visit capabilities to better meet consumer needs, improve provider capacity, and enable more robust virtual care models.

electronic health record Doctor is using tablet pc

One of the few silver linings of the Covid-19 crisis is the adoption and scale of virtual health solutions to reduce virus exposure, concerns, and impacts. Virtual visits have become mainstream, at scale: Medicare virtual visits increased more than 1000% and many health systems are now seeing 50% or more of their patients virtually.

Beneath these figures lie several noteworthy trends. First, while the virus surge drove unprecedented virtual visit increases, some drop off in virtual visits has already been experienced by many health systems as they move beyond the surge. Second, the vast majority of new virtual visits occurred using phone or video technology, a more comfortable but dated methodology that met critical needs but does not leverage newer technologies and modalities that deliver improved convenience and provider efficiency.

This is the time to advance to the next level of virtual health, not slide back. Health systems should embrace an omni-channel strategy that includes asynchronous virtual visit capabilities to better meet consumer needs, improve provider capacity, and enable more robust virtual care models.

Asynchronous care refers to a modality where there is no continuous real-time interaction between patient and provider or between providers. Most commonly, this is an offline store-and-forward approach where the patient completes questions or a form, which are then reviewed, assessed, and responded to by the provider when they are available. In recent years SMS, text, chat, AI, and other technologies have also been developed. These asynchronous approaches represent the next level in more convenient and efficient, technology-enabled virtual health interactions for three important reasons.

First, asynchronous care provides a robust and differentiated self-service experience for consumers. They can initiate a visit or care interaction whenever and wherever they are and from any device. For text-first generations, this is their preferred way of communicating and surprisingly, even seniors have expressed strong interest in text communications. Prices are also substantially less than a video visit or an in-person visit.

Second, but perhaps even more important is the impact on provider efficiency, capacity, and experience. A typical asynchronous visit can be completed in as little as 3 minutes or less, compared to a typical 20-minute in-person visit or an efficient 10-minute video visit. The driver for this efficiency is that patient data is collected and structured in a common format for physician review. The economics are clear: 3-6 visits in the same time it takes to do one video or in-person visit. Provider capacity can be created by utilizing asynchronous technologies, which is particularly valuable for access constrained primary or specialty practices.

From a provider experience perspective, providers can respond when they are available and have the luxury of receiving structured clinical data and, in some solutions, even present best practice guidelines for care and medication. In the case of asynchronous provider-to-provider consults, many of the same attributes apply. In addition, while these tools initially focused on lower acuity care, the capability to cover primary, chronic, and specialty care is expanding rapidly. Providers consistently report that delivering care in this modality was less stressful and convenient, helping to address provider burnout.

Finally, and most critical to a digital-first strategy, asynchronous care can accelerate digital care delivery models. The digital intelligence that is built into these technologies augment provider activities and lets them practice at the top of their license, drive best practice adherence, and automate routine tasks. In addition, the opportunity to reduce friction and increase loyalty through integration with other digital touchpoints in the patient journey is very strong. Leaders in asynchronous care are already connecting virtual visits with chatbot symptom checking, after visit follow-up, educational materials, and even monitoring health through consumer devices such as the Apple Watch and Fitbit. This frictionless flow of digital care is transformative and should be a key element of a digital care strategy.

To be fair, asynchronous care has not been adopted more broadly because of two key barriers. From a financial perspective, not all states will reimburse for these visits – though that is changing quickly, with California being the latest and most substantial example. The human factor is second. Care augmented by AI and/or automated rules that determine best practice responses is a different model of care and many are uncomfortable trusting it. Eyes-on care feels more like traditional care. However, volume in asynchronous care, like video, has skyrocketed during the Covid-19 crisis and efficiency and convenience are powerful incentives.

Looking ahead, over the next 18-24 months, asynchronous care will likely become table stakes for health systems. Tools will continue to become smarter and assist providers in more ways and at higher levels of acuity. Finally, the distinction between modalities will disappear and care will be optimized automatically for modality and location, based purely on clinical requirements and patient preference.

Asynchronous care delivery is surely not the only virtual visit solution, but it is a critical channel and significant opportunity. Any health system that is seeking to not only survive but thrive in this new environment must have this care delivery capability. It’s a foundational part of owning the onramp, growing market share, and capturing and delivering value. This is the moment to take the next step.

Photo: Mutlu Kurtbas, Getty Images


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Oliver Lignell

Oliver has been at the forefront of digital innovation for more than twenty-five years in leading industry and consulting organizations. As the Vice President, Virtual Health at AVIA, Oliver leads virtual health advisory and strategic services.

His prior experience includes roles at Kaiser Permanente, Cigna, Accenture, and Cognizant in digital technology, innovation, strategy, governance, and program leadership.

Oliver is a certified project management professional and holds a BA in Economics from the University of California Santa Cruz, and earned an Associate in Risk Management designation.

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