MedCity Influencers, Health Tech

Enhancing Care and Access with Virtualist Partners

Instead of trying to fix access issues by adding more office-based doctors, health systems should consider how to best implement a program that utilizes Virtualists for workforce expansion.


Virtual care exploded during the Covid-19 pandemic and is now cemented into our healthcare ecosystem. Many health systems, however, are struggling to meet their patients’ demands for effective and efficient virtual care – which puts organizations at risk of losing their patients to other healthcare organizations, and especially to new entrants focusing on virtual care convenience.

For many health systems, a key challenge is having available staffing to see patients in a virtual care setting. Primary care providers in particular are overwhelmed with office-based visits and lack the bandwidth to see additional patients virtually – especially when their patients have urgent care issues.

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Many in the industry believe a “shortage” of physicians is a key reason for access challenges, whether for care in the office or virtually. However, I would suggest that we do not have a shortage of physicians in this country as much as we have a shortage of using them efficiently.

Automation, delegation, and virtualization to improve access

Health systems committed to expanding patient access via their virtual care programs must commit to a strategy that maximally leverages their current office-based physicians through automation, delegation, and virtualization. This approach means that your experienced physicians should increasingly oversee a tech-enabled virtual care team that will manage as much routine care as possible, thus freeing up the physician leader to work at the top of their license – giving them more bandwidth to care for their complex patients that need greater time and attention.

To continue with the traditional approach that relies on the “tyranny of office visits” to take care of every patient problem is merely perpetuating a broken system – one that leads to burnout for physicians, and inconvenience, excessive costs, and suboptimal care for patients.

Consider how most other industries, such as banking and travel, have figured out that face-to-face interaction is not necessary to perform many routine activities. When booking a vacation, for example, travelers used to meet face-to-face with a travel agent to plan out itineraries, flights, hotels, and transportation. Today, consumers can accomplish these tasks quickly and easily via self-service websites, such as Kayak and Expedia. To advance the narrative that “we need more doctors” is akin to saying, “We need more travel agents” – making those who say this appear to be outmoded and behind the time compared to other industries.

Improving access and care with virtualists

Therefore, instead of trying to fix access issues by adding more office-based doctors, health systems should consider how to best implement a program that utilizes Virtualists for workforce expansion. However, where will they find these Virtualists?  Health systems often find that their internal supply is low.  Most office-based physicians understandably want to deliver the majority of their care in their offices where they have optimized their skills, experience and billing abilities. Even harder would be finding physicians who want to provide 24×7 or out of state care requiring multiple state licensing.

To obtain more virtual urgent care availability, some health systems use third-party telehealth platforms and providers to expand coverage. Unfortunately, this creates a discontinuous experience that frustrates both patients and providers, and compromises the quality of care because clinical data is not easily shared. A better approach is a partnership with a Virtualist provider that utilizes an EHR platform that fully integrates with the health system’s EHR to support a more seamless experience and bi-directional sharing of clinical data. This robust data sharing ensures that all care team members have access to the critical patient information they need to optimize care and outcomes.

Consider the following example of the ideal patient journey when a health system partners with a Virtualist provider. A patient visits her health system’s patient portal to request an on-demand urgent care visit. If her health system’s medical group does not have any appointments, she then has the choice to see a Virtualist from a medical group that has partnered with her health system. Common examples of this scenario would include care that is needed after hours or when the patient is traveling out of state.

After selecting the Virtualist partner option, the patient completes her check-in and begins a virtual visit with the virtual care provider – all from within her health system’s portal. Because the patient remains within the health system portal, she does not need to create a new username, input her medications, or add past medical history. Meanwhile, the Virtualist partner has access to the patient’s information via bi-directional data-sharing with the health system’s EHR. After the visit, the patient receives an “after-visit summary” via the health system’s patient portal, and the Virtualist’s notes are shared with the patient’s primary care team. A truly seamless experience for patient, Virtualist and regular care team.

Filling critical gaps with virtualists

Health systems do amazing work taking care of cancer, heart disease, broken bones, and very complicated patients. But to efficiently and effectively manage the needs of their more complex patients, as well as those with more routine or minor urgent care needs, health systems often require additional resources.

In today’s world, adding a tech-enabled virtual care workforce to help leverage and supplement a health system’s physicians is becoming increasingly important to ensure better access for patients and decrease burnout for providers. Furthermore, by aligning with a Virtualist partner using the same EHR, health systems can make the experience easier and better for both patients and their providers. The end result is a win for all – happy patients, happy providers, high quality care, and improved loyalty to the health system.

Lyle Berkowitz, MD, FACP, FHIMSS is the founder and CEO of KeyCare, the nation's first virtual care company built on Epic. He has over twenty years of experience as a primary care physician, an informatician, a healthcare innovator and a serial doctorpreneur. Previous roles include Founder & Chairman of healthfinch, Chief Medical Officer at MDLIVE and Director of Innovation for Northwestern Medicine.

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