This post is part of MassTLC’s 2023 Thought Leadership series on Trends.
In these pandemic years, virtual care has clearly come into its own. The origins of hospital-based telemedicine date back to the late 1950s, however it wasn’t until the pandemic hit in 2020 when clinicians and patients truly started to realize how virtual channels could provide access to high-quality care in a safe environment. While our eyes are open to its potential, we have barely begun to scratch the surface of the impact of a technology-enabled care model. In considering the inflection point in which we find ourselves, I am struck by the many truths of what really drives long term change as articulated in this Atlantic article by Derek Thompson. In it, he hits on a core truth: that the eureka theory of history is wrong.
When a good idea is born, or when the first prototype of an invention is created, we should celebrate its potential to change the world. But progress is as much about implementation as it is about invention.
Even in its simplest forms, virtual care can help hospitals and health systems address present-day challenges such as clinician burnout, lost revenue, and meeting the needs of an increasing number of patients. However, when virtual care goes beyond video visits and is integrated with in-person and automated interactions, the possibilities for impact grow exponentially. With automated care, digital tools are placed in the hands of both clinicians and patients in a way that improves the care experience, can make the clinical team more efficient and delivers on health outcomes.
This excitement is starting to permeate the industry. My clinician colleagues and our Amwell clients using such solutions have found many powerful use cases for automated care programs that are achieving better patient self-management and health outcomes, including:
Automation can address clinician burnout and shortages
Experts predict the U.S. will be short 122,000 physicians by 2032, a particularly acute problem for health professional shortage areas. Additionally – following a six-year decline in physician burnout, a recent study found that symptoms of burnout increased significantly during the first two years of the pandemic, from 38.2% in 2020 to 62.8% in 2021. And nursing burnout is keeping pace. Burnout has numerous repercussions including a poor patient experience, reduced care quality and erosion of the therapeutic clinician-patient relationship which is essential for healing.
We will, in 2023, see more healthcare organizations tapping automation to enhance efficiencies and reduce clinician workload. In fact, automated messaging can help patients adhere to a treatment plan, track disease symptoms, support care gap closure and escalate to a clinician when needed. Automation can also assist with documentation, including capturing notes during a patient visit. Similarly, automation can support routine lab and vaccine orders so physicians can focus on the more complex aspects of patient care and building a patient relationship. These digital tools can connect an entire care team to the information they need, help them coordinate care, and accelerate treatment when evidence for clinical deterioration is detected.
Automation to both standardize and customize the care model
Using automation, we have an opportunity to standardize and customize care at the same time. Automation can help automatically review patient charts to identify, validate and enable care gap closure. A favorite adage heard at the Institute for Healthcare Improvement meetings is that “the office visit is a dinosaur”.
Once basic evaluation has occurred and a relationship of trust is in place, weaving medical expertise into patients’ lives when, where, and how they want it with no delay — and using ongoing virtual conversations — has proven to be better in many ways. Suddenly, the office visit no longer seems central to caring. – IHI Leadership Alliance
We must go beyond the traditional visit by supporting patients between visits in the context of their daily lives. This is where real impact lies. Offering a standardized sequence of automated messages following treatment for common conditions can enable high quality patient self-management to take charge of their own recovery with support when and where they need it. Using automation this can happen without clinician intervention, so clinicians are freed up to focus on those that need their one-on-one attention.
Customization is enabled when the response to these messages indicates something isn’t going according to plan. Care is then escalated to a clinician. These solutions enable a much broader population reach and precise detection of those needing clinical support. Successful organizations will make sure this technology-enabled channel of communication picks up immense steam in 2023.
“There is no heavier burden than an unfulfilled potential.” – Charles Schulz
Potential is nothing without a sound execution strategy. What must be overcome to realize the progress that such a vision holds? How can clinicians continue to trust in the notion of “progress” when there are so many examples of “progress” gone astray. Those examples have led us to a point now in which we run our long days on tired feet (or rather slide around on our tired rear ends) along a hamster treadmill, eyes glued to a screen. We then barely get time to pause to change into our pajamas then stare at the screen until we can no longer hold our eyes open. As we fall into bed or onto the couch or some other flat surface, we pray to the RVU gods that we captured all the diagnoses and checked all the boxes to demonstrate we’re delivering top quality care. Can we even remember the faces of the patients we cared for that day?
Our healthcare system is facing one of the most difficult times in its history. There’s a push to “get back to normal” following the pandemic. But that normal clearly wasn’t so great. This is our opportunity to create a better future for both healthcare workers and those they serve. It is one that enjoys the benefits of in-person interactions enhanced by automation and virtual interactions. 2023 can be an exciting year. We have the tools to realize a hybrid care model that delivers on the quintuple aim. As put so well by the Atlantic writer, Derek Thompson, Invention alone can’t change the world, what matters most is what happens next.
So what must happen next. I propose three things:
- Clinicians must help lead the change efforts. We have too often had change thrust upon us. Yes, we’re tired and burned out, but engaging in these change efforts can be rejuvenating, hopeful and gratifying.
- We must give up some things. Holding onto a past that we’ll never see again is only keeping us stuck. We must stop guarding that cemetery.
- Focus on what happens next. It would be tragic to squander this opportunity brought to us through the black swan event of a global pandemic. We owe it to our profession, our patients and our communities to muster the will to see what’s possible with a technology enabled care model, one for which we carry the commitment to progress.
Dr. Carrie Nelson is Chief Medical Officer at Amwell, where she is focused on empowering providers and payer organizations to achieve better operational, clinical, and financial outcomes via digital healthcare delivery. Dr. Nelson is also committed to helping healthcare providers improve population health in today’s new era of hybrid healthcare and oversees healthcare professional practices on behalf of Amwell’s clinical partner, the Amwell Medical Group.