Virtual Care Visits: 24/7 Care To Monitor Remotely Any Clinical Condition

Finding time out of busy workdays and covering the transportation costs of getting to a clinic are only two demands of primary care visits. Along with many other aspects of telehealth, like remote patient monitoring (RPM) and mHealth, the virtual visit is becoming a means to significantly boost quality and cost-effectiveness of healthcare delivery.[1]

What is a virtual care visit?

A virtual care visit (or e-visit) is a two-way patient-clinician communication via telephone and/or video, using a secured application on their tablet or computer.[2] The video and audio connectivity allow “virtual” meetings to occur in real time, from any location, so that patients can interact with offsite medical specialists. They are normally follow-up visits, after an initial face-to-face appointment with the doctor and they are incorporated in the care plan only if conditions and symptoms allow it.[3]

What conditions can be managed during an e-visit?

Virtual care is an extremely effective tool for non-emergency medical care. It can be used across almost every field in medicine, from primary care to post-surgical management. The most common cases of e-visits involve discussions around:[4]

• Cough or flu-like symptoms
• Red eye
• Diarrhoea
• Insect bites and stings
• Head lice
• Rash

How do virtual care visits improve patient adherence?

Virtual care visits upgrade the traditional model of visiting clinics and hospitals by bringing health care services to the patients. The results are positive. Patients are asking several treatment-related questions, they feel like they provide their input more, and that medical information is now more integrated into health decision making.[5] They also have the opportunity to more readily find qualified second opinions online, if necessary, without the requirement of visiting another clinic.[6]

Virtual care visits not only help reduce costs and improve access to care, which are their principal benefits, but they also contribute to ameliorating chronic disease management, by easing the process of postsurgical follow-ups or medication reconciliation after hospital discharge.[5]

Is it the same with telemedicine?

No, virtual visits are actually a component of telemedicine, which is a broader term encompassing the entirety of remote and/or technology-driven healthcare.[6] Virtual care is a quick, convenient option of telemedicine. Most virtual care services are offered 24 hours a day, 7 days a week, which sets them apart from a doctor’s visit, or something planned far in advance.

In addition to virtually meeting the patients via a secure application, telemedicine also involves instant messaging, audio calls and any other means of communication with them, remotely. This may include checking in after an in-person visit, monitoring vitals after surgery, or responding to any questions about their diagnosis, condition or treatment plan.[7]

The fact that these two terms are so often confused indicates how integral virtual healthcare is to telemedicine.6 Either way, demand for a means to avoid the expense, burden and time to commute to and from clinics and hospitals is growing. This is seen especially in rural areas, which do not attract physicians and practitioners as much as cities do. Therefore, reducing the need for transportation is not only a matter of convenience, but also of basic condition for better access to care.

Have patients embraced the innovation of virtual care?

There is patient demand for electronic health services. Recent data demonstrated that:[8]

• 79% of patients prefer to have a follow-up virtual video visit than a traditional office visit
• 62% of patients reported virtual video visits and office visits had the same quality as office visits, and in fact 21% thought virtual visits' overall quality was better
• 59% of health professionals agreed that, for the patients selected for these visits, virtual visit quality was similar to that of office visits

Another study suggests that virtual visits in primary care are associated with a high degree of patient satisfaction and positive system outcomes.9 These numbers are encouraging and show that people are open to new ways to expand virtual care and optimise healthcare services. However, despite these positive numbers, only 21% of consumers surveyed stated they had received virtual care by that time.[10]

What are the current challenges?

The potential for establishing virtual care visits remains elusive. This is due to the poor integration into the existing fabric of patient care and the inadequate reimbursement structures that support both clinicians and patients.[2] Healthcare professionals need support to appropriately incorporate virtual care services into the current model of care, which could affect fundamental matters, such as physician remuneration or clinical practice guidelines.[1]

One of the most significant barriers to date has been the question of how physicians will be compensated for the time spent on remote care. It appears, however, that the reimbursement landscape is now changing. In January 2020, reimbursement plans were empowered in the US to expand the use of telehealth, including remote patient monitoring, in ways they weren’t before.[11]

Finally, there is a need for more patient education. While 73% of patients surveyed stated they know what virtual healthcare is, only 5% of those consider themselves as fully aware of telemedicine and a shocking 27% have never heard of it.[12] Therefore, more education is needed to help patients enhance their knowledge, so they are better informed about what kind of virtual health advancements are available and their eligibility.

The healthcare industry is changing every day. With the introduction of new technologies, there is no limit to what can be achieved. The goal of virtual care visits is to increase access and enhance patient care while decreasing the overall cost.

Overall, virtual care is a great way to provide options for people who have difficulty getting to the doctor’s office, and it is a smart choice for someone who wants a quick consultation or help with a minor health issue. Extending the office visit across the virtual world is a positive change, but we cannot forget that a high standard of care must also be maintained.

References:

1. CMAJ 2019 March 18;191:E320-1. doi: 10.1503/cmaj.109-5720
2. Anderson and Ganguli. J Gen Inter Med. 2019; 34: 2906–290
3. https://www.brighamandwomens.org/virtual-care/virtual-visits
4. https://www.uofmhealth.org/virtualcare/virtual-care-evisits
5. https://news.careinnovations.com/blog/rise-of-virtual-visit-technology-what-it-means-for-patients-providers
6. https://news.careinnovations.com/blog/what-is-virtual-healthcare-how-does-it-fit-into-telehealth
7. https://intouchhealth.com/finding-the-right-term-for-modern-digital-healthcare/?gdprorigin=true
8. https://www.sciencedaily.com/releases/2019/01/190114130910.htm
9. McGrail el al. J Med Internet Res. 2017;19(5):e177
10. https://positivepsychology.com/virtual-care/
11. https://hitconsultant.net/2019/05/22/survey-83-of-consumers-are-interested-in-receiving-virtual-care-but-only-17-have-access-to-it/#.Xkvs_Sj7Q2w
12. https://positivepsychology.com/virtual-care/