Value-Based Care Requires a Balance of Telehealth, In-Person Visits

Health systems looking for the right balance between telehealth and in-person care shouldn’t think of one service as a replacement for the other. Rather, they should be complementary.

That’s the strategy being used at Sutter Health. And Chris Waugh, chief innovation officer at the California-based 24-hospital network, says that strategy will come into play more often as the network looks to incorporate more connected health platforms and tools to meet the needs of patients during and after the coronavirus pandemic.

“There's a lot of different ways that we interact with each other these days,” Waugh said during a recent episode of Xtelligent Healthcare Media’s Healthcare Strategies podcast series. “When we look at balancing in person and virtual care, what we think about is extending the relationship.”

Waugh says in-person visits with the doctor tend to be effective, but those visits are limited in time – and few and far between, thanks to the COVID-19 crisis. And they don’t take into account what happens to the patient outside the doctor’s office each and every day.

“What we want to look at is how could we augment and enhance that relationship,” he said, “so it can continue after the encounter (and) before the encounter. And what virtual is allowing us to do is work into the everyday lives in which people are living. So it's less about (replacing) the in-person visit with the virtual visit.”

“What we're seeing is we're getting more inputs, we're getting more context, we're getting more family members and we're getting more understanding around what's actually going on in people's lives and relying a little bit less about around, specifically, what are they saying when they (visit) the clinic,” he said.

Waugh says the pandemic has not only taught Sutter Health how to assign a certain value to the in-person visit, but also helped them to reimagine the concept of primary care. That, he says, involves collecting data on the patient from a wide range of sources – sources not found in the doctor’s office or clinic – and using them to create a whole-care plan.

“You can look at everything from information and context on people's lives,” he said. “As you watch the internet of things we could know, with some of our most frail patients, are they successfully getting out of bed and making breakfast? … That gets incorporated into the care planning. And so this all comes back to that theme around holistic understanding of people's lives and using that information to their health benefit, to improve the quality and quantity of the years that they live.”

Waugh says the health system will continue to map out strategies for integrating in-person and virtual care, particularly with remote patient monitoring and programs that address behavioral health needs. And he expects those programs to be modified as state and federal lawmakers and agencies redefine how telehealth and mHealth are covered in the future.

“We need to make sure) that this door that really opened up around reimbursement remains open,” he said. “I think that's been critical to the adoption of care. And … we believe that it's in the best interest of all that the cost of care starts to come down. And we believe that that virtual care delivery does support total cost of care reductions.”

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