Health Systems' Integrated Virtual Clinics Improve Care Quality

By Christine Kern, contributing writer

Infographic reveals commercial telemedicine providers fall short in key quality measures.

Integrated telemedicine services provided by health systems give patients more time with clinicians, lower prescription rates, and better continuity of care than those of commercial telemedicine providers, according to a Carena study.

Based on 2015 data from Carena’s health system partners combined with data publicly available from commercial providers, the accompanying infographic, 3 Ways Integrated Virtual Clinics are Improving Care Quality, demonstrates integrated virtual clinics minimize care fragmentation and meet the highest quality benchmarks for delivering care. Among the study findings are longer average visit times, lower prescription rates, and lower care management rates for integrated telemedicine offerings over their commercial competitors.

“Virtual care is a natural use of technology to extend the availability of care from health systems that patients know and trust. It can meet the needs of patients on high deductible plans and it can help systems prepare for new reimbursement models,” said Ralph Derrickson, president and CEO of Carena, Inc. “The data shows, virtual care, when offered as part of an integrated delivery system, can improve quality and reduce fragmentation.”

Integrated virtual clinics studied provided more face time with patients. While patients who received integrated virtual care spent an average of 20 minutes with a physician, one commercial provider promotes two-minute consultations, another offers 10-minute consultations and a third offers 15-minute consultations.

Not only is the average visit longer, the study found while commercial telemedicine providers cap the consultation length under their fee-for-service payment model, the healthcare systems did not place the same restrictions on length of virtual visits.

“A longer visit means a better understanding of a patient’s needs and better care outcomes,” said Dr. Robert Bernstein, MD, MPH, VP of clinical affairs at Carena. “While a large part of telemedicine is about convenience and immediacy, it’s crucial to slow down and give patients proper, thoughtful attention.”

The study also found that, among patients diagnosed with Acute Respiratory Tract Infection, or the common cold, antibiotics were prescribed only 37 percent of the time via integrated care, compared to 56 percent of the time by a leading commercial telemedicine provider prescribed antibiotics 56 percent. Similar results were seen in the prescription of antibiotics for bronchitis.

“The over-prescription of antibiotics has turned antibiotic resistance into a health crisis,” Bernstein said. “As health care providers, we must be extremely judicious when prescribing antibiotics, or any medication. We want lasting, positive outcomes, not quick, temporary fixes.”

Integrated telemedicine services also emphasize the continuity of care rather than on an isolated healthcare transaction, resulting in improved patient engagement and more referrals in-network. Commercial providers studied had far higher virtual management rates (93 percent) than their integrated counterparts (68 percent), leading to far fewer referrals to clinicians who may have been able to better address patients’ needs.

“While a virtual visit can help address many health issues, others require care that only an in-person visit can provide. In virtual care, a higher referral rate means health systems stay engaged in the patient’s care episode, and they are being directed to specific in-person care when it is required,” Bernstein said.