In-person visits are still perceived more positively than virtual visits when it comes to telehealth quality, outcomes, convenience and utility, according to a soon-to-be-released healthcare survey of more than 6,000 consumers in the U.S., Canada, England, Ireland, Australia and Germany.

The survey was conducted by research and consulting giant EY – and it has plenty more to say about the state of healthcare and health IT today.

EY gave Healthcare IT News a sneak preview of the survey results in an interview with its global health leader, Aloha McBride.

Q. What have consumers been saying about healthcare recently, and how they want telehealth to work for them?

A. In healthcare, paying attention to the consumer is so important. In the EY team’s work around the globe, we see healthcare is shifting focus to value-based care and contracting, and yet it seems as if the views of the consumer or patient are being left out of the equation.

To delve into this and better understand what consumers value in healthcare, in early 2023, we surveyed more than 6,000 consumers in total, across six countries: the United States, Australia, Canada, Ireland, England and Germany.

Our key focus was to understand personal preferences and what matters most to consumers regarding their health and care. We look at this through the three different lenses of people, process and place.

However, given the major investments in such things as virtual care and generative AI, we also wanted to understand the consumer’s level of comfort with emerging technologies. And so, to this end, we consider care delivery modalities including in-person and virtual care, AI, and remote monitoring.

We also tease out consumer preferences around telehealth and willingness to pay, medical innovation, and data sharing.

Overall, three value features for health stand out. Unsurprisingly, consumers value access to care when it is needed and relief from pain and anxiety, but they also value having a cost-effective health system. This is perhaps a little unexpected – although healthcare is highly personal, consumers also see value in terms of social benefit and economic efficiency.

Concerning telehealth services, across all markets, in-person visits were perceived more positively than virtual visits relative to quality, outcomes, convenience and utility.

Consumers strongly prefer in-person visits as they allow health professionals to examine or see the health condition (84%), develop a deeper personal connection with their clinician (77%) and solve their care concern (67%). Close to three in four consider the quality of in-person care is superior to that of virtual care (71%).

However, 44% of consumers would consider a virtual primary care consultation instead of an in-person visit. Specifically, consumers would try a virtual appointment for prescription renewals (67%), test results (61%), to save time (57%) and for a minor medical condition (56%). Consumers were less willing (12%) to use virtual for chronic disease consults.

These results lead us to examine the experience and the integration of virtual care into the health and care continuum. Specifically, health entities may want to rethink the design of the virtual care experience, how it nests within care pathways, the effectiveness of virtual care training and clinician selection, as well as virtual care outcome measures for patients and clinicians (a recent study indicated clinicians prefer providing care in-person, as well).

Perhaps most clearly, our survey results emphasize the need for health systems to truly understand their consumers from a psychographic perspective of beliefs, values and goals. Health entities may need to reconsider their investments in this area to ensure they are designing products and services tailored to the needs of their populations.

Q. A lot of experts are saying the future of telehealth is hybrid care – the combination of telemedicine and in-person treatment. Based on your experiences with clients and your knowledge of the industry, what do you think this is going to look like?

A. Hybrid care integrates digital, virtual, remote monitoring, augmented reality, virtual reality and in-person care, among other modalities, across the care pathway. These are the tools by which care can become decentralized and delivered where and when it is needed, and in ways that make sense for a person’s lifestyle, clinical needs and social preferences.

Hybrid care models use insights about a person’s life, such as their comfort with technology, their activity level, health literacy and family support as well as their health status, to craft integrated care pathways. These seamlessly mix in-person, digital, virtual, community and social care in combinations that make the most sense for the person.

For a tech-savvy patient who excels at self-management and prefers digital communications, this may mean a care experience that optimizes the use of exception-based digital and passive remote monitoring. Only when the patient’s clinical risk exceeds a given threshold would an intervention be flagged and activated.

Beyond the tailored experience, hybrid care models help ensure patients are routed to the most appropriate care setting and are cared for by the right clinical resources. Hybrid models can offer more efficient staffing models and flexibility for clinicians, enhance access as well as support better use of capital infrastructure.

Virtual command centers, for example, allow clinical teams to manage across numerous care pathways for thousands of patients while integrating and communicating with in-person care teams at the point of care. This can include such diverse activities as virtual emergency department triage, overseeing clinical chatbots or home health virtual check-ins prompted by incoming biometric patient data.

Integrated, hybrid care models offer the possibility of enhanced patient engagement, more personalized and precise care with greater staffing flexibility and operational efficiency for health systems. However, as we found in our survey, designing and orchestrating hybrid care models requires a significant understanding of the patient population, their health needs, preferences, behaviors and social risks.

Q. You say healthcare must move beyond digital innovation toward the world of big data and smart technology infrastructure, with human experience at the center. How can this improve the patient and the provider experiences, improve outcomes and lower costs?

A. As health systems around the globe embrace integrated care ecosystems, we believe a new approach to health information architecture is required to gather, create, connect and share data and insights. For this to be successful, it is essential the data is fit to be shared, and this means common or compatible standards, semantics and structure.

Data is shaping up to be a major capital asset. All sorts of data including genomic, clinical, demographic, social and behavioral will be captured and used over a lifetime and used by numerous people for diverse permissible purposes across time and space.

As a result, the information architecture must be fit for purpose. This should take the form of an "infostructure" of hybrid cloud digital health platforms to enable data flow. Also, a key requirement is that the underpinning information architecture separates the data layer from the transaction layer and the logic layer.

With so much data available from across the health ecosystem, we can shift care delivery to make it truly about keeping people well.

A human-centered approach to healthcare along with emerging technologies such as generative AI and advanced analytics will transform the experience of receiving and providing care. Administrative tasks can be automated, and technology allows early identification of looming clinical and social risk and can prevent a patient from progressing to a costly and painful crisis.

Care teams can use data insights to design care that reflects the reality of how a person lives, their challenges and preferences, and to create an engaging experience that supports adherence to the care plan.

Applying these insights at the population level enables health systems to microsegment their customers. Segmentation can support greater precision in forecasting demand, investing in care programs and targeted campaigns as well as in modeling for required staffing, appointment types and supplies.

Ultimately, such infostructure supports cost reduction by enabling pre-emptive decisions and actions that take full advantage of the available data to keep populations well, operations efficient and care coordinated across the community.

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Email the writer: bsiwicki@himss.org
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