During the COVID-19 pandemic, many Americans received care from their primary care physicians via telemedicine. It was just another adjustment forced on people as a result of the terrible virus. But it worked. And physicians and patients alike discovered there were many things they could accomplish over a video connection.

Telehealth technology and services company Amwell now is promoting the concept of "virtual primary care." Healthcare IT News sat down with Dr. Peter Antall, chief medical officer at Amwell, to discuss delivering primary care via telemedicine, and how it can help patients, cut costs and aid population health management.

Q: What is virtual primary care? How is it different from in-person primary care? And are patients receptive to this kind of primary care?

A: Virtual primary care is part of the evolution of home-based telehealth, and is a great example of a successful hybrid approach to care, allowing patients to see their primary care physician in person or virtually, depending on their needs. It combines the convenience of telehealth with the ability to strengthen recurring relationships with primary care physicians. It also can help provide a medical home for patients who have no primary care physician, either due to lack of access or lack of engagement.

The emergence of virtual primary care stems from the recognition that the traditional primary care model doesn't work well for many patients. Access to care remains a major issue for many patients, due to geographical constraints and a growing shortage of primary care physicians, which has only been exacerbated by the pandemic.

Given the shortage of primary care physicians in the United States and the difficulties patients face in finding primary care physicians, virtual primary care takes the best of what traditional primary care has to offer and presents an opportunity to access care in a convenient and user-friendly manner.

Patients not only are receptive, but a recent Amwell survey shows consumers want a virtual approach to primary care – and one in four consumers are willing to switch providers to get it. They also desire continuity in primary care, with 80% saying they would prefer to see the same primary care physician regularly via virtual care. In fact, most consumers (77%) would prefer to see their existing primary care provider via video.

Q: Can virtual primary care provide a simple, seamless care experience? If so, how are patients supported throughout the care process?

A: The best virtual primary care programs are well coordinated and enable a seamless care experience with the ability to transition patients between in-person and virtual care settings, and to various specialties or allied care providers as needed. In this way the care is holistic and the patient journey is clear and simple.

Data sharing is another important part of creating a highly coordinated and seamless care experience. Records from all visits should be available to all providers on the telehealth platform across specialties and should be shared with the primary care physician in brick and mortar if one exists. This interoperability improves care and improves the referral and transition process.

A strong virtual primary care program should facilitate labs ordering, radiology and other testing. Providers also should build workflows to provide other deliverables like forms, sick-slips, durable medical equipment ordering and prior authorization completion. The management of these functions should be seamless for the patient and should preference in-network services to save on costs.

To ensure patients are supported, virtual primary care programs should include care coordination capabilities. While much of the coordination can and should be automatically enabled by the technology powering the virtual primary care program, offering patients this added layer of support also is important.

For example, secure messaging between patients, healthcare professionals and administrative staff can help patients receive quick answers to their questions and ensure that all of their needs are met in a timely fashion, even after a visit has finished. Ultimately, virtual primary care programs have the power to create a seamless and fully virtualized doctor's office experience, from automating the check-in process, to checkout and prescription renewals and everything in between.

Q: Health plans want to save costs. Can virtual primary care cut costs?

A: Virtual primary care can reduce costs for health plans by providing proactive care rather than reactive, and by encouraging recommended screenings and closing gaps in care. This is especially important considering the fact that during COVID-19, one in five adults delayed care in the first year of the pandemic. Among these adults, 57% experienced negative health consequences.

By improving access to primary care via virtual primary care programs, healthcare organizations can bolster patient outcomes while reducing the long-term costs associated with delayed treatment, and can help direct patients to the correct level of care.

To further decrease costs, virtual primary care programs can help health plans keep care in network and drive members toward other in-network services and on-formulary medications, all of which are associated with cost savings and improved coordination for health plans and employers.

For example, physicians should have access to a list of preferred laboratories, formularies and in-network providers in real time during the patient visit, making it easier for them to direct patients to preferred providers that are lower in cost for patients as well as health plans.

Ultimately, health plans and employers can benefit from giving members more choices while helping them find the best, most affordable care, ultimately creating a better and more engaging care experience.

Q: Can virtual primary care help with population health?

A: Virtual primary care is a powerful tool for population health management. The flexibility of remote access makes it possible for providers to see patients' living conditions, evaluate social determinants of health, and respond in ways that make a deep impact on patients' lives. For instance, when evidence of food insecurity is found in a diabetic patient's home, the provider can connect the patient with community agencies that can offer assistance. This approach improves health outcomes and quality of life while strengthening the patient experience.

Providers also can leverage virtual primary care to evaluate medication adherence among patients with diabetes, hypertension and high cholesterol. When breakdowns in medication adherence are discovered, providers and support staff can work to engage patients in following their treatment plan more closely. This avoids complications that can occur when patients deviate from recommended treatment.

Improvements in compliance and ongoing care can be accomplished through use of frequent brief touchpoints, care coordination, nudges and team-based care. If the care experience is seamless and convenient, it is more likely that the patient will comply with recommended interactions. Further, prompts and reminders can be used to reinforce the plan.

With capabilities such as these, virtual primary care positions providers and health plans not only to improve population health, but also to perform well under value-based models of care. More and more, it's clear that the future of care depends on hybrid models of care delivery such as this and I believe we've only just begun to scratch the surface of what's possible with virtual primary care and how it contributes to the continued transformation of healthcare.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.