UPMC Central Pennsylvania, a hospital that in 2021 achieved Stage 7, the top of the HIMSS Electronic Medical Record Adoption Model, has been a leader in telemedicine, with more than two dozen robust virtual care programs.

THE OPPORTUNITY

The COVID-19 pandemic created an immediate opportunity for UPMC Central to rethink healthcare beyond the walls of the office setting. The urgency, and patient demand for care, allowed UPMC to expand existing services and create a virtual center of excellence that has transformed healthcare.

The increase in telehealth adoption by physicians and patients alike continues to allow UPMC to develop new digital health tools that offer patients greater access to high-quality care from the comfort of their own homes.

UPMC in Central Pennsylvania is a large health system serving a wide geography covering more than 10 counties. UPMC launched a virtual-first, full-service primary care clinic that offers a complete spectrum of care to patients aged 18 and above.

"We work to improve patient access to our health system across our geography and beyond, providing patients with a seamless experience," said Dr. Salim Saiyed, vice president and CMIO at UPMC Central Pennsylvania, and president of the Central & Western Pennsylvania HIMSS Chapter.

"Patients increasingly are seeking access to medical care virtually, which is becoming increasingly popular due to its many benefits," he continued.

PROPOSAL

UPMC Central's virtual-first care model offers patients medical consultations, diagnostics, therapeutics, coaching, nutrition and remote monitoring access all delivered with the top UPMC physician experts and clinicians.

"Virtual-first care is different in that care is accessed first in a virtual way," Saiyed explained. "Patients are not dependent on their clinics or health systems if they offer virtual care. The virtual-first primary care was launched in January of 2021 to a 10-county geography in central Pennsylvania.

"Virtual-first primary care provides patients with digital access to medical care, as they can consult with a healthcare provider from the comfort of their own home," he continued. "This is particularly beneficial for individuals such as busy professionals or those in rural or underserved communities, who may face challenges in accessing in-person medical care."

Furthermore, virtual-first primary care is convenient for patients, as they can schedule consultations at a time that is convenient for them, without the need to take time off work or travel to a doctor's office, he added.

"Patients can see primary care physicians for their initial or follow-up visit, be treated for chronic conditions like hypertension or acute conditions like the flu, etc.," Saiyed said. "Virtual primary care is designed to address a patient's total health needs with the virtual-first approach.

"When sometimes, a lab or image is necessary, patients can use one of more than 160 local brick-and-mortar locations closest to their homes," he continued. "Patients can digitally coordinate in-person exams or specialty care referrals with more than a dozen medical and surgical specialties as needed."

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MEETING THE CHALLENGE

Increasingly, patients demand higher-quality care from physicians who understand their healthcare history and can assist with the navigation of their total care needs.

"UPMC is a fully integrated health system and is proud to offer virtual services for urgent care, primary care and specialty care with top UPMC physicians and staff," Saiyed said. "We use virtual-first primary care to take our digital offerings to patients to the next level.

"It allowed us to develop physician-patient relationships digitally, which can offer the greatest knowledge of local resources and specialty services, ensuring best-in-class healthcare for patients in the region," he continued.

The majority of patients using the virtual-first clinic are females (70%), and the average age range has been 40-50. The payer mix of health insurance is typical, with 35% of patients representing government insurance such as Medicare or Medicaid, 60% commercial insurance and 6% self-pay patients.

"This shows that it is being used by all types of patients," Saiyed noted. "It is integrated within our EHR, and seamless for our clinicians and patients alike."

RESULTS

Pivoting to a new virtual-first model of care from traditional brick-and-mortar healthcare can be challenging, even more so on a rapid six-month timeline, Saiyed observed.

"Some of our hard results were regarding the challenges of opening the clinic to patients regardless of their insurance status," he said. "Enrolling a virtual-only practice with insurance companies firmly set in the traditional brick-and-mortar physical address requirements to be enrolled in their plans.

"A significant majority of patients have felt comfortable using this model, and would prefer to continue with the clinic," he added. "A significant majority (78%) felt the physician-patient relationship was unimpaired using virtual-first primary care."

The top Press Ganey satisfaction score with the virtual-first clinic has remained greater than 90-95% since launch. Virtual-first primary care has been shown to improve health outcomes by increasing access, he reported.

"By allowing patients to access medical care, virtual-first primary care helps to ensure that individuals receive the care they need more easily, in a timely manner, reducing the risk of complications and improving overall health outcomes," Saiyed explained.

"Early results have shown the three-month ER utilization rate was lowered by 50%, compared with usual in-person clinic visits," he continued. "In addition to increased access and convenience, virtual-first primary care also is reducing healthcare costs."

By reducing the need for in-person visits, virtual-first primary care eliminates many of the costs associated with traditional healthcare delivery, such as transportation and parking. This is particularly important in light of the rising cost of healthcare and the increasing number of individuals without health insurance, Saiyed noted.

"UPMC also is one of the nation’s 'Digital Health Most Wired' health systems, named by the College of Healthcare Information Management Executives for the 23rd year in a row," Saiyed said. "UPMC is only one of eight health systems with the highest tier of recognition. UPMC Central also is recognized as HIMSS EMRAM Stage 7."

ADVICE FOR OTHERS

As many technology companies, pharmacies and insurance plans look to enter the primary care space, virtual-first primary care is a growing trend in healthcare delivery that prioritizes virtual consultations over in-person visits.

"Healthcare provider organizations are uniquely positioned to create new models of care, though this is not their traditional operating space," Saiyed advised. "It requires engineering the traditional clinical and office staff to operate in all virtual environments to deliver a seamless experience to patients.

"We additionally designed extensive two-day boot camp training to embed the new culture of the virtual-first model," he continued. "Using a startup culture, other organizations can embark on this model to improve access and meet growing demands of patients."

The focus should remain on providing excellent quality care with a continuum for holistic patient needs, he added. This also is a great tool to attract and retain primary care physicians and staff that offers excellent work/life balance, he concluded.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email the writer: bsiwicki@himss.org
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