Shifting to Virtual Care in the COVID-19 Era: Analytics for Financial Success and an Optimized Patient Experience

Shifting to Virtual Care in the COVID-19 Era:
Analytics for Financial Success and
an Optimized Patient Experience

© 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Patrick McGill, MD
Executive Vice President,
Chief Analytics Officer,
Community Health Network
This article is based on a Healthcare Analytics Summit (HAS 20
Virtual) presentation by Patrick McGill, MD, Executive Vice President,
Chief Analytics Officer, Community Health Network, titled, “Virtual
Care in the COVID-19 Era: Enabled with Enterprisewide Analytics.”
Virtual Care in the COVID-19 Era

Early in the spring of 2020, the CMS responded
to COVID-19-related healthcare capacity strain
with a call to delay all non-essential, elective
procedures, heavily impacting ambulatory,
including primary, care.
As of April 2020, the number of visits to
ambulatory care practices had declined by
60 percent nationwide.
In June, Health Affairs estimated a loss for
primary care of up to $15.1 billion nationally,
with primary care practices losing an estimated
$67,774 in gross revenue per full-time physician.

Medical practices and health systems have
scrambled to avoid burning through cash
while also attempting to save lives.
Some organizations made cost-cutting
measures, such as furloughing employees.
However, these solutions were inadequate
because patients still needed care, and
organizations still have revenue gaps to fill.

A more sustainable, pragmatic response to
the downturn in ambulatory care has been
shifting to virtual care.
Whether organizations were ready for the
transition from in-person to remote visits,
the pandemic forced them to rapidly
embrace virtual models and likely maintain
them for the foreseeable future.
Health systems that have made smooth
transitions already had robust enterprise-
wide analytic practices in place, which they
leveraged to inform changes to best meet
patient needs and financial goals.

The Critical Role of Enterprisewide
Analytics in Virtual Care
Even though ambulatory care rebounded
somewhat by May 2020, outpatient visits were
still one-third lower than pre-pandemic rates.
Furthermore, while outdated rules and
regulations previously hindered virtual care
adoption, the CMS announced in spring 2020
that it would pay for virtual visits in parity with
in-person care.
These events reaffirmed virtual
medicine as a new key player in
healthcare delivery and the ongoing
need for analytics to inform and
optimize virtual models.

Analytics that proved essential for
organizations to transition to virtual care
successfully included dashboards for COVID-
19 metrics.
With critical insights—such as positivity rates,
ICU volumes, and more—dashboards helped
team members understand the virus’s state
within their health systems, respond to
pandemic-driven needs, and anticipate
capacity requirements (e.g., personal
protective equipment, ventilators, etc.).

Insight into provider and patient
needs will continue to be critical as
organizations plan for the technology
and policies to deliver virtual care cost
effectively throughout the crisis.
Forward-looking tasks include launching
a video/telephonic platform systemwide
and incorporating virtual care as part of a
financially successful practice (Figure 1).

Figure 1: A dashboard of a financially successful practice.

Shifting to Virtual Care:
Must-Have Analytic Tools
Analytic tools in the ambulatory setting that have
enabled a smooth transition to virtual care measure
performance down to the provider level and identify
what makes each provider successful independently.
This provider-level view, or analytics for practice
management (Figure 2), requires a suite of tools to
look at income statements, productivity, patient access,
no shows, cost and overhead, and revenue cycle.
Organizations with these analytics in place before a
pandemic could make the most seamless shifts to
virtual care, as they had positioned themselves to
understand the impact of the transition per individual
provider.

Shifting to Virtual Care:
Must-Have Analytic Tools
Figure 2: Analytics-driven practice management.

Preparing for a Virtual-Care-Ready Future
Reimbursement was a pre-pandemic barrier
to widespread adoption of virtual care.
But with reimbursement parity for a virtual
visit, for the time being, healthcare can
expect to see the virtual models become a
delivery fixture.
Consumer demand will also drive virtual
care adoption, as patients increasingly want
to interact with the healthcare system the
same way they interact with other services
(e.g., contactless grocery shopping).

Meeting these expectations for healthcare
involves offering e-visits and consults,
asynchronous and on-demand 24/7 visits,
as well as bot-scheduled video visits and
follow-ups.
The following analytics-driven actions will
help organizations move their and their
patients’ comfort zone from in-person
care and make data-informed decisions
about shifting to virtual care:

Offer Training and Education
Meeting patient expectations and
organizational financial goals for
virtual health requires health systems
to change specific processes.
Team members will need new
training protocols from patient
engagement to leveraging different
EMR workflows to measure and
deliver care efficiently.

Redefine Competition
With the in-person care model, competition is
generally a geographically close practice or
provider. In a virtual model, however, competetion
can be anyone across the country.
Also, new technology, such as artificial-
intelligence-enabled care, will become a factor as
patients seek the most immediately available care.
Health systems must identify competitors and
proactively engage patients (e.g., with virtual
outreach), who may be a risk of seeking care
elsewhere.

Leverage Provider-Level Virtual Care Analytics
Analytics that measure and show the
impact of virtual care (Figure 3) will be
critical to understanding virtual delivery
performance, such as identifying barriers to
patient engagement and technology needs.
The ability to filter analytics by specialty,
department, practice, and down to
individual provider will offer the most
actionable insights, as analytics show a
shift from no virtual care to phone to video
visits, then to increasing adoption with the
reimbursement shift.

Leverage Provider-Level Virtual Care Analytics
Figure 3: Virtual care analytics.

Enable Scenario Analysis for Revenue Impact
Scenario analysis helps the organization
understand the revenue impact of changes
under virtual care by evaluating outcomes
by visit type.
For example, users can explore questions
such as: how would a certain percentage
of virtual visits impact revenue?

Promote and Maintain Health Equity
Virtual care may disproportionately affect
certain populations (e.g., vulnerable
communities) who don’t have reliable
internet or smartphones.
By breaking down patient populations
by county, race, and ethnicity, organiz-
ations can identify groups that may
need added support to shift to
virtual care.

Adopt Provider Productivity Analysis
Provider productivity analysis shows the
impact on organizational income of
different workflows.
For example, if a clinician adds another
visit to her schedule, what’s the effect on
work relative value units, patient
experience, productivity, and income?
Heatmaps can inform provider product-
ivity by showing the high-demand time of
day, guiding how to add visits and fill in
gaps to drive virtual adoption.

Leverage Patient Panel Management
Managing an entire patient panel per
care team allows team members to
identify people not coming into the
office and target outreach, such as
virtual care, to engage these patients
outside of the office setting.
Such interventions are essential tools
to avoid losing a patient to other
organizations and networks.

Enterprisewide Analytics:
A Must-Have for Virtual Care
To optimize revenue and patient outcomes
and experience in the transition to virtual
care, organizations must make significant
adjustments, including adoption of new
tools, behaviors, and workflows.

Enterprisewide Analytics:
A Must-Have for Virtual Care
Having enterprisewide analytics that are
drillable down to the provider level will help
health systems understand how to shift
resources to optimize virtual delivery models
across the continuum of care and understand
the care experience beyond the four walls of
a hospital or practice, including how patients
interact with the healthcare system and what
the growth of virtual models means for
competition in a post-COVID-19 setting.

For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

More about this topic
Link to original article for a more in-depth discussion.
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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
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Shifting to Virtual Care in the COVID-19 Era: Analytics for Financial Success and an Optimized Patient Experience

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Shifting to Virtual Care in the COVID-19 Era: Analytics for Financial Success and an Optimized Patient Experience