Image by Joseph Mucira from Pixabay

The health care sector has become well-acquainted with the use of telehealth for patient care, and now as physicians look to the future, they see it changing the patient relationship for the better. 

The California Health Care Foundation recently hosted a discussion about telehealth – how it worked during the pandemic and what’s in store for the future. Most clinics did not offer video visits before the pandemic, but it grew exponentially during the pandemic.

The Connected Care Accelerator Innovation Learning Collaborative is a year-long program dedicated to helping providers in underserved communities reach their patients through telehealth. Three doctors who are a part of the collaborative chimed in on ways they are improving their models to accommodate patients.

Dr. Jason Cunningham, CEO of West County Health Centers in Northern California, has reimagined Zoom for telehealth after finding the electronic health records version of video visits weren’t successful. 

Cunningham serves patients primarily in rural counties where patients have poor connectivity. But the health center has committed to meeting patients where they’re at. When the clinics switched to operating with Zoom, every staff member became a co-host in the meetings, so patients could virtually see the front desk, then be moved to exam rooms where they meet with a series of medical staff – nurses, physician assistants and doctors.

“It became very much similar to an experience we would have in primary care,” Cunningham said.

His health care clinics provided access points at libraries and schools for WiFi coverage. 

It took a serious amount of collaboration, he added. 

“I think it’s probably the future,” Cunningham said.

These video visits went from a 30% to a 50% usage, and is now the default method, as opposed to phone-only telehealth appointments.

Dr. Rakesh Patel, CEO of Neighborhood Healthcare in the San Diego area, said that telehealth removes many barriers for rural areas – means of transportation and taking off work for an appointment at the top of the list.

He believes in taking health care to the community, not the other way around. The health care clinics purchased SUVs to transport medical staff and lab equipment for diabetes patients, to perform blood work in their own homes. 

Dr. Delphine Tuot is the ambulatory specialty care and diagnostics associate chief medical officer at Zuckerberg San Francisco General Hospital and Trauma Center. She explained that some barriers for telehealth are within certain age brackets.

Some populations are not technologically literate, and the hospital found that through the chaos of Covid-19, there was little to no time to educate people on the technology they were using for virtual appointments. The hospital hired a telehealth educator who was on standby for any moment a patient needed assistance, which made the process more efficient. They mainly relied on volunteers and medical students, which helped the students establish a patient relationship while being trained. 

Cunningham sees an opportunity for collaboration in the health care sector in the future. He believes health care should be a partnership not just with clinicians, but with other community partners, libraries, faith-based groups and schools for a well-rounded effort in health care.

“All of health care is relational,” Cunningham said.

Patel hopes that alternative payment models are also part of health care’s future.

Currently, physicians are paid via a fee-for-service model, meaning when they see patients, they are paid a reimbursement. But with alternative payment methods, they are paid based on total population of care, rather than only being paid if a patient visits the office’s four walls. 

This allows for more creativity within the health care sphere in accommodating the patient. It’s set up like prepaid funding, which he said would have been great during the onset of the pandemic. 

“Had we been operating that way, we would have spent less time worrying about payment models, and more concerned with patient care,” Patel said.

He and Tuot said the future of telehealth could expand to seeing a nurse or physician assistant rather than just the provider.

“All members of the care team are really essential, and we really rely on all members of the care team to provide high quality health care. Everybody needs to be able to operate in this virtual system to be able to deliver the health care we need,” Tuot said.