At all levels,doctors are interested in working via telehealth– whether they are young, close to retirement or simply feeling overworked and looking for a less stressful alternative. Some suppliers are evenready to look to organizations that offer telehealth opportunities, whether it's part-time, full-time or on-demand work. Patient access, lower cost of care, and physician burnout are key reasons healthcare organizations are developing strategies to integrate physicians into their virtual care models.
A seismic shift in the telehealth landscape
Before the COVID-19 pandemic, few doctors were registered to practice virtual care – in only a handful of specialties like emergency medicine or psychiatry. Consumers have not embraced it and health systems have not been set up to support it, particularly for hospital and specialty care. Because consumers weren't demanding it, healthcare organizations were unwilling to make the necessary investments in the hardware, software, and vendors needed to support a large telehealth program.
The pandemic has caused a seismic shift that has forever changed the healthcare landscape. Telemedicine visits have increased by0.3% or less in 2019over30% of all visits (some estimate as high as 72%) at the height of the pandemic. Healthcare organizations have rapidly expanded their telehealth capabilities, and consumers and physicians have quickly adapted to virtual care.
Of course, things returned to a new normal as the pandemic eased. On average,telehealth visits now make up about 17% of all visitsand for some specialties, such as psychiatry, telehealth visits have stabilized at 54% of all visits.
Post-pandemic, virtual care has become a more natural and accepted way to practice medicine. Hospitals are using it more for inpatient care, or in some cases, outsourcing entire departments to virtual care. Outpatient providers also rely on virtual care whenever it makes sense. THEThe telehealth boom has been particularly beneficial for rural patientswho now have better access to specialized care than ever before.
Where is telehealth going? Telehealth Trends: The Future of Virtual Care
Best Case for Virtual Medical Care
The industry is still working on the best use cases for virtual healthcare at the specialty level. Some specialties and patient visits are simply more relevant to virtual care than others.
Psychiatry has proven particularly suited to virtual care. According to a 2021Advisory Boardanalysis onsite of care changes, up to 88% of psychiatric visits could be conducted virtually. General surgery presents another opportunity where up to 53% of visits – such as pre- and post-operative visits – could be handled virtually. Cardiology also continues to gain traction in the area of virtual care, where an estimated 29% of visits could move to virtual.
More than 40% of dermatology visits could be virtual, according to the advisory council. It's pretty simple: Doctors can visually examine patients via video conference, or the patient can send photos of areas of concern.
Convenient care clinics, family doctors and other outpatient settings are also suitable for virtual care.
Challenges of Integrating Physicians into Virtual Care
Although many specialties lend themselves naturally to virtual care, integrating physicians into a virtual care model remains a challenge for most health systems.
The biggest hurdle is that most staff doctors are already working at capacity with in-person visits. Hospitals generally do not underutilize specialists to the point where they can devote even 10 or 20 percent of their time to telehealth visits. On the other hand, the demand isn't always there to justify adding a full-time virtual doctor. In reality, they may only need 0.25 FTEs – or less. So the problem is that health systems want to offer more virtual care and use their own doctors, but that's not always feasible.
Besides patient access, another challenge is that during the pandemic, many departments have purchased multipoint solutions and technologies, leaving hospitals with a jumble of unconnected systems. This fragmentation makes it difficult for hospitals to find viable and consistent staffing solutions. Additionally, many telehealth technologies come with their own pool of physicians to staff the service, but this can create issues with process consistency, quality of care, and patient experience.
Solutions for virtual healthcare
Health systems are addressing these staffing challenges in a variety of ways. They mainly contact local specialized medical groups and contract for part of their time. Some are partnering with other health systems to create shared resource models, in which three or four systems share the same virtual specialists.
Both models pose a challenge for health systems accustomed to employing their own physicians. Traditionally, they wanted to maintain this competitive advantage and prevent their specialists from working for other health care organizations. Now they may feel lucky to have 0.25 of a sought-after specialist and are more willing to obtain privileges at multiple establishments.
One of the most innovative models is the creation of an internal telehealth floating pool, which allows the hospital to optimize virtual care workloads in real time. It is an on-demand virtual network that the hospital can access as needed.
As a result of these new staffing models, we are seeing some shift from the wholly owned staffing model (full-time salaried employees) to a triaged model that includes full-time, virtual, variable staff, and independent physicians, all coordinated . to optimize gaps in care. Doctors are looking for the opportunity to moonlight with virtual care or other add-on work, and hospitals are more willing to let them do it.
Many doctors want to be independent and compete for their services in an open market. They also want the flexibility to work hours and shifts that fit their lifestyle.
Integrate locum tenens physicians into virtual care
Locum doctors are a good solution when an organization only needs a part-time telehealth resource and does not want to share that resource. Essentially, a locum tenens physician works part-time or on-demand and serves as a turnkey, white-label physician.
Health systems also use locum tenens providers when staff physicians are stretched too thin to effectively support a virtual care program. Virtual locum tenens physicians are a way to relieve pressure and quickly increase clinical capacity.
An increasingly common scenario is to use fully virtual or hybrid locum tenens physicians on a part-time basis to develop a line of business in a new specialty. This allows the organization to start quickly and either fail quickly – without needing to reallocate medical staff resources – or succeed and gradually hire permanent, full-time physicians as the industry grows. activity develops.
Some virtual care situations are not best suited for locum tenens. When virtual patient volume is very low, it may not make sense to hire a permanent employee or locum physician. In these cases, the best and most affordable solution might be to use a shared service. For some specialties, such as oncology, a long-term relationship with the patient may be essential, making the use of locum tenens a less desirable option.
Virtual doctor's prognosis
Physicians are the most important piece of the telehealth puzzle, and many health systems are still struggling to integrate them into their virtual care models. But doctors are eager to participate in telehealth and are certainly responding to recruiting requests. That's why health systems must quickly solidify their virtual care strategies and create new opportunities for more flexibility and balance to keep their physicians happy and engaged.
Download:Telehealth Strategies: Medical Models for Virtual Care
Want to learn more about how to staff your telehealth program with locum providers? Contact CHG Healthcare at866.588.5996or email(email protected) for a consultation.