Required Reading: Virtual Care Technologies

May 2017

When face-to-face visits between patients and providers are supplemented with technology-supported interactions, benefits can accrue not only to patients — including underserved populations — but to physicians and health plans. In recent years, a number of technological approaches to "virtual care" have matured into seamless, cost-efficient ways to improve care and engage patients. Three such technologies are addressed in a CIN webinar series on patient portals, interactive text messaging, and telehealth/e-consults.

The following essential resources — organized generally by technology type — have been compiled to assist providers and plans looking to start or expand their virtual care capability.

Patient Portals and Asynchronous Messaging

Top 10 Ideas for Optimizing Use of Your Patient Portal (CIN webinar) is led by Jim Meyers, DrPH, a patient portal optimization coach. He describes "aha moments" that have improved the use of portals. Webinar slides show each of the 10 ideas. In addition, Meyers compiled 10 downloads showing examples of forms, dashboards, videos, and hands-on resources.

Patient Portals Resource Center is a CHCF compilation of detailed information and case studies for planning, implementation, and optimization of patient portals.

Email Communication with Care Teams (PDF, see page 4) includes a description of Kaiser's well-established email program. Patient emails are channeled to the most appropriate care team member. From a CIN Partner Report.

Texting

Interactive Text Messaging for a Healthier Patient Population: A Medi-Cal Health Plan Case Study (CIN webinar) highlights ways that texting — a popular technology across safety-net and other populations — is advancing patient engagement and care. Jared Teo, of CHCF's Innovation Fund, leads the discussion with speakers from Inland Empire Health Plan and mPulse Mobile.

Communicate, Engage, Activate: Interactive Text Messages for a Healthier Medicaid Population (PDF) reports on mPulse Mobile's research on texting with Inland Empire Health Plan, a Medi-Cal and Medicare health plan.

Text Messaging in Healthcare Research Toolkit (PDF) provides basics and more advanced information for primary care settings and hospitals, from the Center for Research in Implementation Science and Prevention at the University of Colorado School of Medicine.

Texting for Better Care Toolkit, from the Center for Care Innovations, provides details about ways that a variety of safety-net providers are using texting to improve care. Included are sections on planning, privacy issues, and implementation.

Phone Visits

Phone Visits at Kaiser Permanente (PDF, see page 4) describes Kaiser's 24-hour access to phone visits for patients with emergent problems. From a CIN Partner Report.

Riverside County Primary Care Phone Visits (PDF) is a case study from the Center for Care Innovations (CCI) on "virtual visits" by phone. CCI has other resources related to communications technologies that improve care.

Telehealth and E-Consult

Telehealth and E-Consults: Effective Collaboration for Integrated Care and Patient Access (CIN webinar) highlights the partnership between a health plan and provider organizations in rural Northern California, to enable seamless access to specialists and web-based consults for primary care providers. Webinar slides provide details from the three partner perspectives: Partnership HealthPlan of California; Open Door Community Health Centers, an FQHC; and TeleMed2u, a multi-specialist organization.

Teledermatology Helps Medicaid Patients Gain Access to Lifesaving Care from Specialists describes the DirectDerm program of same-day and next-day consultations for Medicaid plan patients.

eReferral — A New Model for Integrated Care, from the New England Journal of Medicine, describes San Francisco General's web-based specialty referral and consultation system.

Safety Net Connect videos describe web-based systems that facilitate specialty access and emergency care for organizations serving safety-net populations.

Remote Monitoring

Propeller Health: Tools to Track, Manage, and Research Asthma and COPD. This is one of a variety of companies that use mobile phones and web analytics to work with patients and their physicians across distances.

Assessing the Right Technology for Your Remote Patient Care Program (PDF). A three-page white paper of clinical and technical considerations in selecting a remote monitoring vendor, from the Intel/GE company Care Innovations.

Further Reading

Digitizing the Safety Net: Health Tech Opportunities for the Underserved is a CHCF report by Jane Sarasohn-Kahn of Vox Populi, covering a variety of telehealth technologies.

Using Telemedicine to Increase Access, Improve Care in Rural Communities, from The Commonwealth Fund, describes the use of telehealth for specialist consultations. It includes a case study of Avera Health, a pioneer in telehealth, and its use of eEmergency service to over 130 rural hospitals.

Federal Office of Rural Health Policy is an HHS department offering a variety of resources and grant information related to telehealth. Its Telehealth Resource Centers page includes tools, information, and webinars.

Center for Connected Health Policy sponsors projects in video conferencing, store and forward, remote patient monitoring, and mobile health.

US Telehealth Market Analysis, from Grand View Research, forecasts the future of the telehealth marketplace by type of technology, delivery mode, and provider/payer roles.

Early Evidence, Future Promise of Connected Health, two articles in a themed issue of Health Affairs, offer analysis of telephone visits and a discussion of privacy and security risks in telehealth innovations.