By Steve Burrill, Vice Chairman, US Health Care Providers Leader, Deloitte LLP 

 Our 2018 survey results show an interesting juxtaposition

​Virtual health care is popular—in theory. Deloitte surveys of US physicians and health care consumers found support for the concept, but doctors aren’t meeting demand. However, organizations that get on board sooner rather than later may perceive the benefits.

Perspectives
Physicians and health systems could be left behind if they ignore consumer interest in virtual care
Health Care Current | June 26, 2018
This weekly series explores breaking news and developments in the US health care industry, examines key issues facing life sciences and health care companies, and provides updates and insights on policy, regulatory, and legislative changes.

My Take

By Steve Burrill, Vice Chairman, US Health Care Providers Leader, Deloitte LLP
Physicians and health systems could be left behind if they ignore consumer interest in virtual care.

Smartphones and tablets have been with us for about a decade. Fortunately or unfortunately, these devices have become an extension of who we are. We rely on this technology for just about everything—from taking and sending high-resolution videos and photos to conducting meetings or visiting with family and friends using the video functions in our computers, smartphones, and tablets.
Given how much we now rely on these devices, it is surprising that so many hospital executives, physicians, and even consumers remain hesitant to use similar technology for health care visits. While each group has its own reasons for not fully embracing virtual care, they also understand that the technology could help improve the way care is delivered, according to results of new physician and consumer surveys from the Deloitte Center for Health Solutions.
Consumers have strong interest in virtual care—physicians, not so much
More than 4,500 consumers and 624 physicians in the US participated in our surveys. Nearly a quarter of surveyed consumers said they have experienced a virtual visit with a nurse or doctor. Of consumers who said they had never used virtual care, 57 percent said they are willing to try it. Physicians, however, appear less enthusiastic. Just 14 percent of surveyed physicians offer virtual visits. Among those who don’t have the technology, just 18 percent say they intend to add the capability within the next two years.
Half of surveyed consumers say they use wearables and other technology to track their health information, and 53 percent of them share this information with their doctors. But physicians are often either unable to use patient-generated data or they do not see the value in the data.
•    Just 9 percent of physicians say they have implemented technology for remote monitoring and/or integration of data from wearables.
•    Of the physicians who have not implemented this technology, 27 percent intend to incorporate it during the next one to two years.

Many physicians worry there is greater chance for medical error if they are not physically interacting with the patient, and about one-third of physician respondents cited data security as an area of concern. Despite these issues, the vast majority of physicians (9 out of 10) said they understand the potential benefits of virtual care, especially when it comes to helping improve patient experience (e.g., access to care, patient satisfaction, and improved communication with the care team). Our study results indicate that physicians consider chronic-condition management to be the most promising use of virtual care technologies.
Can hospitals and health systems help docs get over the fence?
Physicians who are employed by or affiliated with a hospital or health system are more likely than independent physicians to have implemented some type of virtual care technology in the past year—62 percent vs 49 percent, according to our physician survey (stay tuned for a deeper dive on this coming out in July).
There are likely several reasons for this. One is the cost: the technology isn’t cheap. Some sources cite a $60,000 price point for physicians to add the necessary equipment.1 Hospitals are more likely to have the financial resources for such purchases.
Our survey data suggests that experience with new technologies could help physicians warm up to virtual care. For example, physicians who have implemented at least one type of virtual care technology are somewhat less likely to voice concerns about medical errors when compared to physicians who have not, according to our survey results.
To help physicians and clinical staff accept virtual care, hospital executives need to anticipate and address likely resistance from the front-line staff. Limited experience with the technology, changes to the workflow, and shifting roles and responsibilities could keep virtual care from being incorporated into daily processes. However, many health care organizations are seeing success with virtual care when training is included in the strategic implementation.
Consider this: In Houston, a four-year-old ambulance-based teleconsultation strategy helped reduce unnecessary emergency room visits by nearly 7 percent, according to a recent report from the Deloitte Center for Health Solutions. Using the Emergency Telehealth and Navigation (ETHAN) system, emergency responders can refer patients to the most appropriate site of care on the spot. Training was key for getting EMS staff to buy into the program: the program’s organizers spent more than a year on educational outreach to ensure EMS staff understood the system.
Hospital leaders should communicate the need for adopting virtual care. Some organizations have found that real-life examples of virtual care and the impact on patients and caregivers can be more influential than data alone. Including examples in the implementation could help build a compelling business case for accepting and using the virtual care technology.
Value-based care could create demand for virtual care
As the health care system marches closer toward a payment system based on value, hospital and health system leaders might need to be cautious about the virtual care capabilities they invest in now—and which ones they choose to implement down the road.
While virtual health is being implemented in some health systems, many executives appear to be taking a piecemeal approach, rather than adopting a comprehensive, system-wide virtual care strategy. As the sector moves closer to value-based care, the ability to offer virtual care options could give tech-savvy hospitals a competitive advantage, and physicians who are comfortable with virtual care could become more in-demand. Moreover, health plans and employers might seek out health systems that can offer virtual care options to optimize provider networks, expand access, and reduce costs.
Hospital leaders should help medical staff and patients move past their concerns. The changing reimbursement models, growing consumer demand, and advances in digital technologies will likely make virtual care a must-have for physicians and hospitals. From a business perspective, I see three important reasons why hospital leaders and physicians should consider opening the door wider for virtual care:
1.    It can give physicians and health systems another way to retain and grow their patient base.
2.    Responding to consumer demand for virtual care can be a step toward delivering patient-centric care.
3.    Many nontraditional providers are already offering virtual care services. This could pose a potential competitive threat unless hospitals and health systems quickly move into this space.
Given how quickly our society has made smartphones and tablets indispensable, I expect that 10 years from now, we might find it difficult to remember a time when virtual care wasn’t an option.
This is the first in our consumer and physician series launching this summer and fall. Stay tuned for longer-form reports on this and other topics coming soon!