Are you happy with your current virtual care partner (or partners) and the outcomes they are providing for your members? Finding a partner that is right for you and your unique population can be complex and challenging. When it’s time to assess your current approach or start looking for a new one, you may be wondering what’s most important to consider.
Here are the 6 essentials for virtual care success—for your plan and your members—and the questions to ask as you evaluate your options.
1. Proactive, omnichannel engagement strategy
The future success of any virtual care program begins with the way in which you effectively reach and engage your population. High enrollments happen when the right message reaches the right people, including when and how they want to see it.
- Are you segmenting and prioritizing entire populations using data insights and enrichments (instead of cherry-picking those most likely to engage)?
- Can you engage members according to their communication preferences across the program, including pre-enrollment awareness activity?
- Are you supporting digital strategies with human-led outreach by expert clinicians to drive high enrollment?
2. Clinical support and education delivered by a dedicated clinician
Members continue to engage with virtual care programs that include actionable information and personalized experiences. One-size-fits-all apps are not the answer. A dedicated clinician at the core will ensure educational content is timely, relevant, and clinically appropriate for every member.
- Does your program include access to credentialed disease state experts with a wide range of clinical acuity and comorbidities?
- Are your members able to keep the same clinician as their primary point of contact throughout the length of the program?
- Do your members have access to a dynamic library of educational resources that can be customized to meet their individual needs? What about group learning opportunities to further reinforce lessons from live support sessions?
- Can you offer support to your members across a range of medications and devices?
3. Holistic, member-centered care
Delivering the highest quality support and clinical expertise is a priority for any successful virtual care program. This means accounting for every aspect of an individual’s life that has an impact on their health and providing care that is inclusive of clinical, behavioral, and social needs. Creating space for vulnerability and transparency, by fostering relationships in one-on-one sessions, is paramount.
- Do you have clinicians that deeply understand the daily challenges of their disease to uncover, assess, and determine their needs (instead of relying on self-reported answers from a templated, one-time digital survey)?
- Is your program focused on empowering members through education and self-efficacy skills, which includes appropriate goal setting?
- If your program has care team support, are they trained in motivational interviewing and active listening techniques to uncover unique barriers?
- Does your program promote health equity through addressing social determinants of health (SDOH) and providing referral resources to close care and access gaps?
- Is your program culturally responsive, including expert clinical support and education in multiple languages (Spanish, Catonese, etc.)?
4. Scalable access through a virtual specialty clinic
While the relationship between a member and their healthcare provider is critical for quality and effective care, the reality is many members don’t have regular access to primary care or specialty physicians (e.g., those with mobility or transportation issues, or those living in rural areas). A virtual specialty clinic expands access to care, connecting members to both clinicians and provider specialists.
- Can your program include remote interventions and medication management—including dosage adjustments and titration changes—from specialty physicians when clinically appropriate?
- Can you support coordination with a member’s healthcare provider to enhance care plans by providing visit summaries and dynamic data exchange?
5. Comprehensive & complementary care model
With rising prevalence of chronic conditions and associated comorbidities, having multiple point solutions creates more siloes in an already fragmented care management process. A comprehensive virtual care model that is configurable to your organization’s operations is key to long term success.
- Does your program include a wide range of care, including highly complex cases, with a centralized approach?
- Can you guarantee speed-to-market leveraging standardized yet adaptable best practice care paths across multiple conditions?
- Are you tapping into the latest chronic condition insights from industry experts and thought leaders to inform your overall care management strategies?
6. Clear & measurable outcomes for better population health
Your virtual care partner needs to understand and report on the metrics that matter—with transparency as to how those metrics are calculated. Analytics and reporting, from clinical outcomes to program satisfaction, should be tech-enabled for connectivity and real-time population health insights.
- Do you have a suite of analytics and reporting tools that not only inform program design but give you real-time insights on your population beyond clinical outcomes (e.g., SDOH barriers faced, topics discussed)?
- Do you know how enrollment and engagement rates are calculated, and do they carry caveats based on “proprietary algorithms” without explanation?
- Is your program on the cutting edge of data interoperability—not just with EMRs but also publicly-trusted sources such as lab and pharmacy data, connected devices, and claims data? And do they know how to use and interpret this information to enhance care quality and experience to drive better outcomes?
If your current partner is falling short on any one of these fundamentals, there’s a better way. At Cecelia Health, we are passionate about doing virtual care differently. It is possible to consolidate point solutions into a singular approach that addresses multiple chronic conditions and populations; and to do it in a way that demonstrates long-term, holistic outcomes with engaging experiences for each of your members.