Travis Rush, Reperio Health

It seems everyone is quitting virtual care. Optum and Walmart announced that they are shutting down their virtual care services citing reimbursement challenges and higher-than-expected operating costs. Industry pundits have foreseen a collapse or consolidation of virtual care providers. And they’re right… because we designed those models all wrong and they don’t work.

The virtual care models in operation today expect a replacement of the in-person experience usually for urgent care needs. It’s with a provider the patient doesn’t know, who likely does not nor who has access to their whole health history. And they are hard to staff, as Walmart reported. Most virtual provider services require a minimum number of staffing hours regardless of volume, which can be hard to manage when requests for care do not follow a regular pattern.

I was struck by Becker’s Hospital Review’s reporting on why Walmart’s efforts didn’t pan out from the perspective of hospital executives. They interviewed Saad Chaudhry, Chief Digital and Information Officer at Luminis Health, who said that their optimism abounds because new players might be able to “"inevitably pull on the right levers, in the right order, and change the competitive landscape for the betterment of the most important facet of our industry: the patient."

This is precisely the framework we need to apply to a reborn model of virtual care. One that is preventive, removes obstacles from the patient or consumer experience, adopts gig-economy principles for clinicians, utilizes information exchange for the safety of all stakeholders, and is data-driven. How can that be achieved? 

Here’s the model we have at Reperio Health:

1. Virtual care needs to focus on preventive health. Our virtual care model centers on the use of a full-service, comprehensive biometric screening which can be completed from the comforts of home. The reason why we start here is that without it you begin a virtual visit with very little information to make an effective use of clinical time. Our kit pairs FDA-cleared medical devices with an app that offers step-by-step instructions to the end-user with instant results for their cholesterol, glucose, blood pressure, BMI and other metrics.
   
   
2. Virtual care must be more consumer-friendly. At-home care is the future of care. Providing a way for a patient to test themselves from the comforts of home removes many barriers that typically dissuade them from seeking care at all. Our screenings are done 24/7/365 with the aid of a full support team. Once a screening concludes, the patient can utilize our virtual care services to access a clinician 24/7/365 who will review, interpret, and help keep them healthy and/or work on ways to improve their health habits.
   
   
3. Virtual care must adopt gig economy principles for clinicians. If a patient is going to choose to screen themselves at 2am on a Wednesday, we need to support that care journey with clinicians who are available to serve them. We don’t value preventive care enough to make it this easy for patients–but we need to start. At Reperio, our virtual care model does not limit itself to typical business hours, we offer clinical services at all hours to incentivize preventive care anytime. By working with on-call clinicians, some of whom don’t mind call hours at 2am–this enables the hallmarks of the gig economy where nurse practitioners or other advanced clinicians can choose the time in which they want to be on or not.
   
   
4. Virtual care needs to participate in information exchange for the safety of all stakeholders. Virtual care 1.0 was so flawed because we relied on patient’s to remember all their medications and problems, and memory is the worst record-keeper. Our virtual care model utilizes information exchange capabilities that allow our clinicians to access EHR and laboratory records through Kno2, a recognized TEFCA information network. The information we access on a patient presents a summary to clinicians that allows them to best manage the patient based on this existing data set and the immediate results from our screening kit. There’s no fuller picture available of the health of the individual in front of that clinician then–and this can help to protect the patient from medical errors and the clinician from unknowingly providing unsafe care.
   
   
5. Virtual care can operate more effectively with AI. The last component of our virtual care model is one that incorporates AI for clinical decision making. Our solution presents care suggestions to the clinician that are generated from AI. These suggestions are delivered to the clinician, and informed by the data from both our Reperio screening and that which we import from Kno2. This supportive AI enhancement completes the full picture of a better version of virtual care that aids clinical decision making and does not replace it.

How can we give rise to a different virtual care model for tomorrow to replace what did not work today? We start with easy-to-access testing, use that information along with existing medical records data in an AI-assisted journey to meet patients exactly where they are: at-home, at any time.