Friday, Jan 27, 2023

All Virtual Care and Care Management Must be Grounded in Evidence

Greg SamiosPresident and CEO of the Clinical Effectiveness Business, Wolters Kluwer


The massive pivot to virtual care during the pandemic not only showed the potential for disruption, but it also served as a dry run for widespread adoption of new modes of care delivery and enabling technologies. 

According to a recent AMA report, Return on Health: Moving Beyond Dollars and Cents in Realizing the Value of Virtual Care, “This evolution to digitally enabled care will fundamentally transform the value equation for health care professionals and payers…the attention will shift to how we can use innovative technologies to enhance overall episodes of care, blending a virtual and in-person experience in ways that improve access and experience for some patients while maintaining or improving quality and reducing long-term costs.”

Virtual care affects consumers whether they’re engaging with their PCP over video or with their insurer. Regardless of who initiates the engagement, providers, payers, regulators, and other stakeholders must ensure a strong supporting infrastructure exists. The stakes, from the impacts on consumer health to safety, satisfaction, and cost, are too high to ignore. 

For its part, my organization, Wolters Kluwer is providing valuable access to trusted clinically valid, expert-vetted content and tools to those driving this massive shift in care, both providers and payers. For more than 30 years, through UpToDate and other deeply entrenched healthcare platforms, we have provided healthcare professionals in traditional settings with evidence-based technologies to ensure they can confidently treat patients and answer even the most complex clinical questions. 

Moving forward, all members of the healthcare ecosystem might reasonably expect that care, whether onsite, virtual, or preventative, is guided by the same evidence. With a validated base of evidence – one that is organized and accessible – we can eliminate variability across a consumer’s health journey, reduce diagnostic and treatment errors, create alignment with preventative care, and lower costs. 

This is why Wolters Kluwer is expanding access to our trusted content and tools beyond traditional care settings, where its benefits are already proven. We now provide unprecedented access to these resources through two new solutions: one for virtual care vendors who are developing tools for providers and patients and one for payers who seek to engage more frequently and effectively with their members.

Opportunity and Support for Virtual Care Vendors

Virtual care is a rapidly evolving, quarter trillion-dollar market, and players must move quickly to meet consumer demand. A recent Harris poll of 5,000 consumers, commissioned by Elevance Health, found that more than half of respondents (52%) say they would use virtual primary care in addition to the care they receive from their current primary healthcare provider within the next year. 

Our Digital Health Architect platform is a content-as-a-service solution that lets virtual care vendors build, customize, and deliver their own digital health solutions. Our first suite of content, aimed at Consumer Education, includes hundreds of multimedia programs, drug information, and articles. 

Virtual care vendors will rely on more than technology and usability alone. New applications must link to dynamic content and tools that have measurable impact on health, are safe for consumers, and reduce costs. Starting from scratch is costly, time-consuming, and likely to introduce more variability in care, which negatively impacts patient outcomes.

We’ve created a solution for perhaps the most time-consuming and costly aspect of delivering virtual care at scale, reliably and without compromise: API-enabled access to dynamic expert healthcare content that already guides patient encounters across more than two thirds of U.S. hospital systems. Saving time and costs for virtual care developers while ensuring content is always reliable is good for them and fulfills our mission to help ensure best care everywhere.

Helping Payers Increase Engagement and Improve Outcomes

For insurers, engagement is critical to financial success and, more important, a driver of better health outcomes. In “Supercharging the ROI of your care management programs,” McKinsey authors estimated that “payer care management can leave 90% or more of potential value ‘on the table’ because payers are not able to engage the vast majority of members they identify for care management.”

EmmiGuide is a member engagement solution that helps payers improve outcomes by influencing positive health behaviors through compelling content and guidance based on sound behavior science. By sharing accurate, evidence–based content that is already widely used, plans not only build trust with members, but also help them gain confidence managing their health. 

EmmiGuide provides access to disease treatment plans, drug information, and industry-leading patient engagement, communication, and education materials. It’s fully configurable for diverse populations and rapidly scalable across platforms – email, portal, or interactive voice response.

Studies show that Emmi, the foundation for EmmiGuide, works: 83% of individuals using Emmi through their provider say it motivated them to take new actions to improve health. For payers, this is strong evidence for future ROI. McKinsey advocates for payer care management as well, estimating that “payers may be able to generate more than two-to-one (2:1+) ROI, meaning that for every $1 invested there may be a $2 return, while also ensuring a better, healthier experience for members.”

Conclusion: Go Virtual, Stay Grounded

Virtual care will continue to evolve and improve. We know now that healthcare is about more than inpatient visits; it involves a constellation of smaller interactions away from a physician’s office or hospital. These interactions will increasingly be initiated by payers as well, with members receiving targeted support to improve adherence to everything from medications to diet and exercise. 

Virtual care, including prevention through care management by payers, has an important place in our healthcare and wellness futures, but the evidence and insights that have sustained us for centuries at physical points of care must guide virtual engagement too. By expanding access to our trusted, clinically valid, expert vetted content and tools beyond traditional care settings, we can be the same catalyst for best care everywhere in the virtual world as we’ve been at traditional points of care for decades.

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