It is no secret that telehealth adoption has skyrocketed as a result of the pandemic, and because of that, many health systems are in the process of shifting to a virtual-first hybrid care model. Unfortunately, video visits, which most will equate with telehealth, have done little to help with the age-old issues of patient access and convenience, provider efficiency, and rising health care costs.
Patients often encounter the same frustrations during a video visit as they do for an in-person visit, including difficulty with scheduling and long wait times in the “virtual waiting room.” Providers will tell you that a video visit changes only the geography of a visit. The patient interaction time and the time required for charting are the same as any traditional brick-and-mortar encounter. Further, one recent Amwell study reported that nearly 1 in 4 clinicians say virtual care systems and workflows are not at all or hardly integrated with their organization’s existing systems.
So how can health systems and clinicians provide patients with an improved, consumer-friendly experience while also making strides to decrease provider administrative burden and burnout? They need to embrace virtual care beyond just video visits and look toward asynchronous telehealth. Asynchronous care allows providers to treat patients for common, low-acuity conditions online without a real-time, face-to-face interaction. It automates both the patient interview and clinician documentation, and provides clinical decision support while maintaining provider autonomy, keeping the clinician in control of diagnosis and treatment. Looking ahead, asynchronous telehealth holds unlocked potential for improving access and convenience for patients, reducing physician burnout, and driving efficiencies in care delivery to ultimately lower costs and improve outcomes.
In my conversations with clinicians, I hear a lot of confusion and misconception about this modality of care, which is understandable–it’s relatively new to many, and largely undefined. On the other hand, I also have the unique role of partnering closely with clinician executives and providers as they experience the power of asynchronous telehealth. Not only are they using it to deliver high-quality care, but now they’re also advocating for its value as a telehealth tool.
As asynchronous telehealth continues to gain traction, let’s debunk five of the most common myths.
Myth: Asynchronous appointments are not as effective as in-person ones due to the lack of real-time physical contact with the patient.
Truth: Asynchronous appointments can provide the same quality of care for low-acuity conditions as synchronous appointments. Through consistent and thorough digital clinical interviews that are evidence-based and dynamically changing based on the patient’s responses, asynchronous interviews mimic the history-taking process that typically occurs in a synchronous setting. In fact, many clinicians tell me that an asynchronous interview is more comprehensive than the interviews they typically have the time or capacity to do when speaking directly with a patient. The information gathered in the digital interview is relayed to clinicians in an easy-to-read SOAP note along with evidence-based treatment options, allowing them to provide care that meets, and often exceeds, national quality standards. And it’s done in a fraction of the time. With the right asynchronous platform, providers can deliver care for low-acuity conditions in less than five minutes, and that includes completing all of the documentation for the visit. Research is growing to support the quality of clinical outcomes through asynchronous care as well. For instance, a team of psychiatrists and researchers from UC Davis recently published the first longitudinal study to demonstrate that asynchronous mental health care is proven to improve clinical outcomes in English and Spanish-speaking primary care patients.
Myth: Utilizing virtual care technology creates a greater administrative burden for providers, especially having to build clinical content within asynchronous tools.
Truth: While this can be true for certain digital health tools, the reality is that it doesn’t have to be. Ideally, virtual care technology improves provider efficiency by automating administrative tasks and integrating seamlessly into existing workflows, including EHRs, prescription fulfillment tools, billing, and the like. By collecting the patient’s history digitally, asynchronous care allows providers to focus on medical decision-making rather than data gathering and documentation, optimizing skill-task alignment. What further sets leading asynchronous telehealth solutions apart is that they take on the responsibility of creating, maintaining, and updating all of the clinical content. This means ensuring that everything remains evidence-based and consistent with clinical protocols so that health systems and their providers don’t have to.
Myth: Asynchronous care is fueling health inequity by limiting access to patients with high-speed internet.
Truth: Unlike video visits, asynchronous telehealth only requires a 3G connection. Broadband internet is not needed. This is critical to provide convenient care to the more than 14 million urban homes and 4 million rural homes that do not have broadband access. For many care delivery organizations, asynchronous telehealth provides an important and valuable touchpoint for patient engagement, allowing more members of the community–especially those in rural areas–to get easy, quick access to care without the need to arrange transportation, travel, take time off of work, or find a broadband connection. For providers, it also means a break from the connectivity issues and IT support roles we too often have to play to make certain types of telehealth visits effective.
Myth: Asynchronous care is a chatbot or a symptom checker, which often does not meet clinical quality standards.
Truth: It’s crucial that we distinguish asynchronous telehealth from chatbots or symptom checkers. First and foremost, asynchronous telehealth provides end-to-end definitive care while most chatbots or symptom checkers can only give the patient a list of possible diagnoses based on their symptoms or direct them to another avenue to seek care. Further, while these technologies are designed specifically to remove clinicians from the patient interaction, the ideal asynchronous telehealth solution does the opposite. There should always be a provider on the other end of the clinical interview–just not in real-time. Asynchronous telehealth provides expert-level clinical decision support, while maintaining provider autonomy over how they diagnose and treat a patient, including the ability to escalate the patient to a higher level of care when asynchronous care is not appropriate. All of this in a platform that adheres to the strictest of evidence-based clinical standards. Asynchronous telehealth–when done right–is personalized, high-quality human care.
Myth: Asynchronous care tools fragment patient experiences within the broader hybrid care delivery model.
Truth: Unlike many of the direct-to-consumer care options now available to patients, asynchronous tools do not lead to care fragmentation. Not only are patients receiving care from providers within their chosen health system, but critical information like medications, allergies, and problem lists from the EHR are made available to the treating clinician to help inform their medical decision-making. Once care is delivered, the automated chart note generated by our platform becomes a permanent part of the patient’s electronic medical record, maintaining continuity of care.
The value of asynchronous telehealth is clear: benefits for patients in terms of access and convenience, benefits for providers in terms of efficiency and reduced administrative burden, and benefits for health systems in terms of quality, cost savings, and outcomes. As a clinician, I see firsthand how asynchronous care is already changing health care for the better. It also carries a lot of promise for the other applications, including the potential for pre-visit interviews and integration with remote patient monitoring and other digital tools. With today’s challenges around capacity, staffing, EHRs, and care navigation, to name just a few, asynchronous care will play a vital role in the future of care delivery.
Christina Chen is a family medicine physician.
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