I was struck by a passage in a recent article about the rapid growth of virtual health services for the majority of encounters at Kaiser Permanente, for example, falling into this category (see, for example: (see: In-Person Health Care as Option B). Below is one key passage from this article:
Progress in this direction is already under way. At Kaiser Permanente, for example, 52% of the more than 100 million patient encounters each year are now “virtual visits.” The organization has been able to innovate in this area in part because it spends about 25% of its annual $3.8 billion capital budget on information technology. Nevertheless, these virtual visits only scratch the surface of what’s possible with today’s technology. Virtual visits involve secure email and video engagement, and the patient–clinician interaction time required is similar to that of an in-person visit. Virtual visits are more convenient, but there’s a difference between recreating an in-person approach with digital tools and designing the safest and most efficient way to achieve an optimal outcome.
Although I have commonly used the term telemedicine to refer to remote care with a telelink, I now think that the term virtual care is superior for all e-services. The former term, focusing on face-to-face interactions, ignores many of the elements of virtual care including email, instant messaging, e-prescriptions, and home monitoring. Moreover and going forward, I believe that the major challenge to the growth of virtual care is to define the various elements contributing to the virtual care of a pateint. They then need to be integrated into a cohesive work flow.
One way to visualize an end-to-end virtual care process is to represent the various elements on a time line. At various points on such a time line, processes such as a televisit, an e-prescirption, and home monitoring of vital signs can be represented. The passage quoted above also suggests that there is a linkage between the rapid growth and success of virtual care at Kaiser Permanente and the percentage of the health system's budget allocated to IT. I think that this may not be an appropriate line of reasoning. I would rather compare virtual care to standard care in terms of clinical efficacy.