‘Care anywhere’ is here to stay. Here’s how to make it mainstream.

Telehealth is just one piece of a “care anywhere” strategy. Both payers and providers have a role in delivering experiences that resonate with consumers.

COVID-19 gets too much credit for changing everything. In reality, it’s not the virus itself but how organizations and people respond to the pandemic that will – and in some cases, should – create lasting change. In healthcare, one such change is the concept of “care anywhere.”

Care anywhere can mean care received at home, in a pharmacy clinic, via an app or in a traditional setting such as a physician office or hospital. Being able to deliver care when and where consumers want it will help optimize the cost of care by removing it from expensive settings. It will also improve engagement and outcomes, equipping consumers to manage their health more effectively.

COVID-19 has demonstrated telehealth is a viable channel for virtual care delivery. Consumers are becoming more comfortable using virtual consults and practicing in-home care.  And the range of procedures that can be done in untraditional settings, including dialysis sessions, is growing. Mayo Clinic launched a “hospital at home” initiative this summer designed to deliver complex post-surgical follow-up care in patient homes.

The great promise of care anywhere is that it could keep more individuals out of hospitals in the first place. A person’s wearable and in-home monitoring devices can generate data streams that AI-equipped analytics tools can evaluate for anomalies specific to that individual. The continual data and analysis, plus data captured during “traditional” procedures, can create a truly personalized, actionable health record. With such records, preventive care should be more customized to an individual’s needs, making it more effective. The need for interventions should be identified sooner so outcomes improve while people avoid expensive procedures and hospitalizations.

A Cross-Industry Effort

But telehealth can’t achieve these goals on its own. Healthcare providers and health insurers need care-anywhere strategies that envelop all patient and member touchpoints, gathering data and ensuring the member/patient is recognized at each touch. Providers must integrate telehealth workflows into other clinical workflows and electronic health record systems to capture the documentation needed for reimbursement and care management. Payers need to work with their network providers and health systems to create policies and benefits that incentivize adoption of care at home.

Then, providers and payers must deliver care-anywhere experiences that resonate with health consumers, such as the following:

• Extend in-home monitoring and tailor it to an individual’s needs. Healthcare providers are currently able to monitor patients for cardiac conditions and post-operative follow up. Diabetic patients can send weight and blood sugar readings via surveys or digital devices. These are undoubtedly valuable, but wearables and expected generations of new in-home devices will go further, allowing plans and providers to capture and set baselines for a single person, then monitor for readings anomalous for that individual. Identifying and investigating signals unique to an individual, such as subtle changes in blood oxygen levels, would set new standards for early intervention and outcome improvement.
• Create differentiated care-at-home experiences. Care-anywhere experiences need to be contextual to be effective. For example, the care provided to a relatively healthy pregnant woman could include monthly video coaching, plus weekly weight and blood pressure check-ins. For an expectant mother with gestational diabetes and hypertension, however, data could be streamed and analyzed daily, with daily check-ins via an AI agent mobile app and on-demand coaching sessions.

• Streamline referral and prior-authorization processes so that care anywhere is widely available to members. Providers must capture data from virtual channels and ambulatory care settings and integrate it into electronic health records to prevent health data gaps and ensure continuity of care.

Telehealth has been a vitally important care-delivery channel during the COVID-19 crisis – now, payers and providers need to take a long-term view of its role. Telehealth is just one digital doorway into a potentially much larger virtual care continuum. Recognizing this can help ensure virtual care investments made now support competitive care-anywhere offerings in a post-pandemic world.