How telehealth is starting to reshape primary care delivery

At Columbia, South Carolina-based Prisma Health, “we’re on a journey pursuing aspects of digital health,” said Dr. Mark Wess, the health system’s vice president and chief health information executive. “The asynchronous virtual visit for primary care is one of those.”

For Prisma Health – which is now the biggest not-for-profit health organization in the state, following the 2017 merger of Palmetto Health and the Greenville Health System – virtual care represents a big opportunity to boost access while also, hopefully, improving quality outcomes and lowering the cost of care delivery.

“We’ve partnered with BrightMD to offer that asynchronous virtual visit to reduce the burden on primary care practices for simple visits that can be handled in a beneficial form for patient populations from an ease of access, convenience and speed to care,” Wess explained.

At HIMSS20, he will offer some up-close perspective, best practices and lessons learned from the health system’s efforts to rethink primary care delivery for the 21st Century.

He’ll describe how the imperatives of value-based care encouraged some fundamentally new approaches to how it provides primary care services. He’ll show how a group of different stakeholders – patients, administrators, clinicians and others – helped shape its approach to telehealth, and ensure that care-teams can steer patients to the right care in the right venues.

“We have some lessons learned from that activity of how we’ve embarked upon that journey,” said Wess. “We feel like the audience could benefit from understanding our lessons learned as well as our experience with that implementation effort.”

Among the topics he’ll discuss in Orlando next month: how to go about designing a care-continuum approach that incorporates virtual care, and how telehealth should be incorporated into other care delivery models to get the most from its potential.

Wess will also describe how success metrics for Prisma’s metrics for tracking the success of its virtual care program have evolved, and will address some of the biggest challenges – and opportunities – for health systems hoping to get similar programs off the ground.

“One of the big components is, how does this get incorporated into the routine services of the practice as part of the continuum of care for the patient?” said Wess. “And the second is, how do you get and maintain a provider buy-in to the activity? A third would be, how do you grow it and sustain that growth over time?”

Prisma Health’s deployment of’s SmartExam technology enables patients to connect with providers online, wherever they are, for $20. Whether they have minor ailments or are managing longer-term chronic conditions, the service allows these patients to get a diagnosis, treatment plan and prescription via asynchronous online consults.

“The Smart Exam workflows are very well thought out and these are listed on the navigation page for the patient to select the condition matching theirs,” Wess explained “The patient selects form the list of conditions that can be treated with Smart Exams and then they launch the activity. Questions are geared for that condition.”

The detailed questionnaire can help offer a fuller picture of the patient’s condition than what they might describe to a physician in-person, he said.

“So many of the visits are what the patient perceives as important but are missing maybe some key elements and require additional follow-up questions,” he said, “as opposed to with the asynchronous Smart Exam it’s rare that it doesn’t provide all the information needed to render the diagnosis and treatment decisions.”

Going forward, Wess said he thinks the demands of value-based reimbursement will cause more and more health systems to embrace approaches such as these, to help them deliver efficient and effective primary care.

“The asynchronous, evidence-based solution that we have in place today is needed to be part of a risk-capable organization,” he said.

Dr. Mark Wess will describe Prisma Health’s virtual care strategies during his HIMSS20 session, “Modernizing Primary Care With Telehealth.” It’s scheduled for Tuesday, March 10, from 3-4 p.m. in room W414D.

Wess was interviewed for this story by Jonah Comstock.

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