Cost of contact: redesigning healthcare in the age of COVID

Some healthcare systems are noting a 10-fold increase in video visits compared with pre-COVID levels.13 Many of the previously noted barriers to virtual care adoption, including a lack of a payment mechanism, lack of portability of medical licensure and physician hesitation to use virtual care, have...

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Published inBMJ quality & safety Vol. 30; no. 3; pp. 236 - 239
Main Authors Bhatia, R Sacha, Shojania, Kaveh G, Levinson, Wendy
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.03.2021
Subjects
Ambulatory care
Blood pressure
Cholecystectomy
Coronaviruses
COVID-19
Diabetes
Disease transmission
Health administration
Health care
Health care expenditures
Health care policy
Laparoscopy
Pandemics
Patients
Personal protective equipment
Physicians
Primary care
Quality of care
Surgeons
Wearable computers
United States > US
cost-effectiveness
health policy
leadership
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Summary:Some healthcare systems are noting a 10-fold increase in video visits compared with pre-COVID levels.13 Many of the previously noted barriers to virtual care adoption, including a lack of a payment mechanism, lack of portability of medical licensure and physician hesitation to use virtual care, have largely vanished due to a combination of policy changes and healthcare workers’ fears of getting sick.9 14 15 The cost of contact could be dramatically reduced by redesigning care based on the answers to two questions; is this medical encounter necessary and could it be done virtually? Community pharmacists have been shown to support medication reconciliation and adherence, which can improve chronic disease management.20–24 Retinal screening in people with diabetes can be done using remote technology at an optometrist’s office, with data being analysed off-site by trained ophthalmologists.25 Technology, including wearable devices like portable oxygen saturation monitors and home blood pressure monitors that connect to electronic medical records, may also partially fill in portions of the clinical exam. [...]avoiding a reversion to unnecessary in-person contact will require broader dissemination of payment systems that incentivise providers on factors other than volume of activity. [...]a classic example very relevant to the ‘cost of contact’ from COVID is the RAND Health Insurance Experiment.
Bibliography:ObjectType-Article-2
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ISSN:2044-5415
2044-5423
DOI:10.1136/bmjqs-2020-011624