Is virtual primary care going to be a big thing?

While most of the news regarding telehealth is gloomy, virtual primary care stands out as a service that offers tremendous long-term value.

The bad news for telehealth

Many well-known telehealth companies are in distress or have failed spectacularly (Teladoc, Amwell, Optum telehealth, and Babylon, to name just a few). The hype and enthusiasm for telehealth that was at a peak during the height of Covid has been replaced with a more somber assessment, and many commenters are suggesting that the future of telehealth isn't what it used to be.

What went wrong

The truth is that previous models of telehealth were broken, or at least failed to deliver sufficient value. Companies like Teladoc defined the perception of what telehealth is — namely, short transactional one-off visits to manage low acuity medical concerns: On-demand urgent care delivered virtually. The business model of making this service available to employers with a low per-employee fee made telehealth into a "nice to have" benefit for the convenience of accessing after-hours care, but not the foundation for needed ongoing primary care. Telehealth companies made money, even if employees didn't use the service!

Although many describe urgent virtual visits as "primary care," digital urgent care really doesn't deliver the benefits of real primary care that come from relationship-based care delivering ongoing, preventive, and personalized treatment.

During the pandemic, many office-based doctors were forced to give care to their established patients via phone or skype-like video interactions. This introduced many people to the benefits of virtual care, but the doctors were less impressed. Doctors who had offices asked their patients to come back to their offices as soon as they could. So it's not surprising the volume of virtual care visits has fallen since the end of the pandemic.?

Great remote care experiences for patients and doctors

At the same time, people discovered the many benefits of virtual care, and now ask: "If what I need can be delivered virtually, why should I suffer the inconvenience of an in-person office visit?"

More important, doctors who are not tethered to the costs and realities imposed by an expensive brick and mortar office, equipment, and associated staff have discovered something very powerful: Most of the benefits of effective primary care can be delivered virtually, more efficiently, and at a lower cost.

Doctors have discovered they can meet patients virtually "in their homes", get to know them and spend time with them in ways that are often harder to do in a shorter office visit. Doctors can connect with their patients and learn about the important issues more readily via video consultation than is often possible in the office. And most of the time, for most patients, and for management of most ongoing medical conditions, a physical examination is not required.

Doctors get the data they need to manage their patients' conditions, whether it is their weight from a home scale, blood pressure from their digital cuff, airflow from their peak flow meter, oxygen saturation from their pulse oximeter, or blood sugar from their home glucometer or CGM.

The value of longitudinal, relationship-based virtual primary care

Perhaps more important, virtual primary care doctors can gain insights into potential impediments to care, assess social determinants, and guide their patients to a treatment (and prevention) plan that will be most effective for them.

How will this all turn out? I suggest that the more efficient, cost-effective and relationship-based virtual primary care will eventually become the standard first point of access to healthcare. People who don't need to be seen in the office will expect they can access the doctor who knows them best virtually — via video or text messaging. Even when they need a higher level of care, they'll want to touch base with their doctor who knows them best to confirm what care they need and the urgency that is most appropriate.

At HealthTap, we believe this is true, and are working to make it possible for everyone to have a primary care doctor who knows them and is available to help guide them to the acute, ongoing, and preventive care they need.?