Virtual Primary Care Can’t Be Just the Old Model With Virtual Care Pasted On

If virtual care is achieve meaningful health outcomes in a primary care setting, it must be practiced within a bona fide hybrid approach.

As someone who has been on the frontlines of virtual care for the latter half of a decade, I've witnessed firsthand the integral role it has played in the evolution of healthcare delivery.

In its first iteration, virtual care was presented as a new-aged solution to close access gaps and create efficiencies in the delivery of urgent episodic care. Today, accelerated by the needs imposed by COVID-19, virtual care is being applied in more comprehensive and sustainable healthcare settings. When delivered through an integrated, coordinated, member-focused care team, virtual primary care offers new and promising opportunities to empower trusted patient-provider relationships and better manage health outcomes.

In this evolution of virtual care, it’s important to recognize that meaningful outcomes in virtual primary care cannot be achieved through the old episodic practices of traditional telehealth providers, whose models were built around on-demand urgent care. These virtual care models were designed to serve a transactional need by offering quick triage or access to a prescription. They don’t necessarily to facilitate meaningful patient relationships — or fulfilling experiences for doctors).

This is also true of some virtual primary care models of the pandemic-era, which, in many instances are just the old models (i.e. on demand, urgent care) recast as comprehensive primary care solutions. The fact that some virtual care was not fundamentally different from the prior way of delivering care may be why some efforts have struggled with patient adoption. Another hurdle could be that some patients default to primary care only as an urgent care option.

In order for virtual care to achieve meaningful health outcomes in a primary care setting, it must be practiced within a hybrid approach, inclusive of a designated, consistent care team that is fully integrated across modalities. Continuity of care is essential for the provider to deliver whole patient care and establish trusted relationships with patients.

When virtual care is practiced within an integrated primary care model, providers are empowered to look at the whole patient. Doing so results in better population health management and overall efficiencies in care delivery.

As medical students and physicians learn how important it is to evaluate the whole patient; how so much of medical decision making will be based on history-taking alone, and how communication skills are critical to developing the physician-patient relationship, which is a relationship that delivers the most value when it is rooted in trust. Virtual care models that are achieving high quality primary care outcomes have been designed in such a way that physicians have enough time with patients to ask the right question and to refer alongside an interdisciplinary care team. They may also include a combination of asynchronous messaging and synchronous video care, to allow for quick access and multiple touch points with less attrition.

Virtual primary care models that offer this continuity of care and foster trusted relationships are closing gaps in care across specialties and are resonating with patients. According to original data from my company, Crossover Health, through August, 31 2022, members with diabetes who received hybrid care through Crossover’s Primary Health model were 30% more likely to have glucose controlled than those who received in-person care.

Based on the utilization of integrated virtual primary care models, their impact on the patient journey, and ability to close care gaps, I’d advocate that the time is now for the industry to rethink the scope of virtual care in the primary care setting and recognize its transformative potential in improving healthcare outcomes when implemented as a comprehensive virtual primary care solution. The evolution of virtual primary care models today is foundational to establishing the outcomes-driven primary care offerings of tomorrow.

Danna Chung, M.D., is the virtual medical director at Crossover Health.