Integrated Virtual Clinics Improve Care Quality


Patients who receive integrated virtual care within a health system experience more time with clinicians, lower prescription rates and better continuity of care than those who receive care from commercial telemedicine providers, according to new data released by Carena.

“Virtual care is a natural use of technology to extend the availability of care from health systems that patients know and trust. It can meet the needs of patients on high deductible plans and it can help systems prepare for new reimbursement models,” said Ralph Derrickson, president and CEO of Carena, Inc. “The data shows, virtual care, when offered as part of an integrated delivery system, can improve quality and reduce fragmentation.”

The infographic highlights 2015 data from Carena’s health system partners and data publicly available from commercial telemedicine providers, including:

Visit Length: Integrated virtual clinics studied provided more face time with patients.

A patient who received integrated virtual care spent an average of 20 minutes with a physician. Comparatively, one commercial provider promotes two-minute consultations, another offers 10-minute consultations and a third offers 15-minute consultations.

In addition to averaging longer visit lengths, these health systems do not put a cap on how long a visit can last. Many commercial telemedicine providers restrict consultation length under a fee-for-service model, charging extra for more time.

“A longer visit means a better understanding of a patient’s needs and better care outcomes,” said Dr. Robert Bernstein, MD, MPH, VP of clinical affairs at Carena. “While a large part of telemedicine is about convenience and immediacy, it’s crucial to slow down and give patients proper, thoughtful attention.”

Prescriptions Rates: Prescription rates in health system virtual clinics studied were significantly lower than rates of other commercial telemedicine offerings.

Virtual care integrated within the health systems studied had an overall prescription rate of 48%, whereas the prescription rate at a leading commercial telemedicine provider hovered at 77%.

Virtual clinic patients diagnosed with Acute Respiratory Tract Infection, or the common cold, were prescribed antibiotics 37% of the time. A leading commercial telemedicine provider prescribed antibiotics 56% of the time to patients diagnosed with the same illness.

Virtual clinic patients diagnosed with Bronchitis were prescribed antibiotics 13% of the time while the commercial telemedicine provider had a prescription rate of 83%.

“The over-prescription of antibiotics has turned antibiotic resistance into a health crisis,” Bernstein said. “As health care providers, we must be extremely judicious when prescribing antibiotics, or any medication. We want lasting, positive outcomes, not quick, temporary fixes.”

Care Management Rates: Demonstrating a focus on continuity of care rather than an isolated health care transaction, when virtual care is available within a health system, patient engagement is increased and referrals stay within the patient’s care network. Commercial providers studied had far higher virtual management rates, leading to far fewer referrals to clinicians who may have been able to better address patients’ needs.

Health systems studied had a virtual care management rate of 68% while commercial telemedicine providers touted virtual care management rates of 93%.

Integrated virtual visits resulted in referrals to additional/alternative care 32% of the time. Leading commercial telemedicine providers referred patients only about 7% of the time.

“While a virtual visit can help address many health issues, others require care that only an in-person visit can provide. In virtual care, a higher referral rate means health systems stay engaged in the patient’s care episode, and they are being directed to specific in-person care when it is required,” Bernstein said.


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