It’s Not Just Convenient. Virtual Care is the Solution to Some of Healthcare’s Most Intractable Problems

The parable of the blind men and the elephant is a familiar one. Each man feels a different part of elephant. The one who feels the animal’s side decides an elephant is like a massive wall. The one who feels the tusk says, no, an elephant is like a spear. The one who touches the tail says it is like a rope. And so on. Each perspective has some validity to it but is incomplete.

Virtual care and telehealth in the United States today are like the blind men and the elephant. One consequence of the COVID-19 pandemic was the surge of acceptance of virtual care by both providers and patients. Investment flooded in, and new companies cropped up, many offering care or a remedy for a particular health problem or condition: weight loss, exercise diabetes management, depression, arthritis — you name it.

Kelly Bliss, Teladoc

It was exciting to see virtual care spring to life. But to the weight-loss app, all problems are weight loss, and to the diabetes virtual care solution, everything is about diabetes.

But virtual care doesn’t need to be that way. In fact, partly because people can navigate so easily through a well-designed app or website, virtual care presents a unique opportunity to achieve the kind of whole-person care that has been discussed in healthcare for decades, if not longer.

At Teladoc Health, we are embracing and executing an integrated virtual care model with some remarkable outcomes. Currently, about 85 million people in the U.S., so almost 1 in 4 Americans, have access to at least one Teladoc health service through their employer or health insurance.

Working with insurers, employers, unions and other plan sponsors, we are taking advantage of our status as the best-known, most-trusted telehealth provider to add services in dermatology, nutrition, back and joint care, among others, plus a full suite of mental health services and chronic condition management that includes diabetes, diabetes prevention, hypertension control and weight management. In 2017, fewer than 10% of the people we serve had access to more than one of our products. Today, over 50% do.

We’ve seen improved outcomes with our inte- grated approach. In a study of 24,000 members across 34 Teladoc Health clients, we documented that the HbA1c levels of people with diabetes decreased by 0.2%, on average, for every additional chronic disease program the member enrolled in. We’ve also found that enrollment in one of our mental health programs was associated not just with HbA1c reduction but also a decrease in systolic blood pressure and weight loss.

The results were similar when employees at Graco Inc., a Minneapolis manufacturer, enrolled in our integrated Chronic Condition Management Plus program: decreases in HbA1c and systolic blood pressure, a marked decrease in HbA1c among those who took advantage of our mental health services and self-reported improvements in well-being.

We are also confident that our approach will control cost. So confident that in many contracts we are putting 100% of our fees at risk based on financial and clinical outcomes. It wasn’t that long ago that virtual care and telehealth was a nice-to- have. Now it is an essential ingredient to delivering value-based care. We are no longer just a vendor partner with our clients but an integral part of their value-based tactics and strategy.

Recently, ideas about what constitutes value have been expanded to include health equity, and CMS is incorporating equity measures into its Star ratings. We were the first virtual care company to hire a chief health equity officer, and we are poised to become the industry leader on equity issues. Virtual care, wrongly used, could worsen deeply rooted healthcare disparities. But by improving access and tying together healthcare services into a coherent experience, we believe it will close, not widen, gaps.

The pandemic normalized virtual care and telehealth. Now we are figuring out ways to leverage its potential for solving seemingly intractable problems. As the future unfolds, we will stop talking about virtual care as something separate and distinct and instead consider it simply a better version of healthcare, a version that is easier to use and access, more integrated and responsive to our individual needs, and more equitable.

Kelly Bliss is president of U.S. Group Health at Teladoc Health.