How Teladoc Health Approaches Clinical Quality, Meets Hospital Virtual Care Needs
So recently I came across an article On Talladega with the title. What's not to love about being in virtual healthcare? Maybe you can comment a little bit about the experience that you hope to create for patients as well as what safety and quality measurements. Do you as a clinician hoped to focus on through tele doc solution so I do believe that just like ten or twenty years ago when folks began exploring what it meant to be Devoting one's career to hospital medicine and we had that growing growing definition of the hospitalised. Actually the physician that coined that phrase Dr Bob Wachter WHO's the current chair? Uh of the Department of Medicine that. UCSF recently joined our medical advisory board. But I do believe that There will be in the years ahead. A growing field of medicine known as virtual care and that we will have virtual lists and virtual lists will have outstanding upstanding website manner if you will that ability to connect with patients and a highly personal way and then be able to offer that that individual a whole range of services. meaning that if that person for instance needs an expert medical opinion that virtuous can achieve that or if they need a type of referral to some type of specific expertise again the virtuous can care for that individual increasingly from our clients were getting Strong interest in virtual primary care. You're so this is an area that we believe is very ripe for development right now So no longer. Does it mean that your interaction with your virtual doctor is that episodic interaction but increasingly I do believe that there's a number of individuals who have a variety of chronic conditions diabetes hypercholesterolemia hypertension that really lend themselves into a longitudinal relationship with a clinical care team. And all of this can be done. Virtually what about quality and safety. What are you looking for? What are you tracking with these teams until talk solution so we believe that At the end of the day clinical quality is really what differentiates health In the market today and so we take clinical quality. Quite quite seriously actually Dr Bill Frist is On our board of directors electors and he tears up our quality and safety subcommittee and I would say that my job is a pretty easy job because when coming to that committee and having various ideas in terms of how we can move the quality needle I feel as though the quality and safety committee at CAL is a highly receptive audience for initiatives in these areas. So what are the some of these initiatives one. Our current General Medicine Program does see a tremendous amount of individuals who are suffering from upper respiratory illnesses. As you know there's a ramp's over prescribing of antibiotics And one initiative that. We've been very very focused on is antibiotic antibiotic stewardship. We're very happy to report that. We're currently working on a ARC grant With some researchers from the University of southern in California. Just around antibiotic stewardship. We do believe that we're currently tracking a bit better than brick and mortar in terms of Not Not over prescribing antibiotics. And yet we also feel so there's always room to grow We also feel as though there's ED overuse of steroids Being utilized for individuals who have a variety of upper respiratory complaints so using I using steroids indiscriminately is obviously not good for the patient. So this is another parameter that we're very carefully monitoring and then as you might imagine we look very carefully at our providers NPS scores that member satisfaction. We look at complaint rates. We look at visit time. We look at visit volume And ultimately what we have created for. Our clinicians is a dashboard. Because we do believe getting feedback on how you doing and how you're doing relative to your peers is a very important way that we can dr clinical quality On our expert medical services. We have a whole host of parameters that were routinely ainley tracking changes in diagnosis changes in treatment again. The member satisfaction being the hallmark of We're really trying to deliver care that is meaningful to the individual at the time that they're reaching out for care from Talbot Health. I Love Love The web side Care and As you as you mentioned when you were speaking about the virtual health care physician and I've never heard that before. I believe a lot of our listeners. When they hear virtual healthcare they are going to think that? There's this additional technologies in play other than what is at the normal Brick and mortar clinicians office. If you will could you discuss with us a little little bit about the technology you all are using that help. Sure so I I. I'd say that at its simplest. We really really feel as though we want technology to be deployed in a way that enhances coulda call quality so We do have the capabilities to integrate With Taito care for instance which is a way that one can Listen to someone's chest and look at their ear But we don't want these to be GATING obstacles So if the issue of the individual can be resolved with a simple phone call. Aw We will do that If the individual requires a video consultation. Of course we do that. With a high degree of frequency We also are always looking for digital therapeutics and other ways as in which we can deploy technology to enhance clinical quality. But it's not the other way around so we're not looking to just put if if you will sizzle into our program through integrating devices and technologies. That at the in the end result are not meaningful meaningful in terms of driving meaningful clinical outcomes. That's great so we're we're not adding tech just to have more technology and play. I I think I think we can all appreciate that. You mentioned that one of the largest growing areas is primary care and chronic diseases which is so important A lot of times a diabetic doesn't necessarily need to go in to see the clinician in person every week or every month month. So when I if I'm a diabetic do I have the same doctor each time or do I simply have tele doc health physician each time when I reach out to them. Right so Again we are just beginning to dip our toe if you will into the waters of virtual primary care but I think it is all centered around an individual's care team so it would be a physician. It would be some type of advanced practice. Clinicians being a nurse practitioner or physician assistant would be a medical assistant. And this would be the care team team that would be connected with the individual Seeking care. But it wouldn't be the general network work of general medicine providers. We really feel as though that personal care team will be key In terms of the success of the program. Yeah Lou I think That's a great point. I I like to highlight care team management and personalized. Care as much as I can. I think I think The clinicians that I've worked with over the years in the literature allstate that the healing process and maintaining wellness health. I come from a community so creating that upfront. And being part of the plan is huge no matter how high tech the solution might be a little bit of if you can you had. Yeah right I mean obviously I don't think either one of you on this call would disagree with that. I'm pretty sure our listeners would applaud that as well Not I tonight one point that I did want to make. Is that what we're trying to create in terms of our virtual primary care offering is much more than Instead of seeing me in the office on Brooklyn Avenue we can have a skype call and We can resolve your issue without you needing to come in and park and go through all that inconvenience. I do believe leave. That virtual primary care can achieve a higher level of clinical outcome through the successful deployment of Data analytics so that this program can be specifically targeted to individuals that we know we'll take full advantage digital therapeutics remote patient monitoring a I a lot of other resources that that frankly are not available to the general internist practicing in the office setting so that if one can if you will not only be prescribing medications but also be prescribing digital tools. That will help drive the the individual to a greater state of wellness. I think you can begin to see. How virtual care can in some instances exceed what is traditionally unle available through your routine? Hi Mary Care in a brick and mortar setting.