Virtual visits help patient-provider relationships bloom

Hospital Sisters Health System has good manners: In a move reminiscent of rom-com dating, a day or two after a patient's first telemedicine visit, the health system calls the person, reminding him or her of what a good time they just had. Like a promising first date, the goal is to get a second date.

But Springfield, Ill.-based HSHS won't settle for more of the same. Instead, it wants that second date to be in person, with a primary care provider.

The​ 15-hospital​ system's​ tactics have been somewhat successful, with 18% of telemedicine patients who ask for a primary care appointment later becoming in-person primary care patients.

When HSHS, in partnership with Carena, launched its virtual Anytime Care in 2015, it wanted a way to turn remote patients into loyal customers. With the start of Anytime Care, HSHS began following up with telemedicine patients—most of whom are between 19 and 35 years old—over the phone, giving each a call within 48 hours of the virtual encounter.

"The market segments that are particularly inclined to like virtual health are also the same ages that are less inclined to have a primary-care relationship," said Frances Dare, managing director in Accenture's health strategy practice. "This is a great way to encourage those folks to get into a relationship with a primary-care doc."

HSHS hired Natalia Skaggs to make the phone calls, which Kim Schneider later took over, to talk with patients about their experiences and tell them about the benefits of having a primary-care provider.

"We talk a lot about the value of the primary-care provider in helping you not get sick," said Jeaneene Gesell, Anytime Care service line manager. "Our mantra is that if you don't have a primary-care provider, you need one."

Though just over half of patients actually pick up the phone, the calls that get through have been effective: 33% of patients who pick up the phone eventually see HSHS clinicians in person.

That's good for patients, who get preventive care, and it's good for the hospital system, which gets a boost in patient loyalty and its bottom line. As more providers adopt virtual care, it's crucial for systems like HSHS to hold onto patients once they get them, whether that first visit is in person or across a screen.

"A lot of health systems can potentially have their relationships with their patients disrupted because some of these virtual care providers are competitors," Dare said. One benefit to converting patients, then, "is patient stickiness." As Gesell explained, once a patient is in the system, he or she tends to continue with the system.

While HSHS was growing its primary-care relationships, it also wanted to keep feeding the virtual-care program, so it launched Anytime Care for all of its employees covered under the HSHS Healthy Plan. That way, employees could experience the visits and encourage others to seek care digitally.

For​ both​ efforts​ to​ work, the telemedicine effort had to be successful. For HSHS, it has been. In the first half of fiscal year 2017, telemedicine visits have grown by more than 20% every month for a monthly average of 169 virtual-care patients. Each patient waits an average of 12 minutes for a visit that lasts, on average, 20 minutes.

"It's a great example of how you can use technology to really improve the healthcare system," said Carena CEO Ralph Derrickson. "The big benefit is that it's integrated with all their regular care."

That efficacy is part of the reason the phone call strategy works, Gesell said.

"It's really about getting them right after they've had a warm and fuzzy visit," she said. "Timing is everything."

The phone call also works because of the tone HSHS takes.

"We're taking a stand and saying, 'You need to come to us,' " Gesell said.