“How can we deliver care in a very different way and not compromise quality?” was the question that drove Blue Shield of California and Adventist Health to implement a virtual multi-specialty physician network, dubbed a payor-provider telehealth collaborative, says Lisa Williams, Senior Director of Strategic Integration and Execution for Healthcare Quality and Affordablity at Blue Shield of California. Here, she explains the five main reasons such a network keeps the patient at the center of the care continuum.
- Access: I can’t underscore the importance of access. Now, when we think about rural parts of the United States, and in this case Blue Shield is a California-based company, there are many areas across the country where we have problems and opportunities to further develop access to care. We thought about access in three different ways. Think about it, even in the urban areas. We looked at some of the underserved and underrepresented, I guess I should say, urban areas, as well as our rural areas. When I think about convenience, I think about that busy family that may have young children or caring for elder parents, and they just don’t have the time to leave their home or leave their place of work, nor do they have time potentially to wait for several weeks for an appointment. So convenience became very much of a cornerstone for us as we started to shape this telehealth specialist program that we have in place.
- Need for more specialty care: We looked at primary care and we also looked at specialty care, and we recognized that of the two, specialty care was in much greater need and we had far more opportunities to advance specialty care through telehealth. Not to say that primary care is not an excellent option for telehealth, because it is, but in this case we wanted to have a niche focus and to start with specialty care.
- Timeliness: As more and more people get coverage through the Affordable Care Act (ACA), thhe time for an appointment may be longer to see a cardiologist, as an example. With our program, we can be assured that the time it takes, from the point of time someone calls or they’re referred, to the point of time they see a specialist through our telehealth program, is far less than what it may be if you were going in-person.
- Affordability: It’s all about bringing care to the patient and the community. As I mentioned, people who are on the lower end of the income spectrum, we did numerous focus groups across the state with the underserved population, people who fell in that federal poverty level of 133 to 400 percent of the federal poverty level who qualifies for a subsidy through the government. What we found from the focus groups is that many people said, “I have a full-time job. I have young children. I have elder parents. I don’t have the time to take off a day from work, I’m going to lose pay. I don’t have a car. I don’t have the money to travel long distances. I need a better option for care.” From that, we took a lot of that information and built our program based on what we heard the population telling us.
- Integration and coordination: The beauty of us working with Adventist is they have a common EMR. All of this information is recorded in the EMR, so that the primary care physician, the specialist, or other members of the care team who see our patients will be able to access this information real-time. Also, we’ll be assured that the care plans developed for our patients, for our members, and Adventist patients are coordinated all across the care spectrum or care continuum.
Creating a Virtual Multi-Specialty Physician Network: A Payor-Provider Telehealth Collaborative presents Robert Marchuk, vice president of ancillary services, Adventist Health, Christine Martin, director of operations, Adventist Health, and Lisa Williams, senior director of strategic integration and execution, healthcare quality and affordability, Blue Shield of California, all of whom share the inside details on the collaboration and the shared mission and values of the organizations that is leading to the program’s success.