Instead of relying solely on in-person office visits, health systems are offering virtual health care visits to provide care when and where patients need it. Consulting company Accenture found in 2019 that 49 percent of patients expect video conferencing, up from 36 percent just three years before. 1Staff at Christiana Care in Newark and Wilmington, Delaware, found a way to utilize Cerner solutions to offer virtual video visits to employees and their family members through a pilot program.
“There aren’t enough primary care clinicians to meet all of the primary care needs of a community,” said Janice Nevin, MD, president and CEO. “As we thought about reimagining primary care, one of the innovative ideas that emerged was a virtual primary care practice.”
From Nov. 28, 2018 – Feb. 26, 2019, Christiana Care staff enrolled more than 110 patients and conducted 150 clinical visits.
“I was having pain on my lower right side, and it was going on for months,” said Randy Gaboriault, MS, chief information officer, senior vice president, innovation and strategic development. He took advantage of the pilot program shortly after the option became available.
“I signed up for the virtual practice and I got online with our nurse practitioner, and the nurse said, ‘Position your phone, line it up, and I want you to walk back and forth. You know what? I think you have a labral tear.’”
An MRI confirmed the diagnosis, and Gaboriault began the recovery process.
Janine Jordan, MD, became one of the first providers at Christiana to provide virtual care. While excited about the opportunity, she also faced technology concerns she quickly overcame.
“I was definitely one of the advocates to get this launched,” she said. “I’ve been a provider for more than 20 years, and in-person visits are really important. I’ve found that the video visit is not a barrier, that it’s as engaging as in-person visits, and I was surprised by that.”
Patients schedule visits through Christiana Care’s patient portal, powered by Cerner’s consumer engagement solution, HealtheLifeSM, and launch the video visit using a desktop or mobile device. Providers use PowerChart®, part of the electronic health record (EHR), to conduct the virtual visit. After the visit concludes, a prompt directs the patient to take a brief survey about the visit and its effectiveness. Out of those who answered the survey, 94 percent gave a satisfactory rating.2
“When we conduct the visit, the patient is on one screen and their EHR is on the other,” said Jordan. “In near real-time, we’re seeing the patient and doing documentation. I have access to their record right in front of me, so I know their medical history, medications, any chronic diseases and what’s worked and hasn’t worked.”
Virtual visits enable patients to schedule an appointment and receive care much quicker than a traditional in-person visit.
“It enables a patient to get the care when it’s convenient for them. They can contact us readily, and we can communicate via video. They don’t have to schedule a visit to come in the office in a week or so,” said Jordan.
While launched as a pilot program, Christiana leaders plan to scale the program to allow other employees, and potentially even their patient population to utilize video visits.
“We think this is going to meet the needs, particularly of working people,” said Nevin. “I think the home really could be the place where most care is delivered and received. I absolutely can see that we grow this, and it becomes part of our primary care network.”
2 Among the 85 responses received from Nov. 1, 2018 - March 14, 2019