In the span of a few months, the COVID-19 pandemic has managed to unceremoniously toss out our assumptions about what healthcare consultations should look like. In a pre-COVID world, we believed that in-person appointments were a necessity and shrugged off telemedicine and carer navigation services as “nice-to-haves.” Now, those tables have taken a drastic turn. 

With the risk of infection still looming, patients have remained hesitant to seek out in-person appointments for care they view as “avoidable.” One recent report published by Strata Decision Technology found that, across all verticals and regions, the average number of patients seeking care in a hospital setting dropped by 54.5 percent since the start of the pandemic. Routine care appointments and health screenings fared even worse, with volumes that plummeted by a startling 75 percent. 

Our approach to facilitating routine care needs to change. The global pandemic is unlikely to fade anytime in the immediate future, and even when it does, patients may remain wary of returning to “normal” modes of seeking care. 

Employers, payers and providers need to adapt to the times — and that means making digitally-facilitated healthcare navigation services and telemedicine a core part of future benefit plans. 

Be clear; what I’m proposing is much more than your mother’s tried-and-true nurse helpline. Modern care navigation services don’t just provide insight on whether or not callers should seek professional attention — they actively support and guide those patients through every step of their care journey. Patients can text or call a professional to better understand their symptoms and, if necessary, schedule a telemedicine visit and facilitate pharmacy services. 

I’ll provide a hypothetical. Let’s say that you wake up one morning with ear pain and a decreased appetite. You want to seek out a professional opinion, but you’re concerned that you might put yourself at risk of infection by dropping by your local clinic. So, you text the care navigation service provider affiliated with your benefits package, explaining your symptoms and concerns. 

Within minutes, you’ve been rerouted to a physician. The doctor concludes a diagnosis, develops a treatment plan, and routes you through a virtual pharmacy to ensure that you receive your medication as quickly and conveniently as possible. The entire consultation occurs virtually and without any need for in-person contact. 

This digitally-facilitated care navigation should be at the front end of every post-COVID benefit plan — not only because it works, but also because the solutions we once relied on to ensure cost-effective and quality care no longer do. 

Take onsite health centers as an example. Before the pandemic, employers who maintained healthcare clinics at or near their corporate offices often experienced remarkable cost- and productivity savings. According to a study conducted in 2016 by the National Association of Worksite Health Centers, companies with onsite clinics note a 70 percent decline in time lost to employees seeking off-campus care, a 64 percent decrease in medical care costs, and 63 percent reduction in emergency room use. 

Before the pandemic, onsite centers gave employees access to convenient, high-quality, and in-network medical care. As a result, they tended to stay healthier and cost their employer less than they might have without easy access to quality care. 

But in a post-COVID world, matters are different. Now, many of the knowledge workers who might have taken advantage of a corporate-campus health center are working remotely. Recent surveys indicate that as much as a third of the American workforce — 42 million people — will be working from home full-time by the end of 2021. Already, notable tech companies like Twitter and Square have rolled out policies that allow all workers to work from home permanently. Over time, remote knowledge workers may begin to move away from expensive tech hubs in search of cheaper living arrangements. 

By definition, onsite care cannot provide employers with cost-savings when the majority of their employees are no longer on site. If remote work is here to stay — and it’s safe to assume that it is — payers need to find new, remote-friendly ways to deliver affordable, in-network care to their employee base. 

But what if we could use care navigation services as a remote replacement for onsite care? They would ultimately serve the same purpose — to direct patients towards convenient and high-quality healthcare solutions. The primary difference would be that the services provided would stem from a dedicated telemedicine service, rather than a central clinic. 

In a best-case scenario, the pivot to a greater care navigation centric services may even increase patient engagement. 

While investment in telehealth solutions like Teldoc and remote care solutions like Grand Rounds is at an all-time high due to COVID-19, relatively little has been done to explore digital channels as a medium, and not just as a platform for communication. However, when care navigation services are reimagined within a digital medium, they can do an incredible amount to improve engagement and help patients make informed choices. 

Consider Sitka, a peer-to-peer video messaging platform and specialist network, as an example. Sitka uses digital services to connect clinicians and patients with world-class specialists in fields that include but are not limited to endocrinology, neurology, orthopedics, pulmonology, and rheumatology. 

When most people think of digital healthcare, they might think of a simple videoconference — a socially-distanced version of an in-office visit. Sitka takes its utilization of a digital medium several steps further. Rather than holding a one-off, real-time health consultation, Sitka specialists take the time to record and send a video that comprehensively reviews the patient’s condition, potential treatment routes, risks, and other considerations. The specialist may also use digital drawing tools to annotate scans and ensure that patients fully understand the condition at hand. Then, the specialist reaches out once more to schedule a more conventional, real-time video consult. 

The efficacy of this two-pronged approach is remarkable. A few weeks ago, I had the opportunity to accompany Sitka’s chief medical officer and orthopedia surgery specialist, Dr. Sohrab Gollogly, on his rounds. To a person, every patient was able to repeat, almost verbatim, what Dr. Gollogly had shared in his video. Due to the digital presentation, they had developed a comprehensive knowledge of their condition. They were thus better equipped to make an informed decision about their care and determine their next move, all via virtual channels. 

Sitka’s use of technology to support patient understanding offers a remarkable example of how the health sector can leverage video as a medium. However, it would be a mistake to think that payers can simply drag-and-drop Sitka’s communication approach into its provider networks. 

The caliber of Sitka’s services is partly provided by its well-crafted communications protocol, yes — but it also hinges on the quality of its experts. Sitka boasts a cohort of world-class specialists; few broad payer networks have vetted their covered physicians as thoroughly as the specialist organization has. Thus, if payers want to replicate the benefits that Sitka gleans from its communications approach, they will need to develop a similar tech-savvy strategy within the context of a high-quality referral system like Grand Rounds. 

Some background is necessary here: Grand Rounds is a firm that helps payers and patients access high-quality care and second opinions. The company maintains a database of over 700,000 physicians and uses a wealth of biographical and insurance-claims data to evaluate its member providers’ skills and specialties. With this network, Grand Rounds can ensure that patients can connect with a top-tier physician who has the specialized knowledge necessary to provide an accurate diagnosis and treatment plan for their specific condition

Now, imagine if Sitka’s telehealth communication strategies were broadly implemented within the context of a Grand Rounds’ care navigation and quality assurance infrastructure. Theoretically, patients could be guided to the right provider and receive the right care — all while developing a better understanding of their health and having the power to make informed care decisions.   

Care navigation shouldn’t just be a benefit — it should be an integrated dimension of every benefit plan. We should be using all of our resources to hyper-personalize telehealth interactions during and beyond the current crisis. As I see it, the benefits of care navigation are threefold:

  • It empowers patients who are afraid to seek in-patient care due to COVID-19 to address their health concerns over telehealth. 
  • It provides the virtual equivalent of onsite care, thereby facilitating convenient and cost-effective treatment. By ensuring that employees have access to digitally-facilitated and high quality routine care, payers ensure that their patient populations are healthier and less expensive to maintain. 
  • It takes advantage of the features that a digital medium can provide to bolster patient engagement and facilitate well-informed care decisions. 

We need to evolve benefit plans to suit the post-COVID landscape. Modern care navigation is so much more than nursing helplines of the past; when paired with telemedicine, it stands as a core aspect of the “new normal” of post-COVID care.