The scaling of virtual care is both a moral and financial imperative, says Sanford Health Exec

In rural America, virtual care often means the difference between care and care without care.

Few people know that this is more true than Dave Newman, chief doctor of virtual care at Sanford Health. For more than 13 years, he has worked in the Sioux Falls health system, in southern Dakota, which operates 56 hospitals and 288 clinics in several Upper Midwest states.

In Sanford, virtual care is defined as “everything that is not face to face”, noted Newman during a conversation by the fire Thursday at News from Medcity“Invest the digital health conference in Dallas.

Many people think that virtual care simply means video telemedicia visits, but Sanford has spread far beyond, he said. For example, the health system provides remote monitoring of patients to help manage the chronic patient conditions, and it offers electronic visits, in which the patient fulfills a questionnaire and the supplier responds with a treatment plan.

Remote specialized consultations are also an important part of the provision of virtual care in rural communities, because access to subcupecients is a huge challenge in these areas, added Newman – noting that it is one of the four endocrinologists who practiced in the Dakota of the North.

“It takes about a year to enter to see me, which is completely unacceptable. If there is a blizzard and you cannot drive the six hours you were going to drive to see me, you are reprogrammed for a year, right? It is absolutely unacceptable.

The offer of several virtual options allows patients to get care more easily, regardless of their location or situation, he said.

He underlined one of his patients who lives in the small town of Dickinson, Dakota from the North.

“He is a breeder who lives on a ranch by himself. He has a rotary phone,” said Newman. “I do virtual care that way – I prove to be careful through his rotary phone. It’s quite incredible. “

Even if verbal visits are reimbursed at a much lower rate than video visits, they can always be a decent way to provide care, he said.

This option is sometimes the only way to reach a patient, especially for imprisoned people or those who do not have internet access or video devices.

“There are some cases where it’s just the easiest thing to do and it’s the right thing to do, so we do it that way,” said Newman.

He added that access to broadband ended up being less a problem than some people think, as

“About 99%” of Sanford patients have it. For him, real challenges are digital literacy and resistance to providers.

Newman thinks that change management is essential to overcome these obstacles. Many suppliers have resisted until virtual care becomes a necessity, he noted-saying that it was with his friend and colleague Dr Adam Jackson, a neurosurgeon from Sanford.

“He categorically said to me:” Dave, I will never do virtual care. It’s stupid. I can do the same in my office. And then we had a blizzard, and on this postoperative clinic day, which he did twice a month, he was not going to see his patients.

In his opinion, the scale of virtual care is not only the right thing for rural suppliers, but it is also the financially prudent thing to do.

Sanford has conducted that its virtual care programs allow patients to save on average 176 miles of travel and around $ 300 per visit, said Newman.

He also noted that Sanford is an integrated health system that takes the risk for its Medicare Advantage patients, and it uses free virtual visits to primary care to fill the shortcomings in terms of care and manage risks among these beneficiaries. They are even encouraged to grocery gift cards to encourage participation and ensure that they remain involved in preventive and follow-up care.

Newman pointed out that in rural areas, this type of innovation is motivated by the need, because the alternative is often not care.

Photo: Nick Panion, Breaking Media