There is a shortage of all physicians across the United States, but it's most keenly felt with specialists.

It is difficult enough to find access – especially timely access – to needed medical specialists in large urban areas, but it can be next to impossible in rural communities.

Virtual care has proven that it can be a big help in connecting patients with the right specialists, and in a timely manner.

Julian Flannery is founder and CEO of telehealth technology and services company Summus Global, which focuses on specialty care. We interviewed him to discuss the state of specialty care in the United States, how virtual specialty care can help overcome specialty-care challenges, and how providing specialty care to employers via virtual care is one solution.

Flannery also describes an actual example of specialty care his company has delivered via an employer, and the outcomes.

Q. What is the state of specialty care in the United States today? What challenges does it pose?

A. Specialty care is where the cost and complexity lives in healthcare. For patients, having unanswered questions, receiving a new diagnosis or managing an existing chronic condition presents real challenges that induce stress, confusion and real risk to health and financial wellbeing.

More often than not they don’t know where to go, who to see, what’s covered by insurance, and what tests or medical records to get. Most importantly, they face a serious access problem, where it can take weeks or months to see someone – and there is no guarantee on that specialist being the right physician or having the expertise required for their condition and medical history.

Today, too many patients are lost in the labyrinth of the U.S. healthcare system – taking a toll on their physical and mental health, creating redundancy and driving exorbitant costs.

Lengthy wait times and lack of access are challenges further exacerbated by the fact there are fewer specialists in any given community, while physician shortages persist and greater administrative responsibilities take time away from patient care.

With most top specialists concentrated at academic medical centers or at large health systems, geographical barriers limit access to their expertise for a significant portion of the U.S. population.

From the perspective of the specialist, they want their expertise to help more people, answer more questions, develop more treatments and get back to connecting with patients on a personal level. They want to use their expertise to do what they envisioned in medical school – help people.

The good news is the new virtual world in medicine can create efficiencies and the ability to scale specialist expertise and transcend geographic boundaries. For patients, accelerating access to leading medical expertise drives better, more cost-effective health outcomes and, if done right, also improves the healthcare experience for both patients and specialists.

Q. How can virtual specialty care help overcome these challenges?

A. Advancements in technology have dramatically changed the landscape of healthcare delivery, including the delivery of medicine and clinical services via telemedicine to virtual care that encompasses the broad range of healthcare services, such as patient guidance and education, remote monitoring, longitudinal care management and access to health information and resources.

Historically, virtual care technology was used for primary and urgent care. More recently, it has been deployed to support narrowly focused, condition-specific point solutions or point-in-time solutions like second opinion.

Looking forward, virtual specialty care can be used to address patient questions and care across the continuum of conditions in a longitudinal manner – from allergies to migraines and more complex conditions, like ALS and cancer – across all health journeys.

Simple and elegant virtual specialty-care technology designed for specialists can drive real value to patients, health systems and to specialists. In today’s landscape, the video medium is a commodity, so innovative business models also are required to further enable virtual specialty care.

Using a model that provides real value to specialists and allows them to scale their expertise will win the day. For patients, models that can attract high-quality specialists and deep and diverse provider networks also will be hugely valuable. Some of the benefits of virtual specialty care include:

• Support access across geographic boundaries. A virtual medium coupled with a network of leading, high-quality specialists expedites time to connect with a specialist, and breaks down geographic limitations through connecting virtually with specialists. Not only does this create a better physician and member experience, it also reduces the need for expensive travel and time away from work with fast answers and a path forward.

• Accelerate access to leading physicians. Specialists and primary care providers face competing pressures when trying to help and reach their patients, and are concerned about the ones who don’t come to their appointments as much as they are focused on the ones who do. Innovative models that allow physicians to answer questions from patients, families and other members of the healthcare system prove most successful in building the right kind of experience and sustainable outcomes for patients.

• Create quality healthcare experiences with specialists. In the virtual specialty care environment, specialists spend nearly an hour with patients, and focus on the value these specialists can provide in an unhurried, in-depth conversation. The physicians with whom we work tell us routinely the ability to see a patient in their home environment and to have the time they need with each patient reminds them why they went to medical school in the first place. More time with specialists empowers patients with information and instills confidence that lends to better decision making. And specialists find the experience satisfying.

• Deliver demonstrable outcomes and impact on medical costs. Fast access to specialist expertise results in changes to everything from medication to treatment pathways. Plus, quick and convenient access to specialists reduces unnecessary emergency room and other in-person visits that result in medical cost savings.

Virtual specialty care technology continues to evolve and extend use for providers at health systems, health plans and primary care practices for answers to their questions that help them direct patient care.

With a differentiated escalation model tied to patient case complexity, primary care physicians and other clinicians can participate in consultations that range from dynamic, text-based e-consults for streamlined questions to curbside or expert consultations for more involved patient care questions.

Q. Your company specializes in providing specialty care to employers via virtual care. What's the angle here with employers? And how is it different from patients seeking virtual care via a provider organization rather than via an employer?

A. In a recent survey conducted by Summus, large employers are managing an average of 46 different benefit vendors and more than 50 condition-specific solutions. This overabundance of point solutions is challenging for HR teams to manage and measure, and creates confusion for employees about what benefit to use and when.

As a result, more than 75% of HR and benefits leaders are looking to consolidate their benefit offering in the next 12 months.

In contrast to point solutions, virtual specialty care serves as the clinical front door to healthcare, accelerating access to high-quality medical expertise across all health concerns and conditions contributing to a healthier, more productive workforce.

Q. Please describe an actual example of specialty care your company has delivered via an employer and the outcomes.

A. The University of Notre Dame offers Summus’ virtual specialty care platform as part of its employee health benefits package, and the human resources department receives proactive emails from employees on a weekly basis, thanking them for the access to high-quality care.

Summus has saved Notre Dame employees 3,231 hours of time that would have otherwise been spent searching for and traveling to see specialists, the university has reported.

Notre Dame employees have shared sentiments about their experience using Summus, including:

•  "This is the first doctor in three years that we feel has us on the right path."

• "Everyone has been helpful and responsive."

• "Summus has been a lifesaver since my diagnosis. There’s no one in the area who has the expertise to treat what I have."

Virtual specialty care and access to the right, high-quality specialist can and has demonstrably improved patients' lives, and addresses the major issues in healthcare today.

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Email him: bsiwicki@himss.org
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