The rapid rise of digital healthcare has placed the industry in a transformative phase, and one thing is needed to seize this opportunity and improve access to care successfully: accountability.
Digital care is becoming mainstream — more than 90 percent of health systems have telehealth programs in place, and 71 percent have expanded their offerings in the past year. Yet, as the number of digital health programs available to patients grows, the major challenge has become how to facilitate trust and navigation of virtual care, particularly when it comes to addressing chronic and/or specialty conditions.
Both employers and health plans can tackle this challenge by creating personalized navigation across the patient experience, serving as a digital “coach” or virtual primary care provider (PCP) that delivers a consumer-centric experience to improve access, efficacy and appropriateness.
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A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
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How virtual specialty care could revolutionize healthcare
Virtual specialty care is tackling many of the challenges consumers face when meeting with a specialist — 42 percent of families encountered at least one barrier in meeting with a specialist.Common barriers include getting appointments quickly, challenges with leaving work, adequate transportation and the physical location of the specialist office. Virtual specialty care mitigates those obstacles by connecting patients virtually with physicians. In addition to improving care access in remote or underserved areas, it reduces travel time and other patient costs, making specialty care significantly more accessible and convenient.
Streamlined virtual specialty care simplifies the care delivery process, boosting patient satisfaction and allowing providers to deliver timely and effective care that improves patient outcomes. It also empowers patients to take a more active role in their healthcare journey, fostering engagement and collaboration between patients and providers.
Despite its promise, virtual specialty care presents several challenges and barriers to adoption. For example, data security and privacy are top-of-mind for any organization dealing with large amounts of sensitive information, while plans and providers also need to navigate regulatory and reimbursem*nt issues. Another challenge is the digital divide; disparities in access to technology, such as broadband internet and digital literacy, can be problematic for a small — but not insignificant — patient population. Addressing these specific challenges will require all stakeholders, including healthcare organizations, payers, lawmakers, and tech providers, to develop solutions promoting widespread adoption and successful implementation of virtual specialty care.
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The need for a digital “coach” in virtual specialty care
A major issue that must be addressed as virtual specialty care gains traction is the absence of the traditional primary care provider role in virtual settings, which can leave patients without trusted guidance and support. Employers and health plans have an opportunity to create personalized experiences to help patients navigate the increasingly crowded virtual specialty care landscape.
Of course, this differs from traditional healthcare settings, where primary care providers serve as the foundation of patient care and provide coordination and guidance throughout the healthcare journey. This critical role is often absent in the digital paradigm, leaving patients to navigate complex treatment options independently, often leading to confusion, uncertainty, and diminished patient outcomes.
Trust and guidance are vital for patients navigating virtual specialty care. They need a familiar presence to offer reassurance and support, or they might feel overwhelmed and hesitant to engage with specialty care services. Further, a lack of personalized guidance can lead to uninformed treatment decisions and unnecessary delays in care delivery.
Organizations can leverage artificial intelligence and personalized algorithms to guide patients throughout their journey to fill the primary care provider void in digital settings. When health plans and employers up the ante on personalization, patients receive the insights, educational resources, and decision support tools needed to make informed decisions and confidently navigate the complex healthcare system.
The idea is to place the patient at the center of the care experience through personalized and proactive engagement, which will lift patient satisfaction, streamline delivery, and ultimately drive better health outcomes.
How AI drives navigation and personalization
Employers and health plans are critical in facilitating access to virtual specialty care for their members and employees. By leveraging new technologies and embracing partnerships with providers, employers and insurers can expand access to virtual specialty care services, ultimately improving healthcare outcomes and reducing costs.
Collaboration and innovation are essential; fostering partnerships between healthcare organizations, technology providers, and research institutions creates opportunities to develop AI-driven solutions that enhance navigation, personalization, and patient engagement.
A common refrain in technology is that AI is only as good as the data it’s built on, and that is no different in healthcare; data and technology are at the forefront of enhancing the patient experience. Through collecting, analyzing, and utilizing vast amounts of health data, AI-powered systems can deliver personalized recommendations, treatment plans, and interventions tailored to individual patient needs. Data-driven insights help providers identify trends, patterns, and opportunities for improvement, driving continuous innovation and optimization in care delivery.
The trend is underway; many organizations leverage AI algorithms and predictive analytics to identify high-risk patients, anticipate healthcare needs, and intervene proactively to prevent complications or emergencies. As AI continues to mature, the technology will empower clinicians to make better evidence-based decisions, enhance diagnostic accuracy, and improve treatment efficacy.
A unique opportunity for digital PCPs
No matter what form they take, one thing is clear — there is an urgent demand for digital primary care providers to guide patient navigation in the digital health era. The development and adoption of digital solutions that coach patients as they identify the right programs for them will help shape the future of virtual specialty care.
Making this a reality will require a collective effort from stakeholders across the healthcare system. By investing in the development of tech-forward yet intuitive navigation tools and supporting initiatives that promote patient engagement and empowerment, the industry can make virtual specialty care accessible, effective, and patient-centered in a way that meets the expectations of modern consumers.
Photo: cyano66, Getty Images
Ed Liebowitz
Ed Liebowitz has spent more than a decade building, commercializing and scaling digital health businesses — serving stakeholders across the care continuum. He has developed products representing a broad spectrum of digital health use cases from diet and fitness applications to AI solutions for clinical decision support. He is currently EVP, Chief Product Officer at Solera Health. In the early 2010s, Ed managed two of the top ten grossing health and fitness apps in the iTunes store, launched the Mayo Clinic Diet and helped build the Payer / Provider business unit at Everyday Health.
Ed then joined Becton Dickinson to lead their digital diabetes efforts, spearheading their first consumer-facing mobile application. Prior to joining Solera, Ed served as Chief Product Officer at HealthReveal, where he launched an analytic revenue stream, expanded product management capabilities and transformed the company to an agile delivery model. Prior to his endeavors in digital health, Ed held a variety of analytic and operational improvement roles at financial services firms including Standard & Poor’s and Brown Brothers Harriman. He holds an MBA from the Darden School of Business at the University of Virginia, an MA in Political Science from Fordham University and a BA in economics from Hobart College.
