Health care is rapidly changing from the traditional in-person delivery model to a virtual one, where patients visit with their medical professionals remotely using video and audio technology.
Thanks to COVID-19, the virtual platform has grown rapidly over the past year. Using a camera, microphone and the internet connection on their cellphone, tablet or computer, patients can visit with their doctors without leaving home, work or college.
All four local health systems have embraced virtual health care. Here’s how:
In January, UPMC Pinnacle introduced Virtual Primary Care-UPMC, offering almost total virtual primary care (95+%). The virtual full-service family medicine practice provides a complete spectrum of secure and HIPAA-compliant care for patients 18 and older.
Like most health systems, UPMC Pinnacle quickly increased telehealth options last spring when the pandemic became a serious threat. While UPMC doctors returned to seeing patients in their offices last summer when the virus somewhat subsided, they found some patients preferred the virtual visits. This led to the birth of the new virtual primary care practice.
“We’re very excited about this new practice and what it represents for the future of medicine and for the care and convenience of our community members and patients,” says Dr. Carleen Warner, a UPMC family practice physician at Columbia Regional Health Center, St. Anne’s Retirement Community and regional medical director for Lancaster and Lebanon counties. She is one of eight providers who split their time between their traditional practices and the new virtual primary care model.
The virtual model, Warner says, is an opportunity to truly put patients’ needs and convenience at the center of care.
Virtual visits mirror traditional ones in the office. You make an online appointment through MyPinnacleHealth patient portal or call 717-207-4800. Your visit includes review of any issues, medications and vital signs. Patients can monitor their own temperatures, blood pressure and weight and report to the virtual primary care provider. A physical exam can be done remotely with simple instructions from the provider.
“There are very few patients who couldn’t receive high-quality health care remotely,” Warner says.
She acknowledges there are issues that cannot be assessed safely or managed virtually, such as chest pain or wounds needing stitches. These would require a visit to one of the eight Virtual Primary Care-UPMC satellite offices most convenient for the patient. Locations are available in Lancaster, Lititz, York, Harrisburg, Middletown, Mechanicsburg and Spring Grove.
“Many of our patients like virtual care visits compared to a brick-and-mortar one taking more time out of their work day to travel to an office,” says Dr. Heather Morphy, a Virtual Primary Care provider and UPMC primary care physician at Oyster Point, Lancaster.
Some older patients, she says, are uncomfortable with virtual visits with a few worried about being forced to do them.
“VPC isn’t for everyone and we’ll continue to offer traditional office visits in the future,” Morphy says.
She agrees with Warner that virtual primary care will remain when the pandemic ends. Many patients see the convenience of how virtual visits reduce time off work and the need for child care, she says.
Penn Medicine Lancaster General Health
Penn Medicine Lancaster General Health’s network of nearly 350 primary-care providers currently cares for over 25% of patients via telehealth.
“Our primary care network is utilizing virtual medicine as another means to connect with patients. It’s no different than seeing them in person or by phone,” says Dr. Vito DiCamillo, clinical director, corporate partnerships, and urgent care medical director, Penn Medicine Lancaster General Health.
DiCamillo says patients want multiple channels to connect with providers and Penn Medicine is focused on meeting patients on their terms. Patients can interact with providers using any video-enabled device or by phone.
Penn Medicine OnDemand serves as the fully virtual, urgent-care service to address primary care and acute needs. The service is available every day, any hour, for anyone 14 and older located anywhere in Pennsylvania, Maryland, New Jersey or Delaware.
WellSpan Health Online Primary Care was rolled out as a pilot program to its 20,000 employees in September 2019.
“We chose to use the term online versus virtual to better define the care and make it easier for patients to understand the service provided,” says WellSpan spokesperson Ryan Coyle. Urgent care is also included in the online care option. Plans are to expand the online service to the public this spring.
Recognizing services were shifting to online even before COVID-19 gave WellSpan the advantage to implement telehealth phone and video visits across all practices to patients during the early days of the pandemic, Coyle says. Video visits can be scheduled directly through the MyWellSpan secure online patient portal.
Currently there are two physicians dedicated to the Online Primary Care practice.
“It’s a unique offering designed to meet patient’s health care needs and goals through partnership with skilled physicians and easy-to-use technology,” Coyle says.
Penn State Health
Penn State Health offers unlimited 24/7 live video visits through Penn State Health OnDemand. It includes urgent care. Chris LaCoe, vice president of virtual care for Penn State, explains the OnDemand app platform was introduced in 2018 to employees enrolled in their health insurance. Its success led to opening it up to the public six months later, before the pandemic.
“Adoption of the app was huge by patients following the COVID-19 lock-down of most health systems in March last year with 120,000 downloads and 70,000 visits,” LaCoe says.
He explains health care systems embraced virtual care as being more convenient for provider and patient plus it reduces cost. But there were questions early on about who would pay for it. Medicare wasn’t on board originally, LaCoe says, but the pandemic led to their acceptance of virtual visits.
A unique benefit of virtual care for Penn State Health, LaCoe says, is being one of the first health systems in the U.S. to offer a user-friendly telemedicine solution for care of patients with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease.
“Virtual care addresses the debilitating difficulty for ALS patients to receive care. It’s unique in being able to provide a team of specialists to electronically see a patient in the same visit,” LaCoe says.
Along with all the advantages of virtual care, consideration is needed to recognize the disparity in digital access for some people due to lack of broadband, particularly in rural areas, he says. Technological issues like dead spots, tower overload and dropped connectivity can also be problematic.
LaCoe stresses part of the digital health revolution is due to the majority of people who can easily connect with their health care provider using the app on their phone, which is always with them. And while tech-savvy younger people take to transportable health care, it may not be a good fit for everyone.
As with all the health care systems in Lancaster County, Penn State Health is not replacing in-person office care with remote care. Specific health issues will always require traditional visits.
“There’s always a life cycle maturity to a new health care model. Virtual care is here to stay, but there will be questions about reimbursement when the pandemic ends,” LaCoe says.