Episode #110 - Straight Talk on Virtual Care, with Tom Hale MD

Creating a New Healthcare

Friends & Colleagues,

There are a few healthcare delivery enablers which will catalyze the transformation of healthcare delivery over the coming years. In our dialogue today, we’ll be focusing on one of them - virtual care. Our guest this week has spent years directly leading the charge in virtual healthcare redesign and deployment.

Dr. Tom Hale is the Chief Medical Officer of VirtuSense where he and his colleagues are using virtual care to build value-based services for ACOs, MAs, and other at-risk models. Prior to this role, Dr. Hale pioneered the development of telemedicine and virtual care at Mercy Health. Under his leadership, Mercy telehealth services launched the world’s first virtual care center, Mercy Virtual. Prior to that, he led a 350-member multi-specialty organization as the President of Mercy Medical Group.

In this episode, Dr. Hale and I will touch on:

1. Some insights as to how Mercy Health developed its world renown Virtual Care services and the amazing outcomes they achieved.

2. Examples of AI-enabled monitoring technologies that VirtuSense has created, such as one that reduces falls by 50 to 70% in the home and in hospital rooms.

3. Common missteps that healthcare organizations make in deploying virtual care.

4. Tom’s belief that success in virtual care is largely about people and process; requiring more than just an overlay, but instead an overall redesign of clinical and business models.

Dr. Hale provides us with a very pragmatic understanding of the benefits of virtual care. He busts the myth that virtual care is merely a video substitute for a supposedly superior in-person visit. He proposes that virtual care redesign is actually far superior to the traditional approach of in-person healthcare encounters. I love his metaphor comparing traditional care to a series of ‘snapshots’ that provide disconnected, infrequent and lagging representations of a patients’ health; which is in sharp contrast to virtual care with its AI-enabled, remote monitoring and rapid responsiveness, which provides a continuous ‘movie’ of the patient's health - continuous, connected and contextual.

Dr. Hale also points out that virtual care increases access to care; and through standardization and automation, it can reduce harmful variation of care - all leading to improved outcomes and lower total costs. He backs these claims with data. The reduction of falls was significant, as well as the 60% reduction in healthcare costs that he and his colleagues achieved by placing simple remote monitoring technology and iPad’s into patients' homes. Another fascinating revelation was how AI-enabled software can detect the onset of sepsis or the worsening of chronic disease long before they become apparent through our current monitoring. An example of this is the increasing variability in heart rate that precedes the onset of heart failure by days, allowing providers to more proactively respond to and prevent ED visits and hospitalizations.

I really appreciate Tom’s thoughts regarding the impact of virtual care on the Social Determinants of Health and vulnerable populations: “Virtual care increases access to [proactive preventive] care. It decreases harmful variation. It removes the geographic barriers to care. It brings the best of the best to everybody. How can it not help the poor and underserved populations?”

And I hope his final message in this podcast makes it to the ears of policy makers and payers. “Virtual Care will increase access and decrease variation in care, and you’ll get lower costs and higher quality. But, for that to happen, we need you to decrease the regulatory barriers, and prove and support the economics around virtual care that brings value to patients.”

Until Next Time, Be Well

Zeev Neuwirth, MD