Virtual Care
Half of face-to-face clinical office visits can be conducted virtually.
face-to-face clinical office visits every year1
can be conducted virtually
The top 15 types of encounters (like routine checkup, medication refill, joint pain) account for 50% of face-to-face clinical office visits.
Armed with a smartphone or device, 13 of the top 15 encounters can be virtual visits.
The other two visits that remain face-to-face are Gynecological examinations and Well baby examinations.
The table below documents whether an encounter can be virtual or face-to-face, how it would be conducted using a spectrum of tools, and what health information is necessary to collect.
The Top 15 Encounters Breakdown
| Reason for Visit | Encounter & Device | Text | Image | Audio | Video | Vitals | Labs | Imaging | Other | % of Visits |
| Routine checkup | 24.5% | |||||||||
| Medication, other and unspecifed kinds | 3.6% | |||||||||
| Joint pain (knee, shoulder, etc.) | 2.9% | |||||||||
| Postoperative visit | 2.6% | |||||||||
| Cough | 2.1% | |||||||||
| Gynecological examination | Gynecologic exam (specialist) | 2.1% | ||||||||
| Prenatal examination, routine | Ultrasound | 1.8% | ||||||||
| Back pain | 1.6% | |||||||||
| Hypertension | Blood pressure | 1.6% | ||||||||
| Stomach and abdominal pain, cramps, and spasms | 1.5% | |||||||||
| Well baby examination | Milestones exam (specialist) | 1.3% | ||||||||
| Diabetes mellitus | Every 3 months Hemoglobin A1C. Every year fasting lipid profile, liver function tests, urine albumin excretion, serum creatinine. | 1.3% | ||||||||
| Skin rash, lesion | Photo of rash/lesion | 1.0% | ||||||||
| Preoperative visit | EKG | 1.0% | ||||||||
| Symptoms referable to throat | Strep test | 0.9% | ||||||||
| All other reasons | 50.2% |
Virtual Visit | Face-to-face Visit | EKG Monitor | Blood Pressure Cuff | Required | Optional |
"Healthcare delayed is healthcare denied"2
On average, it takes 24 days and 59.21 minutes for a patient to complete an office visit with their clinician.
| Time-to-diagnosis | |
| Waiting for appointment | 24 days3 |
| Waiting for clinician in office | 41 minutes4 |
| Consultation with clinician | 18.21 minutes4 |
| Total | 24 days and 59.21 minutes |
Given the time investment for receiving care, it's no surprise that 15.6%5 of patients avoid medical care due to time constraints.
Physicians don't scale.
Patients and software scales.
Care must go virtual
- For patients to have better access, cost, and outcomes.
- For clinicians to provide timely care for more people.
- For personalized medicine and services.
Subscribe to our open source healthcare newsletter.
Methodology
The Virtual Care diagram documents which clinical office visits could be virtual, how they could be conducted, and what health information is necessary. The diagram examines the top 15 reasons for clinical office visits from Table 11 in the National Ambulatory Medical Care Survey in 2015.
Our working document of research is available for review and comment.
v1 - 31.Jan.2019
The section below documents how we consolidated the 20 reasons for office visits down to 15.
'Routine checkup' label is new and represents:
- Progress visit, not otherwise specifed
- General medical examination
- Counseling, not otherwise specifed.
'Joint pain' label is new and represents:
- Knee symptoms
- Shoulder symptoms
'All other reasons' label existed but now also represents:
- For other and unspecifed test results
- Other special examination
The section below documents how we calculated the 'Percent distribution' due to the consolidation of reasons for office visits.
Routine checkup (24.4% | 242,782,000) = Progress visit, not otherwise specifed (14.1% | 140,842,000) + General medical examination (7.6% | 75,412,000) + Counseling, not otherwise specifed (2.7% | 26,528,000)
Joint pain (2.9% | 28,860,000) = Knee symptoms (1.6% | 16,241,000) + Shoulder symptoms (1.3% | 12,619,000)
All other reasons (50.2% | 498,058,000) = For other and unspecifed test results (1.5% | 15,159,000) + Other special examination (0.9% | 9,092,000) + All other reasons (47.8% | 473,807,000)
The section below documents how we calculated the 46% (rounded down) and 459M (rounded up) of office visits that can be conducted virtually.
Virtual office visits (46.4% | 458,798,000) = Routine checkup (24.5% | 242,782,000) + Medication, other and unspecifed kinds (3.6% | 35,232,000) + Joint pain (2.9% | 28,860,000) + Postoperative visit (2.6% | 25,441,000) + Cough (2.1% | 20,984,000) + Prenatal examination, routine (1.8% | 18,152,000) + Back pain (1.6% | 15,875,000) + Hypertension (1.6% | 15,762,000) + Stomach and abdominal pain, cramps, and spasms (1.5% | 15,026,000) + Diabetes mellitus (1.3% | 12,432,000) + Skin rash, lesion (1.0% | 9,464,000) + Preoperative visit (1.0% | 9,443,000) + Symptoms referable to throat (0.9% | 9,346,000)
Authors
Contributors
About GoInvo
GoInvo is a healthcare design company that crafts innovative digital and physical solutions. Our deep expertise in Health IT, Genomics, and Open Source health has delivered results for the National Institutes of Health, Walgreens, Mount Sinai, and Partners Healthcare.
References
- National Ambulatory Medical Care Survey: 2015 State and National Summary Tables. (2015). Retrieved January 24, 2019: https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf
- Why You Have to Wait Longer to Get a Doctor’s Appointment. (2017). Retrieved January 24, 2019: https://www.healthline.com/health-news/why-you-have-to-wait-longer-to-get-a-doctors-appointment
- 2017 Survey of Physician Appointment Wait Times. (2017). Retrieved January 24, 2019: https://www.merritthawkins.com/news-and-insights/thought-leadership/survey/survey-of-physician-appointment-wait-times/
- BA Ahmad, K Khairatul, and A Farnaza. An assessment of patient waiting and consultation time in a primary healthcare clinic. (2017). Retrieved January 24, 2019: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420318/
- Jennifer M. Taber, Ph.D., Bryan Leyva, B.A, and Alexander Persoskie, Ph.D. Why do People Avoid Medical Care? A Qualitative Study Using National Data. (2015). Retrieved January 24, 2019: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/