What Does 2021 Hold for Virtual Care?

Michelle Davey
7 min readDec 9, 2020

Well, we’ve just about arrived at putting an end to 2020 — the year that nobody expected or wanted.

I’ve written before about what it felt like when our new normal was suddenly forced upon us. One day it was business as usual, the next we were grappling with a virus that we knew little about yet was exponentially spreading.

While the healthcare industry has historically been resistant to change, the pandemic allowed little room for sluggish responses and preconceived notions. For the last ten months, everyone from industry stalwarts to digital health innovators have been sprinting at full speed to stand up telehealth and virtual care solutions in order to expand access while decreasing the risk of exposure. While the pandemic forced the industry to think outside the box, virtual care champions welcomed the embrace.

Many of the healthcare companies you’re familiar with turn to Wheel when they’re looking to grow and scale virtual care services — including corporate giants just starting to expand into healthcare — providing our team with a unique perspective and intimate knowledge on where the industry is today, as well as where it’s headed. I recently sat down with my Executive Medical Director, Dr. Rafid Fadul, and my Co-founder, Griffin Mulcahey, to take a few deep breaths, reflect on the last year, and ruminate on what we can expect in 2021.

This past year gave our industry the opportunity to put the vision of virtual care to the test, and we all agreed that this next year will be our opportunity to demonstrate that it’s much more than headlines and hype. Moreso, virtual care is a solution that can be applied to much more than a band-aid fix for a global pandemic.

At the same time, there are caveats to fulfilling the promise of virtual care, including a murky regulatory environment and a knee-jerk reaction to simply bringing a broken system online. That said, while we still have a long road ahead, we decided that we still feel optimistic about the direction our industry is heading.

With that in mind, here’s what the Wheel team predicts we’ll see from virtual care in 2021 from the regulatory, clinical, and business perspective.

Michelle Davey, Wheel CEO & Co-founder

2020 WAS THE YEAR OF TELEHEALTH, 2021 WILL BE THE YEAR OF VIRTUAL CARE

While these terms are used interchangeably, in 2021 we will be able to further shift away from simply focusing on convenience and urgent needs towards prioritizing holistic care and long-term health outcomes, supported by virtual care. Advances in remote patient monitoring, team-based remote care, and at-home diagnostic services will be a fundamental driver of this shift from telehealth to virtual care — adding efficiency as we move away from simply replicating the doctor’s visit online.

Many companies and healthcare incumbents moved quickly to shift services online at the beginning of the pandemic this past year. Their future success will depend on their willingness to embrace permanent solutions that support long-term use and ability to scale now that we have the technology and infrastructure to turn this vision into a reality.

VIRTUAL CARE WILL ESTABLISH A NEW WAY FOR CLINICIANS TO WORK

Just as the pandemic has done across nearly all industries, we are actively redefining what “work” looks like for clinicians. Virtual care will offer clinicians the freedom and flexibility they deserve to work across multiple providers and organizations — especially now that we are recognizing that limiting clinicians within a single organization inhibits their ability to expand access to care. Simply put, part-time vs full-time is now an outdated concept.

But in order to make this work, let’s provide clinicians better tools and products so they can focus on what they do best. Telemedicine v1 did not remove the tech burden for clinicians, and they are long overdue for a better and easier experience.

OUT WITH THE PATIENT, IN WITH THE CONSUMER

This past year has underscored the consumer’s louder voice in their healthcare decisions, which will continue to gain steam in 2021 now that there is mainstream adoption of telehealth and virtual care. As we’ve seen with our white-labeled service, the concept of “brand loyalty” will continue to grow over time with healthcare organizations recognizing the importance of leveraging stronger brand identities in order to gain patients’ trust, as well as their wallets.

At the same time, it’s up to us to ensure the consumer-patient isn’t drowning out those who aren’t able to speak up — otherwise, we will create and even exacerbate many of the same inequities that exist in today’s healthcare system.

Dr. Rafid Fadul, Wheel Executive Medical Director

TUNE OUT THE NOISE, FOCUS ON CARE

For far too long, clinicians have been overworked and under-resourced while being stifled by overwhelming bureaucracy, fear of litigation, and losing touch with the patient. Adding to this, the last several months have created a perfect storm. Even outside of the front lines, clinicians have been navigating a muddled, misleading, and even malicious discourse on the validity of science, medicine, and motivations. Even with a change in leadership, this will leave a lasting impact on healthcare workers.

The shift towards virtual care provides an opportunity to introduce a new standard of care that actively reimagines how to practice medicine while also tuning out the noise of bureaucracy and politics. By offering a wider set of tools to treat and diagnose patients, clinicians have the opportunity to offer a truly holistic experience that encourages patient compliance, data tracking, and a more personalized touch.

“WEBSIDE MANNER” WILL BE STANDARD CURRICULUM

Simply put, there is no room for remote care stigma in the clinician community. Now that virtual care is the norm rather than the exception, clinicians may even find themselves competing to provide the best virtual care experience.

In order to support this shift, training and education will now include how to appropriately and effectively treat and build relationships with patients behind a screen. This includes everything from how to introduce yourself and set expectations with the patient, to the importance of using positive body language, and how to neatly wrap up the visit. At the end of the day, patients want to be heard and understood, and virtual care offers clinicians an opportunity to build a relationship with their patients that isn’t possible in the traditional office model.

THE COVID RESPONSE WILL CONTINUE THROUGH THE HOUSE CALL

It’s difficult to remain optimistic as we’re facing this current wave of infections, but In 2021 we expect to see a shift towards earlier detection and remote monitoring at home — reducing the burden on our hospitals and decreasing the spread of the virus.

One of the greatest challenges we faced with the pandemic over the last several months was connecting people with testing, education, and care while simultaneously slowing the spread of the virus and managing the burden on our healthcare system. With expanded access to testing — including improved sensitivity and specificity, as well as self-administered testing that doesn’t require clinical oversight — we will be able to identify more cases earlier on.

Patients with early diagnoses will have treatment options that do not require hospitalizations (IV antivirals, convalescent plasma, monoclonal antibodies). In addition to early identification and treatment, they’ll be able to recover at home with remote monitoring and clinical oversight — which will ideally keep patients out of ICUs, decreasing spread, and decreasing mortality.

Griffin Mulcahey, Wheel President & Co-founder

POST-PANDEMIC POLICY: ONE STEP FORWARD, TOO MANY STEPS BACK

We’re nearing the end of the year without clear visibility on whether many of the temporary policies put into place during this public health emergency will become permanent. Moving into 2021, we should expect to still face the uphill battle of convincing policymakers that regulation should not be written from the perspective of replicating the in-person visit virtually.

While CMS will continue to reimburse more telehealth services, it’s unlikely that payment parity will extend past the pandemic. We will also see the emergency waiver for clinicians to provide care nationwide rolled back at some point in 2021. Considering this is one of the most significant barriers to expanding care to patients, this may be readdressed overtime.

Another long-term expectation is that digital health providers will continue to put pressure behind allowing care to be delivered across multi-modality platforms (phone, email, video, text, image-sharing). Once that’s unlocked, we’ll see an acceleration of innovation and ultimately expanded access to patients.

PUTTING OUR MONEY WHERE OUR MOUTH IS

Innovators and advocates are overdue in putting evidence behind the promises, which has proven to be one of the largest barriers to shifting policies and regulations in favor of virtual care. Now that our industry has been able to push significant progress forward thanks to (albeit temporary) regulatory decisions, we will finally start to see more resources and attention put towards research, data, and insights that back up many of the claims made around the virtues of virtual care.

For example, many digital health providers are focused on shifting our healthcare system from fee-based care to value-based care. Research will be focused on how to improve patient outcomes while driving down costs, backing up the promises and tag-lines with the evidence needed for both clinical and policy buy-in.

TURNING THE CORNER ON TRUE DATA INTEGRATION

Interoperability will continue to be a primary focus on the policy front, especially now that healthcare organizations are acknowledging that the patient experience will continue to move online, leading to potentially more fragmentation. While the timing of the pandemic postponed the enforcement of many interoperability standards, it also illustrated what happens when data sharing is manual, cumbersome, and incomplete.

Now that there is enough pressure to be able to easily share medical records across clinicians and healthcare organizations, this may be the year that we convince regulators we need to stop hiding behind HIPAA and start allowing patients to own their own data. We need to make sure that new innovations — and outdated regulations — do not get in the way of the patient experience as well as the clinician’s ability to provide the best care.

2020 will be remembered as the year of reckoning for the healthcare industry. 2021 will introduce yet another new normal as we continue to actualize the promise of virtual care.

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Michelle Davey

CEO & Co-Founder of Wheel on a mission to change the way healthcare works by putting clinicians first and delivering the highest quality virtual care at scale.