Virtual Telemedicine: Innovative Care Delivery Models

Healthcare, specifically virtual telemedicine, is experiencing a fundamental shift in focus to become more patient-centric. (About time!) Patient-centric virtual care means that patients have more control over where, when, and how they receive care. This level of virtual telemedicine also gives providers the tools they need to offer valuable, effective care to their patients. It gives providers better access to their patients and more control over when and where they work.

As a result, not only are patients more satisfied with the care they’re receiving, but their providers are happier, too.

Maybe what I’m describing still sounds like science fiction or a too-good-to-be-true dream of what healthcare could be. But let me assure you—it’s happening right now, all across the country.

Our healthcare partners are making this virtual “dream” come true today because of their innovative approaches to care. As a result, they’re seeing unprecedented upticks in patient engagement and provider satisfaction rates.

Three of our partners joined a recent panel to discuss their care delivery models: New York City Health & Hospitals, ReferWell, and Heritage Valley Health Systems. Each partner uses Bluestream Health’s flexible API integration to offer a unique care delivery model. Together, they provide an inspiring glimpse into the future of virtual telemedicine. 

(You can catch the full webinar here.)

While their care models and modalities are different, you’ll see they share several core similarities:

  1. Patients can receive care where, when, and how they need it.
  2. Physicians can spend more time caring for patients and less time dealing with cumbersome technology or red tape.
  3. Healthcare organizations and plans can create new revenue opportunities and solve staffing challenges.
  4. The total cost of care goes down while patient health outcomes and satisfaction ratings improve.

Heritage Valley Health System:

An integrated delivery network (IDN) with over 600 physicians, 3 hospitals, 55 physician offices, and 21 community facilities, Heritage Valley Health System provides comprehensive healthcare for residents in Pennsylvania, Ohio, and West Virginia. HVHS has built a strong reputation for patient engagement by giving patients more control over their healthcare experience.

What’s so innovative about their virtual care model?

Their single-click virtual telemedicine care model meets patients wherever they are. Plus, it integrates so seamlessly into the overall experience and EMR that not a single provider has declined to be part of their virtual care platform.

Improving the patient & provider experience:

Like so many other healthcare providers in 2020, HVHS knew video visits would be vital to providing care during the height of the pandemic. But they wanted to do more than just meet the status quo. They knew patients wouldn’t tolerate yet another app to download or log-in to remember. And they definitely didn’t want to dump unnecessary work and mouse clicks onto their providers. Instead, they chose to integrate Bluestream Health directly into their EHR so they could facilitate a smoother, seamless virtual care experience.

“Patients couldn’t come to us, so we wanted to come to them, to meet them where they are,” Mark Freed, Integration Manager at HVHS explains. “And our providers wanted an easy way—essentially a one-button-click—to launch from their EHR into a telehealth visit with their patient.”

This one-click solution solved the problem of patients being unable to come to in-person appointments while also solving another significant problem facing many healthcare settings: limited staffing. Now, providers from across the Heritage Valley delivery network can be logged in from anywhere to easily connect with patients. Additionally, administrative staff no longer need to facilitate the virtual appointment.

How do they do it?

When patients request an on-demand virtual visit or schedule a virtual appointment, they receive a text message that invites them to join the secure telehealth session. It takes patients just a couple of clicks or taps to sign the consent form and enable their microphone or camera. In seconds, they’re given immediate access to their provider, from wherever they are.

Meanwhile, from any clinic or hospital within the HVHS network, a provider can view the patient’s health record and interact directly with the patient’s video call simultaneously. The transfer of patient health information is minimized, keeping the encounter secure.

Real-world results of better virtual care:

For any care delivery model to be a success, it must be readily adopted by providers and easy for patients to use. When HVHS presented the single-click telehealth solution to their providers in 2020, every single provider decided to use it–and they still do today.

“We haven’t had a single provider come back to us and say, ‘you know what, that’s great but I’m not going to use it.’ Or, ‘I’ve had these problems with it, so I won’t use your solution,” Freed said. “We’ve had great provider feedback and adoption for this platform.”

Patients have also responded well to the new virtual care offering. Even though a percentage of the patients don’t have broadband access, Heritage Valley Health Services has still been able to reach them with virtual telemedicine options.


With a mission to drive efficient care transitions and improve patient outcomes, ReferWell automates the process for patients to get from a primary doctor referral to booking a specialist appointment at the point of care. Their solution integrates directly into the provider’s workflow, regardless of which EMR is used, and makes it easier to schedule visits with providers, whether they are face-to-face or virtual.

Check out the ReferWell case study.

What’s so innovative about their virtual care model?

Even before the pandemic, ReferWell discovered that many patients missed referral appointments because they were inconvenient or they felt uncomfortable attending an appointment in person. Providers lost patients to outside networks and other telehealth providers. Caused by ineffective care transitions—i.e., too much friction—these missed appointments and “leaked” patients resulted in poor patient outcomes and cost billions of dollars in unnecessary spending.

ReferWell reduces the friction in care transitions by making it easier for doctors to facilitate visits, stay in touch with the patient, and get data back into the patient chart with very few clicks. Additionally, they make it possible for doctors to work anytime and from anywhere (provided they meet licensing requirements).

Improving the patient & provider experience:

But it’s not just the convenience of providing a video encounter that has made ReferWell’s delivery model so innovative. What ReferWell has done so well is remove logistical barriers to care, which gives more people access to frictionless care, and helps providers receive incremental revenue.

As Vytas Kisielius, CEO of ReferWell puts it, it’s a “win, win, win” for the patient, provider, and the plan.

Booking referral appointments at the point of care has helped patients follow through on a significantly higher number of referral visits. Because ReferWell integrates with any EHR, using Bluestream Health, patients’ primary care physicians can track their care without any extra effort on their part.

How do they do it?

ReferWell Bluestream Health API integration makes it possible for patients to view a provider’s schedule for face-to-face visits and virtual appointment times. Providers can set specific times they’re available to provide virtual care for patients, which gives patients many more options to choose from.

Real-world results of better virtual care:

Greater access to virtual telemedicine has led to greater utilization of the available care in-network, and much faster access to care. In fact, ReferWell cuts the amount of time it takes for a patient to see a provider by 29%. Patients also complete the visit 29% faster than before when the televideo and in-person scheduling capabilities are bundled together.

“We see more patients following through when they’re scheduled at the point of care—whether that’s to a virtual or an in-person visit—more than doubling within the Medicaid population and greatly increasing within the Medicare commercial population,” Kisielius says.

NYC Health + Hospitals:

The largest public health system in the US, NYC H+H offers on-demand telemedicine and on-demand care to their patients and all the residents of New York City. NYC H+H blends in-person care and virtual care, integrating complex workflows customized to the patient’s entry point of care. Leveraging the Bluestream Health API, they can connect with anyone, anywhere. Technology and location are no longer limiting factors in providing excellent service.

What’s so innovative about their virtual care model?

The care NYC H+H can give is built around where and how the patient accesses care. NYC H+H providers leverage the power of telemedicine and technology to bring care closer to home. For example, even during emergency calls, physicians can connect with a patient anywhere and only bring them to the emergency department as needed.

Erfan Karim, Executive Director of Express Care at NYC H+H, explains: “The pandemic presented us with new challenges for access to care, but also gave us opportunities to think about what blended digital and in-person care could look like. It all revolves around the patient experience. The patient is put in the center of healthcare, so how do we meet their needs? And how do we give them the best experience possible?”

Improving the patient experience:

Instead of requiring a patient to find their way to a hospital or other care facility with the risk that the visit might be unnecessary, unproductive, or unsafe, NYC H+H set up an on-demand virtual care portal. Using the portal, patients can quickly reach a provider through video or audio and are evaluated and triaged. If they need immediate care, they’re told to come in or an ambulance is called for them. If their need isn’t urgent or doesn’t require in-person care, they’re transferred to a virtual telemedicine provider.

Emergency 9-1-1 calls also leverage the same system, transferring patients to a virtual telemedicine provider, through audio or video.

Throughout the care encounter, the patient can call back with questions or even involve family members on the call. Providers and emergency dispatchers work together to give patients the care they need in a way that’s built around the patient, not the system.

Patients can stay home and receive follow-up care as needed, instead of reflexively visiting an emergency department. Soon, patients will even be able to receive video consults in the ambulance with EMTs, further reducing the need for an expensive trip to the hospital.

How do they do it?

NYC H+H uses Bluestream Health’s API integration to create a virtual experience that functions like a smoothly run clinic instead of just a video conference call.

More importantly, patients don’t even need to have access to broadband or a smartphone to use the virtual care options available to them. This matters because 30% of New Yorkers don’t have access to broadband services, according to Karim. Without broadband access, “they couldn’t access traditional telehealth. We’re making sure that affordable telehealth, telephonic visits are available as well. We’ve been able to bridge the gap and reach patients who wouldn’t traditionally use virtual telemedicine or telehealth.”

And what about patients who have the technology but don’t know how to use it? Friendly NYC H+H agents walk them through the process in about 30 seconds. All the patient has to do is click or tap a button and they’re connected.

Connecting patients to their primary care provider in this way keeps the patient from delaying care until the issue escalates and they end up in the emergency department.

Real-world results of better virtual care:

Out of 23,000+ calls made to NYC H+H, 90% of the patients have been able to receive the care they need at home. Preventable admissions and readmissions are reduced. And patients report higher satisfaction ratings because they have a better experience.

“Telehealth has allowed us to adapt quickly to the evolving care expectation of the patient as a healthcare consumer. Patients are expecting an array of options that come to them and are brought closer to their home,” Karim explained, describing the group’s progression toward offering value-based care. “Whether it’s virtual urgent care, mental health, remote patient monitoring, even delivering medication—where the value comes in, from the patient’s perspective, is that they’re receiving care and their needs are being met on an ongoing basis.”

Virtual Telemedicine Care Delivery Means Healthcare Moves Back Home

Each of these health partners offers a different spin on virtual care, but they all share an unmistakable passion for giving patients and providers the best care experience possible.

After such a successful implementation of virtual Urgent Care, Heritage Valley Health is expanding its telehealth services to include behavioral health. They’re also looking forward to incorporating wearables, such as blood glucose monitoring or at-home heart monitors, into telehealth video visits.

Likewise, NYC H+H is considering ways to implement remote patient monitoring and home monitoring of vitals to give clinicians additional information they need to support their diagnoses.

As ReferWell looks to the future, they aim to help even more providers move disjointed telemedicine visits from unsecured platforms like Facebook and Zoom, and onto their integrated, secure platform. They also want to provide more digital health add-ons, such as remote patient monitoring.

Bluestream Health is excited to partner with these and so many other forward-thinking care providers, healthcare networks, and thought leaders. What they offer to their communities now was the stuff of sci-fi novels and “what-ifs” years ago. 

We believe that tomorrow’s virtual care delivery models will continue to look at each patient visit not as a separate instance, but as an event that takes place over a series of interactions with the patient. Tomorrow’s virtual care will navigate patients through their virtual encounters, making timely adjustments based on the patient’s needs or location in their care journey. Tomorrow’s virtual care makes this kind of mass customization approach possible through flexible integration.

Flexible, integrated virtual care gives more patients access to care, when they need it, where they want it, by simplifying the process for everyone involved: the patient, the provider, and the payer.

Join Bluestream Health in providing tomorrow’s virtual care, today. Give us a call, we’ll show you how easily it can be done.

You can watch the full webinar here.

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