What Dialogue learned about virtual care best practices after 1 million consultations

With the rapid adoption of virtual care and several providers to pick from, you may be wondering what the single most important element you should be looking for in a virtual care provider is. Virtual care features and functionality are important. However, most are now considered table stakes. Timely access to a healthcare professional? Check. A high level of satisfaction from members and countless positive reviews? Check. What, then, can be considered as a requirement from virtual care but hasn’t become the norm yet? Measurable positive health outcomes.

Positive health outcomes can be defined as “being alive; functioning well mentally, physically, and socially; and having a sense of well-being”. This means:

1. Actually being able to measure these elements;

2. Providing the option for all members that reach out to connect with a care team member;

3. Supporting members through an empathetic and patient-centred approach;

4. Ensuring members actually get better after consulting with a care provider, without requiring an in-person evaluation. 

At Dialogue, we’ve built our operations in a way that allows us to measure these elements and provide valuable insights regarding your virtual care investment.

Why should measurable positive health outcomes matter to HR leaders? 

After completing 1 million consultations, establishing the largest multidisciplinary team in Canada and building an unmatched technological infrastructure to facilitate access to care, we pondered just that. 

For example, using our platform, we can consistently follow up with people to see if they are feeling better (and take action if they aren't) and use this data as part of our quality improvement processes. Do walk-in clinics undertake this kind of tracking? The vast majority do not. They simply don't have the technological infrastructure to do so. And why is it critical to track individual outcomes? Because it’s necessary to drive improvement of the entire care experience and its results. Why is this relevant for you as an HR or organizational leader?

Employee feels better faster → Gets back to work sooner → Productivity increases

How does Dialogue deliver measurable positive health outcomes?

At Dialogue, we have built complex operations specifically to deliver outcomes for all of our programs, from primary care to mental health to EAP, and to reinforce our collaborative care model. We’ve set ourselves up to measure just about everything that meaningfully impacts health outcomes for our members, for example:

• Consistency of high-quality empathetic medical care 

• Resolution of issues for primary care issues

• Significant mental health improvements

• Effectiveness of treatment plans and time to resolution

• Reduction in anxiety and depression scores

• Improvement rates post-consultation

• Member satisfaction with the care journey

• Improving clinical and cost efficiencies through judicious use of antibiotics

• And much more.

Moreover, thanks to 1,000-1,500 various data points captured per month by our dedicated team of clinical quality specialists, we can reach unprecedented industry standards when it comes to the breadth of our analyses and audits. Here are a few examples:

Significant mental health improvements

Continuous monitoring of mental health questionnaires from our mental health program, for example, has shown that our collaborative approach – the gold standard in traditional large-scale brick and mortar models – to common mental health disorders allows us to achieve a response to therapy. For example:

• We reduce short-term disability to less than 6 weeks in 70% of cases¹ (compared to a Canadian average of only 30%), which means:

• your employees are 230% more likely to recover more rapidly  

• your employees are 2.3 times more likely to require a shorter disability leave (under 6 weeks) 

• We decrease the percentage of members needing a longer-term disability absence

• only 23% of Dialogue members report a disability duration >3 months (compared to a Canadian average of 50%)

• Our response to therapy results are benchmarked and compare well to best practices in collaborative care models to improve common mental health disorders²

Resolution of primary care issues

Furthermore, when it comes to common primary care issues, not only do we track clinical outcomes, but we benchmark ourselves against best evidenced-based practice guidelines from Canadian and international medical societies to then drive further improvements. For example, we’re able to reduce this time to get better, thanks to a collaborative care team and having an average of 3.2 interactions with care professionals to ensure treatment is effective.

A key to ensuring improvements in every single interaction is to be able to follow up on every case. Through the use of our technology, 100% of symptomatic members requiring a follow-up get one to determine if they got better, stayed the same, or got worse. And 100% of those members who should have gotten better but report they didn’t will receive a follow-up with a medical professional. No case is left unresolved; we are able to close the loop on all issues. This also means that for chronic or longer-duration issues like anxiety or depression, a member will feel supported and have a higher likelihood of completing a treatment program, reducing disability duration and increasing recovery rates.

And if you consider the compound effect of your employees feeling better faster, the results are impressive.

Why do we measure health outcomes?

Tracking and providing our clients with results keeps us accountable for the quality and safety of our services. We drive towards a single goal which is the resolution of issues for our members whether they can be treated virtually or need an in-person consultation. 

We measure ourselves to improve continuously and offer best-in-class care in the industry. Our doctors are paid hourly to enable this focus on quality rather than trying to see as many patients as possible: quality versus quantity. 

Since our inception, Dialogue set out to transform how people access great care. But access is only one piece of the puzzle. The other part, equally important, is making sure patients get better. It’s essential for virtual care providers to be able to prove what their positive outcomes are. Dialogue is the only virtual care provider that has done so by combining technology with a trained and empathetic on-staff multidisciplinary care team. 

So go ahead: ask your current or potential virtual care partner about the breadth of their tracking and what processes are in place to help improve the lives of your employees and their families. The next frontier of virtual care is the use of data and technology to track positive health outcomes, and to build better models around patients so that we can improve diagnosis and disease treatment for your employees. Your organization deserves a virtual care service that continuously innovates and sets new standards of care. Because, after all, health is everything. Don’t settle. 

Resources

• Based on an internal study of 44 short- and long-term disability cases from May 1^st, 2020 to July 31^st, 2020

• https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-8-135#Sec12