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Our Take

Why asynchronous care belongs in your digital strategy

15 Minute Read

Asynchronous technology allows for remote, non-real-time communication between providers and patients. It is uniquely positioned to function both as a gateway to the health system and as a modality for providing immediate care for common conditions—often at capacity rates higher than synchronous video visits alone.

As health systems expand their virtual care offerings, asynchronous tools will be essential to realizing telehealth’s potential to transform care delivery at scale. Some provider organizations are already realizing important benefits from asynchronous tools for patient intake, low-acuity care, and care management.

Asynchronous telehealth [ ā ' siNGkrənəs 'teləˌheLTH ] noun

Asynchronous telehealth is virtual care in which information such as symptoms and health history are recorded and sent to a practitioner who then provides care decisions outside of a real-time interaction. Asynchronous care ranges in complexity from simple secure messaging in the EHR, to intake forms, chatbots, and AI-augmented adaptive interviews.


The conventional wisdom

Telehealth has traditionally functioned as a replacement for in-person care. Synchronous video visits have been the norm. But this attempt to mirror in-person care often exacerbates the inefficiencies and care management challenges that accompany traditional in-person care.

Our conversations with vendors and health system IT leaders revealed that asynchronous care is, for most, a new priority. Covid-19 called for new investments and scaling of telehealth services. Providers initially took a familiar approach and focused almost exclusively on synchronous telehealth visits. Asynchronous tools have mainly been limited to online symptom checkers or simple messaging in the EHR.

These tools are a first step, but they tend to use digital solutions as simple substitutes for in-person care. This limits asynchronous technology’s potential for providing true digital transformation—and the cost, outcome, and efficiency benefits that come with it.

While many providers have adopted synchronized video functionalities, the rest of the health care industry has broadened its focus to include new or greater investments in the asynchronous sphere. New asynchronous vendors have entered the market within the past year, while other synchronous platforms have expanded their services to include asynchronous modalities. Some vendors seek partnerships with payers and/or health systems, while others market to consumers directly under episodic or monthly subscription models.


Our take

Health systems can—and must—use asynchronous tools to efficiently augment care delivery and replace parts of the care visit, or even the entire visit itself.

Asynchronous tools can drive value for the health system, helping to retain patients, improve care outcomes, reduce total cost of care, and increase access and provider efficiency.

In addition, asynchronous care offers a potential market differentiator: a new digital entry point to a health system that can attract—and keep—patients, promising fast care and boosting consumer loyalty in the process. A recent Optum survey found that 87% of commercially insured patients who have used an e-visit would consider using it again.

At present, there is no guarantee of reimbursement for asynchronous care, with little indication as to whether payers and CMS will begin to reimburse for services in the future. However, regardless of reimbursement regulations, there is a strong value proposition for health systems to implement asynchronous telehealth. The rise in overall telehealth utilization and direct-to-consumer vendors amid the Covid-19 pandemic means that implementing asynchronous care will help health systems to retain more patients and better manage care programs. This will allow health systems to remain competitive with direct-to-consumer vendors.

Furthermore, if health systems do not invest in the asynchronous sphere as payers and self-funded employers continue to do so, they will be consequently sidestepped within the patient care journey. Systems must begin investing in asynchronous technology now or risk losing primary care, urgent care, and even care management volumes.


Three winning asynchronous strategies

One size does not fit all when considering asynchronous care technologies. The versatility of these tools allows for a spectrum of strategies to find the right fit. Health systems and providers may even combine their technology investments as a next-level approach for care delivery.

Still, our conversations with vendors and health system leaders point to three key asynchronous strategies that automate current care offerings:

  • Strategy

    Autonomous digital entry point

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  • Strategy

    Augmented low-acuity care modality

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  • Strategy

    Ongoing care management tools

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Parting thoughts

One element of successful asynchronous platforms rings true across all scenarios: robust back-end processing and cross-system resource coordination. Derek Streat, CEO of Providence Health System’s access optimization platform DexCare, suggests three keys to seamlessly integrate digitally enabled care while balancing capacity and demand across the health system.

1. Optimal patient routing requires considering more than just clinical need.

DexCare’s true power lies in its assessment of more hidden back-end factors, such as provider availability, economic profiles, and system resources. These multiple layers of automated decision-making ultimately result in access and resource optimization for both patients and the health system.

2. Just because a health system has the capabilities for digitally enabled care does not mean it will be successful in its delivery.

With the onset of the Covid-19 pandemic, health systems with fragmented digital strategies struggled to scale and shift their patients to virtual care, creating strains on provider workflows and operational capacity. Optimization platforms like DexCare will be essential in coordinating back-end sources and integrating virtual care across other parts of the health system, for Covid-19 and beyond.

3. An estimated 20 to 30% of volumes in the post-pandemic world could shift to virtual. For unprepared health systems, this could be consequential.

Health systems must be adept across care delivery spheres, balancing their digital health strategies alongside in-person priorities. It will be challenging to balance both and effectively manage patient information. Health systems without a sturdy virtual care foundation face the risk of patient leakage and volume loss to competitors.


Optum Healthier Connection Consumer Panel, December 2020.

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