November 5, 2022

Virtual Care Playbook: Designing a Care Team

An approach to building a care team that’s centered around your patient’s needs and delivers a world class experience.

When building a virtual care offering, one of the most critical components is how you shape the team that will be interacting with your patients. While there’s no one “right” way to design a care team, your strategy should take into account the population you’re serving, the services you offer, and the health outcomes you’re hoping to drive. In virtual care, there is a lot of emphasis on the technology through which care is delivered, but at the end of the day, so much of the patient experience is influenced by their interaction with the people providing that care. 

In this installment of the Virtual Care Playbook, we’ll discuss strategies for identifying the different roles and responsibilities you’ll need to build a care team that can deliver an excellent patient experience.  

Care Team Roles

First, let’s align on what we mean by a “care team”. A care team is made up of all the individuals who will interact with a patient on their care journey and includes clinical and non-clinical roles. It’s important to think of these individuals, and the specific roles they play, as one unit. They should each serve a specific purpose, and address a specific need for the patient journey. 

When you’re starting from zero, the idea of building a multi-role care team can be difficult to approach. Starting off by mapping out the high level patient journey can help you identify the key points at which patients will be interacting with that team. Once you’ve identified those touch points, you can assess what patients need from each of those touch points, as well as what they want. For instance, they might need a prescription for a medication, but they might also want counseling on how to take that medication or the potential side effects. Once you have a better understanding of the outcomes you are aiming for with these interactions, you will be able to match the skillset of a certain role to that interaction. 

The care team that you start out with will likely change over time. As you scale and add more patients to your patient panel, the ratio of clinical to non-clinical roles will change. In the beginning, you may be able to get away with clinicians doing some double duty on admin work, but be cognizant of how much of their time it takes up. If you have a high-touch care model where patients are interacting with a care team on a daily or weekly basis, you need to think about provider support (either from other clinicians like RNs or from non-clinical support staff like a concierge) early. Asking physicians (or mid-level providers) to handle daily communication in addition to conducting consultations, prescribing treatment, and creating care plans is likely to cause delays for patients, contribute to provider burnout, and cost you a lot of money.

In addition to overall growth, it’s likely that you will add different services to your offering over time. When expanding these services, you should evaluate the makeup of your care team and determine if new services or touch points warrant the addition of a new role. 

Full-time vs Contract hires

High-quality patient care can be delivered by part or full time providers, so your care delivery model can help you decide what works best for you. For example, if you are offering care for complex chronic conditions in which patients will have repeated interactions with their providers on a regular basis, you may want to consider full-time providers. In that type of environment, not only are your patients more likely to form a deeper relationship with their care team, but continuity of care is extremely important to drive clinical outcomes. On the other hand, if your delivery model is more episodic or narrow in scope, a part-time work force can offer you more flexibility to scale up or down based on patient demand. 

In addition to considering the patient experience and how to best support your care delivery model, you should also take into account the administrative components of a part-time vs full-time workforce. Not only are the regulatory frameworks different across states, but the type of employees you hire will also influence the resources required to manage your workforce. A team of all contract workers is likely to be larger, but full-time employees will require more time and ultimately a larger management infrastructure. Either way, you’ll need to support onboarding and training, ongoing education, and quality assurance for your provider team. 

Physicians vs Advanced Practice Providers

Across the healthcare landscape, institutions utilize Advanced Practice Providers (such as Nurse Practitioners or Physician Assistants) to supplement their physician workforce. APPs are able to provide many of the same services as physicians at a much lower cost, so they can be very useful as you expand your provider team. If you’re considering hiring NPs or PAs, it’s critical that you understand the regulatory requirements for these providers in the states where they will be practicing. Physician oversight requirements vary greatly from state to state, and you should take into account any additional administrative burden on your physicians when you plan out APP hiring. While nurse practitioners are able to practice independently in certain states (generally they qualify based on hours of experience), other states require frequent meetings between the NP and supervising physician as well as chart review. Before bringing these providers onto your team, you should review their proposed responsibilities and workflows with regulatory counsel to ensure compliance, and have a plan to track any oversight requirements. 

Putting the pieces together

In addition to the specific roles on your care team, you also need to determine what types of employees are the best fit for those roles (full-time, part-time, or contract), and how many of each you’ll need. The best place to start by asking yourself a few key questions: 

  • What is the key value behind your offering? Examples might be access to specialized provider care, monitoring and accountability for a chronic condition, or a more streamlined experience for an established treatment.
  • How often are patients interacting with your team? This could range from daily to annually.
  • What is the nature of those interactions? Are they mostly clinical? Are they mostly about care coordination?
  • How often might you encounter acute or emergent clinical scenarios? Based on your treatment offering, you may also need to consider how you handle emergencies during and outside of business hours. 

The answers to these questions will be different for everyone. For example, many direct-to-consumer telemedicine offerings have built strong businesses around making existing treatment options more affordable and convenient for patients. In these models, speed and consistency of experience may be more important than a long-term relationship between a patient and a provider. On the other hand, for a specialty chronic care practice, patients will likely build deep relationships with individual providers over the span of years, so continuity of care and trust become more important than speed. In other areas, such as behavioral health, patients may value both experiences in different circumstances; choosing to have a primary therapist they trust for each scheduled session with the option to speak to someone immediately if they’re experiencing a crisis.    

Your hiring model will likely change over time as you expand your patient population and your services. Keeping the patient experience at the center of your hiring strategy will ensure your care team is built around meeting their needs effectively. Once you’ve done that, you can think about how to optimize that model for cost efficiency.

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