BLOG: Addressing Workforce Challenges in and Through a Digital-First Clinic

By Lauren Gums, Chief Clinical Officer at 98point6

The labor challenges of the pandemic have not gone unexplored. Hospitals and health systems are facing unprecedented strain on their workforce with labor expenses increasing upwards of a third from pre-pandemic levels.¹

With challenging balance sheet positioning and an austere labor market, the answer for health systems cannot solely be to hire additional staff. In a period of continued volatility, they must reframe workforce management to emerge stronger in a digital-first world. 

98point6 has spent the last seven years refining the operating model for a digital-first clinic that operates 24/7 and has provided care in all 50 states and Washington, DC since 2018. Measuring provider satisfaction and refining the delivery model to maximize physician time, manage cognitive load, and building a community of providers who support one another have been key to our success. Scalability of that model, which enables us to serve more than three million patients with under 150 providers, has required discipline and development of new tools and models to be successful. Here are a few of the lessons we’ve learned along the way.

• Forecasting is everything. 

• • • With the exponential growth in virtual care demand, predicting future volumes for virtual care is an increasingly complex equation. Workforce management for a virtual care clinic, particularly one handling episodic care issues, requires accounting for patient growth, acuity and expected needs of population, daily and hourly staffing needs, and long-range hiring planning. We maintain expedited wait times by focusing on visit forecasting and translating visits into staffing requirements, building a schedule two months in advance. As a result, our wait times are generally 5-15 minutes for primary care.

• Align service level agreements (SLAs) to actual patient expectations.

• • • Many of our early conversations with clients center around a desire for SLAs in under two minutes, presuming that a patient expects or even demands that level of service to be satisfied. What we’ve found in most cases, however, is that patient satisfaction for a text-forward visit does not materially change until the patient waits over 30 minutes. Cost for providers, planning tools and support staff increases significantly for an SLA under two minutes compared to under 30 minutes. Balancing patient expectations with budget realities goes a long way towards managing operating costs.

• Empower all members of the care team to operate at top of license (including the patient!).

• • • Our technology at the front of every visit enables us to take in over 60% of the information that is needed for a visit. This means that over the course of our history as a clinic, we have been able to reduce “active clinician time,” where the provider and patient are texting, semi-synchronously, by over 50%. The patient is able to share as much detail as needed during intake and technology organizes what’s most pertinent for the provider, allowing the provider more time to focus on the patient. This empowers both patient and provider to have a productive, high-quality conversation.

• Support providers to determine the right care modality for them.

• • • Not all providers will be fulfilled or best suited to provide care to patients virtually. If an organization is going to invest the time and cost to license a provider across multiple jurisdictions, that organization should feel confident that the provider will be successful with virtual care. Through our years in operation, we have developed a simulation tool to assist in diagnosing if a text-based modality suits a provider’s temperament and processing speed. Additionally, we have developed an operational tool kit for hiring, onboarding, compensation modeling, training, licensing and scheduling to ensure our clinic can execute successfully. 

• Community makes a difference.

• • The experience of working in a virtual environment has been different for many of us, and all remote workers, providers included, have had to learn to build their professional relationships in new ways. The same has been true for our virtual clinic, where peer auditing offers providers a feedback loop, there is collaboration on refining practice standards, and there are other ways to connect with each other while on clinic service and off. Creating these touch points has helped the clinic care team build their professional community as well as connect them to the mission and vision of the company as a whole. 

Many patients grew to love virtual care during the pandemic with the ease and convenience of healthcare providers being able to address medical concerns quickly and efficiently. Virtual care visits also have advantages for healthcare professionals, providing more control over their day-to-day schedules with a patient-centered approach, unlike rigid 9 to 5 in-person visits of the past.

The growth of digital healthcare represents the future of health, a win-win situation for healthcare workers and patients alike.

Learn more about virtual primary care by visiting the 98point6 Team at ATA2023, Booth #1103.

Lauren Gums is the Chief Clinical Officer at 98point6. The company is pioneering a new approach to primary care by pairing deep technology with the expertise of board-certified physicians. Our innovative service offers consistent access to comprehensive care and includes diagnosis, treatment, prescriptions and labs as well as consultation for any health-related question. 

¹ KaufmanHall. (2022). (rep.). The Financial Effects of Hospital Workforce Dislocation. Retrieved December 13, 2022, from https://www.kaufmanhall.com/sites/default/files/2022-05/KH-NHFR-Special-Report-2.pdf.