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The Fourth Key Commitment of Revenue Resilience – We Need Hospitals to Adapt

Crashing waves

Series Authors: Tom KiesauDr. Sam BhatiaPaul Griffiths

This series explores the uncomfortable reality that this adaptation will likely span a longer period of time than the authors believe has been widely expected. Three leading organizations — SalesforcePerficient, and The Chartis Group — have come together to share bright spots within the healthcare community that can point the way to building the necessary capacity to adapt.

We identified Six Key Commitments, and here are the first, second, and third articles.

Today, we turn our attention to:


Expand access to all clinical specialties virtually, deploying a clinical operating model that seamlessly provides both virtual and physical care as needed/demanded.

Many healthcare systems rise and fall on the strength of referrals — the historical idea that primary care doctors maintain relationships with specialists who, in turn, are relied upon to address significant medical issues with that primary care doctor’s patients.

In previous weeks, we’ve discussed how virtual care for primary care visits has been a resounding success. Irrespective of platform, nearly every hospital system we’ve talked with has achieved remarkable gains in telemedicine.  We’ve heard of exponential growth of 10x, 20x or 100x increase in telemedicine volumes, overnight.

Despite the challenges of dealing with an epidemic, we also know clinicians have expressed a sense of renewed engagement. The opportunity to re-examine old habits, pull together for the good of the patient, and achieve a common victory has energized many departments.

Now that the first waves of a crisis have passed, we can’t help seeing another storm on the horizon.


The gains in telehealth advancement were not an accident — hospital systems had enacted pilot projects to augment care virtually.

What really hastened the ability for hospitals to deliver virtual care were payment model changes.  Recent legislation now allows for the practice of telemedicine beyond rural regions, where access was limited out of population, and across state lines, where rights to practice medicine were governed at the state level.  These changes have upended a largely provincial model of care.

We can no longer count on the old standard of patient loyalty: build primary care volume, leverage that volume for specialty care, and engage consumers in a complete cycle of care.

Today, consumers can see physicians in a variety of modalities digitally:

  • As a stand-alone payment model, via third-party applications on their phone
  • Incentivized from their health plan, as a way to lower costs
  • Via concierge medicine practices, for a “medicine as a service” fee


Many metro areas have a handful of potential health care systems for a consumer to choose from.  It’s not uncommon for a market to be dominated by two or three systems that provide a full suite of care services — less, if you live in a rural area.

We must recognize that health systems are going to compete for overall fewer patients for the same level of procedures. As virtual care has been accepted by patients, the competitive landscape has increased.

In fact, new data from Salesforce indicates that 36% of Gen Xers and 43% of millennials/Gen Zers believe they will receive better care from providers if they first undertake their own research.

This twin hammer of lowered patient volume and increased ease of competition will allow hospitals to adopt new virtual operating models to achieve outsized results of their investments.


The only response of a truly patient-centric healthcare system is to embrace these changes.  This Commitment requires that healthcare providers examine their differences in care for virtual and in-person protocols.

Building consumer-driven, experientially led journeys is no longer an optional view — we must find ways to deliver care seamlessly between a virtual and in-person setting.

Having no control over where, when, and how a health crisis may re-engulf a population, healthcare providers must commit to an experience that allows for patients to receive timely, sufficient, and comparable care from home or from the office.

While we acknowledge that loss of lab fees is a major concern for healthcare providers as we move to a virtual-first setting, the great impact we see is the shift away from in-person treatment as the dominant mode of care.

Many new, unproven primary care start-ups are attempting to disrupt the referral model — both in the primacy of the PCP-patient relationship, but also in the ability to receive care how, when, and where a patient wants to receive it.


We have witnessed a shift in patient behavior towards receiving care that fits their concept of other consumers experiences.

People increasingly want to engage with companies who provide services which are:

  • Easy: I understand what to do and how to do it.
  • Sticky: I don’t need to repeat myself; features are easy to use.
  • Pervasive: I can interact when I want, how I want, and on terms that suit my needs.

57% of Americans say healthcare is more focused on industry needs than patient needs.

Patients want experiences that are easy, sticky, and pervasive.  In practice, this looks like care  from home or from an office, including escalations to specialty care.


We have to provide clinicians with the same level of information, whether remote on onsite, in order for them to effectively do their jobs.  The corollary is that we have to provide patients with a comparable experience, whether in real life or remotely.

This Commitment demands that health systems not see Virtual Visits as its own service line, but rather as a core function that they must provide to be relevant.

In short, organizations who commit to serving their patients the same regardless of how patients want to connect, will be able to find opportunity to deepen those relationships.

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In next week’s post, Tom Kiesau, from The Chartis Group will discuss the fifth commitment:

Expand access to all clinical specialties virtually, deploying a clinical operating model that seamlessly provides both virtual and physical care as needed/demanded.

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Paul Griffiths

Paul Griffiths is the GM of the Digital Healthcare Solutions unit at Perficient, where he works with hospital and health plan marketing departments on digital initiatives. DHS services integrated healthcare delivery systems around the United States.

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