Virtual care? Face-to-face? How health care navigates the “omnichannel” moment

A female patient looks at her doctor; the doctor has an overlay of a cellphone over her face and shoulders.

Coming out of the pandemic, consumers are more varied in how they want their health care. Here’s how the industry can deliver.

First came the rise of telemedicine. Driven by safety concerns during the pandemic, about half of all patients had some form of virtual visit with their providers in 2020. Medicare, which had less than a million telehealth visits in 2019, saw 52.7 million virtual visits the next year, as federal regulations were relaxed.https://www.hhs.gov/about/news/2021/12/03/new-hhs-study-shows-63-fold-increase-in-medicare-telehealth-utilization-during-pandemic.html

Then the tide of telehealth ebbed. This year, only about 11 percenthttps://www.chartis.com/insights/telehealth-adoption-steadying-toward-new-normal-rate of provider visits have been virtual, as in-person options returned. This lower number still represents a significant jump from the 1 percent of virtual visits in 2019 and signals a steadily rising normalization of digital health delivery. As a result, dual channels—in-person and virtual care—are becoming standard at every point in the patient journey.

Health care, then, is faced with twin challenges: integrate virtual care into the mainstream, and at the same time, serve audiences in more traditional ways they might want to receive care. “Consumers have more and more of a choice nowadays, and they are voting with their feet and their fingertips,” says practicing physician Creagh Milford, DO, MPH, and Senior Vice President of Retail Health at CVS Health®. “To serve them well means serving them in the way that best fits their lifestyle.”

Both channels—in-person care and virtual care— come with pros and cons. The average wait time for a new patient in-person appointment with a provider, for instance, reached 26 days in 2023,https://www.merritthawkins.com/physician-appointment-wait-times-up-from-2017/, an all-time high. Virtual care, while more convenient, can pose technical barriers for some and many patients (and providers) are still uncertain what to expect. In many ways, consumers are evenly split. About two-fifths of consumers said that in-person visits are still important to them, while a similar number find virtual visits more convenient, according to the 2022 Health Care Insights Study from CVS Health.

While both methods are critical for reaching patients, large sections of the health care industry aren’t yet equipped to handle both virtual and in-person care. A recent McKinsey survey found just 41 percent of physicians believed their practice had the technology to deliver virtual care seamlesslyhttps://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/patients-love-telehealth-physicians-are-not-so-sure. A separate 2022 report found that most providers struggle to find the right mix between office and virtual visits.https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality

Ideally, consumers soon won’t have to choose one modality over the other. The goal is to marry digital and in-person services in a way other sectors have already done. “People have become accustomed to interacting digitally with other industries, such as banking, with the option of sometimes going into the store,” Milford says. “Health care can move in the same, consumer-centered direction. And by doing so, I believe we can shift from the episodic care that exists today to something that is more proactive and creates deeper relationships.”

The case of MinuteClinic®

MinuteClinic, retail health clinics in CVS Pharmacy stores, began piloting its virtual care services in 2015. A sharp increase in telehealth visits since the pandemic have brought critical lessons about how and where virtual care works for the consumer, according to David Fairchild, MD, MPH, Senior Vice President and Chief Medical Officer of MinuteClinic.

“We’ve confirmed that virtual care works — that there are a good number of things a clinician can diagnose and treat safely through a virtual visit,” Fairchild says. Research supports the notion that respiratory disorders, skin conditions, mental health services and other common concerns can be managed virtually. But the experience needs fine-tuning. “At first, one provider was handling both in-person and virtual calls,” says Fairchild. “That was challenging, in part because toggling between in-person and virtual visits during one clinical session was inefficient for providers.”

Lessons from the first wave of virtual care helped evolve the experience on both sides of the screen, MinuteClinic invested in expanding services, which now includes virtual mental health services in some states. There were also infrastructure improvements to make it easier for patients to request on-demand virtual appointments and access their personal health information online.

To Fairchild’s point, the clinics now also have designated providers who cover virtual visits exclusively. That way, in-clinic providers don’t have to hop back and forth between in-person and virtual appointments. “Sometimes simple changes can make all the difference,” says Fairchild. Consumer responses have been positive, and adoption continues to grow: “If we’ve learned nothing else from the pandemic and how people have reacted, it’s that we’ve got to make our services convenient and meet people where they are.”

“Consumers have more and more of a choice nowadays, and they are voting with their feet and their fingertips.”

— Creagh Milford, DO, MPH, Senior Vice President of Retail Health at CVS Health

Three directions for an “omnichannel” future

The term “omnichannel” begins to capture how an integrated future might work. In omnichannel health care models, consumers access care in the way that suits them, which may include in-person, virtually or at home. 

According to Milford and Fairchild, omnichannel care will require a commitment to a handful of best practices.

Teamwork: As the toolbox of virtual care expands, so will the human team that supports it. Health care will soon be incorporating more remote patient monitoring devices, AI-driven nudges and post-acute care at home. That also means that providers will have to adapt their practices to accommodate and manage these many touchpoints with patient-specific programs and interventions, says Milford.

Team-based care is central to several initiatives at CVS Health. Next year will see one key step in that direction with CVS Health Virtual Care™. This will give consumers access to primary care, on-demand care, chronic condition management and mental health services virtually, with the option of being seen in-person when needed at an in-network provider, including MinuteClinic. It is also supported by a physician-led care team that can consist of nurse practitioners, registered nurses and licensed vocational nurses. The care team can also consult with CVS Pharmacy pharmacists.

“Virtual can be the first step in a patients’ care journey, and it can be extended to in-person care when needed,” Milford says. The forms of that virtual care don’t even have to be high-tech. “We learned during the pandemic that, for example, a phone call or text may be the most efficient interaction. It can save a patient an in-person visit altogether.” 

Simplicity: Innovation in digital health has bloomed in recent years. More than 400,000 health care smartphone apps now exist, promising to track vitals, monitor exercise and manage chronic conditions. “Doc-in-a-box” telehealth companies have also crowded into the marketplace, many offering care for only a single condition. The challenge is that many new apps, devices and sites have a hard time integrating with each other or in-person, physical provider networks.

This fragmented experience can be daunting for consumers and potentially harmful. Having many touchpoints can risk gaps in care or dangerous overlap, says Fairchild. “The patient has to collect and integrate different pieces of information from different apps and health records and pull it together without the benefit of an integrated provider team,” he says. 

One major goal of CVS Health is to create a “single digital front door to health” — an effort to organize a consumer’s experience. Ideally, this connects providers, insurance plans, pharmacy, and digital care management solutions under one umbrella. A single consumer portal would provide an integrated way to perform a number of tasks, including ordering medications and communicating with care teams across sites of care. Critically, it also aims to provide an interoperable electronic health record, which allows providers and patients to see the entire health care picture in one place. 

Flexibility: Most of all, the move to omnichannel should be guided by putting consumer preferences at the center of care. While recent trends in venture capital investment in health care have focused on flashy apps and new wireless devices, greater value may be found in a range of practical solutions—things that make health care more accessible, convenient and affordable. 

For instance, two out of three health care providers said that communicating by standby virtual care channels — phone calls, texts and emails — improved their ability to engage with patients and achieve outcomes, according to the 2022 Health Care Insights Study from CVS Health. The trick is finding solutions that make people feel comfortable. 

“People today are going to the doctor less and less, and when they do it is only when they are really sick,” says Milford. “By making it easier for patients to connect with their providers, through the channels that are convenient to them, we can help address health issues sooner and potentially close gaps in care.” 

“In health care, patient engagement has always been the big challenge,” Fairchild adds. “Lowering the barrier to care — and giving people more choices about how and when they want to access that care — is a precursor to engagement. And greater engagement means healthier people.”   


Unless otherwise stated, data points in this report come from the CVS Health Insights Study.