Winters often bring a surge in sicknesses that can overwhelm many health systems. More specifically, a winter-related uptick in the flu, COVID-19, and other illnesses can create overcrowding in physician offices and emergency departments (EDs), which then decreases a health system’s ability to provide timely access to care for non-urgent issues, such as chronic and preventive care needs.
Additionally, EDs see a rise in a wide variety of non-respiratory illness cases during the winter holiday season, such as slips and falls, sharp object injuries, falls from heights, workplace accidents, abdominal pain and diarrhea, and psychiatric disorders. Many hospitals are further overloaded with “patient boarding” issues, when patients remain in the ED for extended periods because there is no bed space available elsewhere.
On top of this greater need for urgent and emergency care during the winter months, overall demand for care often increases at the end of the year as patients seek to book annual wellness exams and scramble to schedule appointments with specialists and for procedures before their new deductible year kicks in.
How health systems respond to surges
Planning for surges is a complex process that requires health systems to consider numerous factors as they develop appropriate blueprints for dealing with seasonal spikes, according to a report from the U.S. Department of Health and Human Services’ (HHS) Technical Resources, Assistance Center, and Information Exchange.
Traditionally health systems have implemented a variety of strategies to address surge challenges, including:
- Decreasing preventive care exams and other non-urgent care visits during the wintertime to ensure enough space for more urgent issues
- Expanding the use of telehealth and telephone care for routine urgent, chronic, and preventive care
- Increased reliance on community paramedicine programs and community health centers.
Furthermore, health systems may consider media campaigns to share key messages with their communities, including when to seek care in the emergency department, when to go to urgent care or a primary care provider, and when to stay home and treat symptoms with over-the-counter medications. These efforts may reduce unnecessary patient visits and direct those who do need medical care to the most appropriate treatment site, according to HHS.
However, many of these approaches come with downsides. For example, decreasing preventive care activities to make room for spikes in urgent care may lead to delayed diagnoses and worsening chronic conditions, as well as less opportunity for clinicians to help patients close care gaps. In addition to decreased quality of care, health systems in value-based care plans, such as accountable care organizations, stand to lose significant revenues because of worsening quality measures, as well as experience higher costs for caring for these patients down the road.
The power of adding virtual care partners to the mix
An increasing popular option for health systems addressing surge periods is the expanded use of virtual care for urgent, non-life-threatening issues such as rashes and sinus infections. Health systems are finding they can greatly improve access to timely urgent care through virtual programs that optimize a physicians’ time via automation, delegation, and virtualization. Virtual providers are empowered to manage more of the routine urgent care, giving office and ER physicians more bandwidth to work to the top of their license and care for complex patients needing greater time and attention.
Virtual urgent care also brings many benefits for patients, including increased access to timely care, more convenience for those with busy schedules, and lower out-of-pocket costs. In the future, these benefits will likely increase as more health systems incorporate AI tools into virtual care, such as technology that assesses real-time video and performs voice analysis to identify biomarkers that may indicate a particular health concern.
However, virtual care is not a fully fungible service, meaning if a health system shifts their office-based providers to virtual care, then they are decreasing office visits at the same time. Therefore, many health systems are looking for virtual care partners that can augment their own teams in a way that supports expanded overall capacity in a coordinated manner.
Of course, virtual care is not always a perfect solution. For example, because a clinician can’t touch or physically examine a patient during a virtual visit, some issues will either be treated with less information or need to be triaged to an office-based setting.
In summary, winter surges in health care are inevitable, which is why health systems are smart to proactively plan for their arrival. To manage these surges, more health systems are moving beyond traditional approaches and expanding virtual care partnerships that provide, in many cases, an excellent alternative to urgent care and emergency rooms. Such initiatives benefit patients by providing greater access and convenience, while also helping health systems allocate their internal resources more efficiently.
Lyle Berkowitz is a physician executive.
