By Thomas Vincz, Public Relations Manager

You could call it the COVID-19 telemedicine paradox.

On one hand, with so many patients seeking virtual care due to social distancing guidelines, wait times for online appointments extended to an hour or more. On the other hand, many primary care practices were seeing large reductions in the number of in-person patient visits, leaving many doctors idle.

It was a bizarre situation suited for these extraordinary times: patients couldn’t see doctors while doctors didn’t have any patients to see.

But for members of Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), a heavy dose of collaboration and innovative technology solved both these problems – helping patients access care within minutes and doctors deliver care in a safe, efficient way.

Working together – and working smart

The quickest way to create a better, easier health care experience? Increase capacity within Horizon BCBSNJ’s primary telemedicine platform – Horizon CareOnline. Horizon BCBSNJ first turned its dedicated physician partners, like the Verona-based Vanguard Medical Group and Sanitas Medical Centers, which provide primary care services in Union City, Bellville and Elizabeth.

“We engaged our New Jersey network physicians, who agreed to be trained on the tools, software, workflows and to staff the hours of operation needed to make our solution work,” said David Gambino, Vice President, Transformation and Chief Pharmacy Officer at Horizon BCBSNJ. “Within a week, we were able to equip them with laptops and put all of the operational pieces in place to add capacity to Horizon’s telemedicine service.”

Horizon BCBSNJ also needed to expand the platform’s technical capabilities. Horizon BCBSNJ worked with Pager, a technology vendor that powers the Chat for Care function on the Horizon Blue App, to introduce a “triage” function that navigates patients to the right point of care based on their needs and symptoms.

With this telemedicine workaround, about two dozen physicians from Vanguard and several others from Sanitas have added about 130 more virtual appointments each day for the 2.4 million eligible Horizon BCBSNJ members covered through all Commercial, Medicare Advantage and most self-insured plans. Since the initial outreach, several other practices have answered the same call, including Avenel Iselin Medical Group, Princeton Medical Group and the family practice of Dr. Harold Cotler.

“The new solution allows Horizon members to come through Pager’s Chat for Care tool to connect with one of the New Jersey physicians who have stepped forward to help meet the growing demands for virtual visits,” said Douglas Blackwell, Executive Vice President and Chief Information Officer for Horizon BCBSNJ.

By accessing the Chat tool through the Horizon Blue app, members needing telehealth services are being connected almost immediately to an online physician, who are available for 16 hours each day, from 6:00 am to 10:00 pm.

Flattening the “wait time” curve

Since the expanded telemedicine platform started running at the beginning of April, patients seeking a virtual consult have been connecting more promptly with a doctor, completing their visits, on average, in five to ten minutes.

That’s a lot different than when the COVID-19 crisis broke out in March and member usage of telemedicine surged by 300 percent. Appointment wait times that averaged one hour or more at peaks back then are now averaging under 15 minutes, while completed virtual appointments have risen from 100 per day during peak demand in March to 170 per day today.

“The abrupt swing to virtual care in recent months exposed the reality that with all the convenience and technological value of telemedicine, its existing capacity wasn’t configured for a pandemic,” said Blackwell.

An experience approved by both members and doctors

Members have appreciated this revamped experience. In feedback following a virtual session, one New Jersey woman wrote, “The nurse and the doctor were empathetic, knowledgeable and friendly. The nurse really helped ease my anxiety during this tough time of COVID-19. They’re both rock stars!” Another commented on the convenience: “It’s just like going to visit a doctor but in the comfort of anywhere as long as you have your phone!”

Doctors too have seen the value of this expansion to their practices, giving the Pager service a satisfaction rating of 9.8 out of 10. For them, it’s more about improving patient health than simply increasing patient volumes.

“Unfortunately, many patients are self-reducing their care out of virus fears and social distancing. This trend is concerning since many of these patients have chronic conditions that require regular medical checks and treatments to keep them well,” explained Dr. Thomas McCarrick, a family physician with Verona-based Vanguard Medical Group.

Virtual visits fill this care deficit with a safe, effective alternative – as long as care providers and health insurance companies work in harmony. “It’s more important than ever for an insurer like Horizon to work together with its network physicians so we can all adapt to the changing health delivery landscape,” Dr. McCarrick added. “With this collaboration and support from Horizon, practices are better able to treat patients in this challenging time, keep them well and make sure New Jersey’s health care safety net stays strong.”