Q&A with Steve Giannini of Bright.md: Entering the Telehealth 2.0 Era

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AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the virtual visits space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

Bright.md’s asynchronous telehealth solution focuses specifically on low-acuity care, which drives down costs and increases provider capacity for higher-acuity patients. The Navigate solution captures symptoms and instantly guides patients to the appropriate level of care within the health system, with pathways that can be adjusted based on the time or chief complaint. The Interview offering utilizes a library of evidence-based clinical interviews to support diagnosis, with automated documentation and interoperable chart-ready SOAP notes. Providers can utilize the Treat solution to treat more than 140 low-acuity conditions in as little as two minutes, with instant diagnosis, prescriptions, and referrals.

Chief Executive Officer Steve Giannini’s career has spanned over two decades in business growth, operations, and development in the software, technology, and healthcare industries. As a member of CNET’s leadership team, he focused on strategic partnerships and business development, which eventually inspired him to co-found Alliance, a San Francisco-based business accelerator. Prior to joining Bright.md, Steve co-founded the Portland-based software company Opal.

Q: Can you tell us about your company and the challenges you are solving within the virtual visit space?

Many health systems are struggling with staff and provider shortages and financial constraints. These shortages and limited resources are leading to greater patient access problems (long wait times) and clinical staff burnout. Meanwhile, a large number of patients have low-acuity needs that often don’t require a face-to-face visit.

The typical Bright.md customer is looking for a solution to help “right-size” care delivery workflows, direct patients to the appropriate venue of care, improve the patient experience, and reduce the administrative burden on staff and providers. Bright.md’s asynchronous telehealth solution can help alleviate the access strain on clinics, provide convenient care that patients are looking for, and allow flexibility for providers to deliver care with greater efficiency and less administrative burden.

Our solution lets providers treat low-acuity conditions virtually, without a real-time interaction—all while driving patient satisfaction and quality outcomes. Consisting of evidence-based, self-service clinical interviews designed to treat more than 130 conditions, patients answer questions about their symptoms and medical history and upload photos when necessary. Clinical decision support serves the provider with a recommended diagnosis and treatment plan that they can simply confirm or modify based on their own clinical judgment. Bright.md automates the documentation process with a chart note in SOAP format that is fully integrated with the EHR encounter, resulting in only about two minutes of provider time per patient.

Q: How does your company differentiate from other virtual visit vendors?

A: Most virtual visit solutions don’t even come close to unlocking asynchronous care’s full potential as a tool for quality, cost-effective, and clinically efficient care. In contrast, Bright.md offers:

  • Expansive proprietary clinical content: We offer 30 unique patient interviews, with clinical decision support that aids providers in treating more than 130 diagnoses. Our interviews are developed and maintained by a team of board-certified physicians.
  • Bi-directional EHR integration(Epic, Cerner, athenahealth) means that asynchronous care isn’t just an add-on, but an integral part of care delivery workflows.
  • Automated documentation drastically reduces the administrative work required by clinicians. Bright.md includes SOAP-formatted chart notes, after-visit summaries, prescription orders, and billing.
  • Self-service configurability, ease of use, and our in-depth reporting and analytics make it easy for systems to develop an asynchronous care program that fits their unique needs.
Q: What are some of the biggest changes your company has seen around how health systems are approaching virtual visits, given the changes in the landscape over the past couple of years?

A: As a result of the pandemic, many health systems stood up video visits as quickly as possible to accommodate quarantine requirements. Video visits were great to solve immediate problems, but are not set up to solve today’s challenges around staffing shortages, workflow inefficiencies, and patient access.

Now that systems are able to look at their long-term hybrid care strategies and not just the immediate response to the pandemic, they are looking for integrated virtual capabilities that overhaul their processes for more efficient providers; less administrative work; and easier access for patients.

Q: What does an ideal client look like? How are health systems best organized for success in standing up virtual visit capabilities?

Our ideal client profile includes large health systems in the U.S. that employ at least 1,000 physicians, operate urgent care centers within their systems, and use Epic, Cerner, or athenahealth as their EHRs.

Our most successful customers have a centralized staffing model in which advanced practitioners provide care through multiple virtual care modalities, such as video, chat, asynchronous, and so on. This allows them to provide care quickly and efficiently. In addition to staffing, our clients who offer asynchronous visits at lower costs see the most volume and success. Systems who can negotiate with payers to offer a $0 service drive the highest volume, and those who charge patients $20 to 30 out-of-pocket per asynchronous visit–the cost of a typical co-pay–see high volumes as well.

Q: What measurable outcomes have you seen from your clients?

A: Clients who choose Bright.md as their asynchronous care solution see a number of benefits related to clinical efficiency and patient and provider satisfaction, including:

  • Two minutes of provider time to deliver care asynchronously, which leads to significant clinician cost savings, frees up additional capacity, and addresses staffing challenges.
  • 97 percent patient satisfaction rate. Our solution attracts new patients to help capture downstream revenue and drives patient retention and loyalty.
  • 90 percent provider satisfaction rate. Bright.md improves provider experience and retention, and reduces provider burnout.
  • 35 percent of patients who have used Bright.md avoided the ED or urgent care, which reduces unnecessary traffic in these venues, improves patient access, and lowers overall costs to deliver care. 
  • 13 percent of asynchronous visits are completed by net new patients to the system–our solution drives downstream revenue.
  • 89 percent of Bright.md patients did not seek follow-up care within 30 days for the same condition (compared to 76 percent of primary care office visits benchmark). This highlights the clinical quality of Bright.md’s asynchronous care and its ability to deliver treatment that replaces unnecessary in-person visits.
Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of virtual visits?

A: At Bright.md, we believe that asynchronous care can add value to every clinical interaction. With that said, our product strategy consists of three pillars that drive our innovation:

  • Delight patients with easy, accessible care through ongoing improvements to reduce friction and boost satisfaction, including user experience enhancements.
  • Empower providers with asynchronous tools they love by continuing to drive efficiency and usability for providers, embedding their experience in Epic through hyperdrive and In Basket notifications, delivering a new e-prescribing experience, building a custom formulary for more clinical autonomy, and more.
  • Put asynchronous care into more hands, by expanding usage of asynchronous care with new clinical content for chronic conditions, perioperative care and travel medicine, in addition to integrated workflows for acquiring new patients.
Q: How is your company partnering with clients as reimbursements and use cases shift?

A: While reimbursement policy for asynchronous telehealth continues to shift on a state-by-state basis, we partner with our customers to equip them with the right data, clinical quality metrics, and more to bring to negotiations with payers to make the case for equal reimbursements. In 2022, we also released new capabilities around how we onboard patients to unique billing paths, as many of our customers want to serve different populations with different costs. For example, many systems want to offer Bright.md visits at $0 for their at-risk contracts for maximum cost savings, while they may want to offer $25 cash pay for the general population.

As for evolving use cases, we are gaining more interest in the role of asynchronous visits for chronic care management, including hypertension and post-operative care. Each quarter, we meet with our clinical advisory board, which is composed of clinical leadership at our client sites, to discuss new and evolving use cases of our product.

Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to virtual visits?

A: We’ve entered into a promising “Telehealth 2.0” era. The healthcare industry is shifting away from thinking about digital health tools and telehealth that merely replicate the in-person experience, and looking instead to the tools and solutions that transform care delivery.

As health systems continue to hone their strategy this year, video visits and traditional virtual visits that don’t solve capacity challenges or integrate into existing workflows need to change. More health systems should continue to explore asynchronous, remote patient monitoring, digital tools for chronic disease management, and other opportunities for virtual visits. This movement will help us maintain critical momentum as we continue to move toward a care delivery system that can not only get us out of our current crisis, but set us up for longer-term strategic growth.

Q: How do you see virtual visits evolving in 2023 and beyond?

A: Five years from now, we’ll see virtual visits as not only another modality of care, but a truly integral part of a hybrid care model that is better for patients, providers, and healthcare’s bottom line. We’ve only begun to tap into the potential for asynchronous telehealth to address challenges like capacity constraints, patient access and health equity issues, and workforce shortages.

As asynchronous care expands to become more widely available, understood, and used in the coming years, we’ll see it leveraged to make every single clinical interaction more productive and enjoyable for patients and providers. We’ll see things like automated pre-visit intake so that providers can spend time building relationships with their patients, asynchronous annual wellness visits, remote asynchronous perioperative care, and so much more.

At Bright.md, we’re excited to continue working with health systems and other digital health companies to power a healthier future with asynchronous care, and to make high-quality care more accessible, affordable, and convenient for everyone.

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