Premise in Action: Adapting to Virtual Care During a Pandemic

Updated February 8, 2021

It’s impossible to be prepared for every scenario your organization may encounter, but it is possible to build nimble platforms, systems, and processes that can quickly adapt in any situation or environment. By having flexible cultures and decision-making frameworks in place that can quickly shift, you’re in a better position to minimize disruption. For the healthcare industry, this has never been more necessary as our country battles the coronavirus pandemic.

Recognizing the importance of ensuring access to primary care in the face of a public health crisis, Premise Health pivoted its onsite and nearsite access models to a virtual-first environment. This shift has allowed Premise to continue delivering quality care while helping alleviate the burden faced by resource-constrained community systems and hospitals treating more severe cases.

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During a pandemic, virtual health plays a vital role in allowing individuals to access care when and where it’s needed, especially when their employer’s onsite health center may be shut down. For Premise, virtual health takes shape in two forms that are complimentary and can work together interchangeably:

  1. National virtual health enables members to seek care where they are, when they need it, 24/7. Providers are licensed in all 50 states (and D.C.), which gives members access to on-demand care – no business hour or geographic restrictions.
  2. Local virtual health extends the reach of an onsite or nearsite health center provider team and is a direct replacement of an in-person encounter. Members can see a local provider from the health center during normal business hours via either a video or telephonic visit.

Today, we offer nearly 20 products virtually. Read on for a few examples of virtual care at work for our clients during COVID-19.

Pharmacy

Our pharmacy model continues to go beyond the pill, placing emphasis on building relationships to support the overall health of a member.

Premise pharmacists meet members where they are to provide accessible, personalized care, even in a virtual environment. When members can’t visit their onsite or nearsite pharmacy in-person, our pharmacists make it a priority to continue personal outreach. From calling to ask how a member is doing to sending out personalized postcards, these relationships are an essential part of the member experience. For those with chronic conditions, our pharmacists ensure these members are equipped with enough medication to get them through an extended period of time. Whether that’s through curbside pick-up or mail-order, members can avoid risk of exposure at community pharmacies.

Virtual Pharmacy in Action

This commitment to each member proves critical in challenging times. In one provider outreach call, our pharmacist found a member unexpectedly quarantined in another city. The individual didn’t have enough medicine with them and had just gotten their medication filled a week prior. They were worried a refill wouldn’t be available. Given the uncertainty of the situation, our provider put in an override to let them get the medication filled in that city and informed them it was also available by mail.

Wellness Coaching

Being healthy is more than the absence of illness. The Premise wellness coaching program is the cornerstone of our commitment to helping members understand what it truly takes to be well. From a nutritious diet to managing stress, there are a multitude of avenues to improved health. Our program inspires members to make positive changes and then assists them each step of the way as they work to achieve their goals. Our wellness providers have pivoted their approach to deliver value in a virtual environment.

Virtual Wellness Coaching in Action

One of our providers consulted a member virtually to help them understand how their food choices may affect their high cholesterol. The wellness coach/registered dietitian took time to “go through” the member’s pantry over the phone and identified how certain ingredients could potentially impact the individual’s health. To deliver an above and beyond experience, the provider had the member share their favorite recipe and modified it for improved nutrition.

Occupational Health

With certification, training, and ongoing support, our occupational health team helps maintain and improve the health of organizations’ most important asset – their people. Our providers make sure members have what they need to stay comfortable, and a virtual-first environment is no exception. Our occupational health providers are arming members with proper stretching techniques they can do from the comfort of their homes, ensuring they have optimal workstations, and conducting virtual assessments.

A virtual visit provides members with the same quality of care they would receive from an in-person visit. To measure progress, we benchmark results and alter the care plan as needed to promote healthier lives. After each visit, members receive a link with a summary of their visit and home exercise routines, such stretching and strengthening exercises.

Virtual Occupational Health in Action

As many organizations had to shift to a remote workforce with little warning, employees were tasked with quickly setting up a home office. The challenge? Creating an office that is ergonomically friendly to prevent injury. Our cross-functional musculoskeletal team created a program to help members adjust their current seating positions to optimized angles, in addition to providing simple stretching routines that help relieve tension in muscles and joints. When needed, our musculoskeletal providers (physical and occupational therapists, chiropractors, and occupational health nurses) conduct virtual consults over the phone or through a video visit to evaluate potential issues, address concerns and keep members healthy while working from home.

Primary Care

Healthcare needs don’t stop during a pandemic, and it’s critical people have access to primary care during this time. Primary care is oftentimes the beginning of a member’s healthcare journey, as it plays a critical role in early detection for many illnesses. Our primary care providers are continuing to deliver high-quality, preventive care virtually. If a referral to a specialist is deemed necessary, our teams will coordinate it.

Virtual Primary Care in Action

The work of our national virtual health provider team proved essential for a mother and daughter who found themselves experiencing symptoms related to chronic kidney disease. The member scheduled an appointment with one of our national virtual health providers to discuss their symptoms and determine the appropriate care plan. Our provider reviewed their medical records and noticed chronic kidney disease was listed in the mother’s chart. Recognizing certain medications could have adverse effects for someone with kidney disease, they talked the mother through what she should and should not take, in addition to outlining certain dietary restrictions she should be aware of, all during her virtual visit. The provider encouraged the mother to speak with her primary care provider to discuss options for seeing a nephrologist. A few days later, our provider proactively reached out to check in on the woman and her daughter who expressed their appreciation for the attention to detail and excellent care.

Fitness

As fitness centers remain closed throughout the nation, our fitness team has been hard at work to continue helping members move more and sit less virtually. Through a variety of innovative approaches, we are still supporting all members with inclusive programs that support increasing physical activity. Our fitness team now offers a number of classes virtually to help individuals keep routines strong when access to fitness centers has been cut off.

To ensure participants can perform every activity safely, our fitness team provides photos and detailed instructions to demonstrate how to do each exercise correctly. Exercises have been tailored to at-home environments using practical equipment such as laundry baskets or ropes. In addition to our virtual group classes, we’re also offering virtual personal training for 1:1 opportunities.

Condition Management

For an individual with a chronic condition, it’s critical they have access to a provider – no matter the situation – to ensure their care plan remains uninterrupted. Our condition management programs are a combination of education and treatment strategies, which we can deliver virtually when needed.

To continue to provide care and support when members are unable to visit their onsite or nearsite health center, we created new programs to identify and proactively enroll eligible members into a hands-on monitoring program that includes frequent virtual visits with a condition management nurse and local provider. For example, providers reach out to individuals with uncontrolled hypertension to review their medication over the phone to ensure that is still the right dosage and there are no abnormal side-effects. If needed, necessary adjustments can be made, and a Bluetooth blood pressure monitor can be sent right to their door to support daily monitoring.

Today, Premise members have access to virtual visits for behavioral health, clinical pharmacy, condition management, nutrition, occupational therapy, physical therapy, and wellness coaching, among others. From February to the end of March 2020, we saw a 1,500 percent increase in local virtual health visits and a 150 percent increase in secure messages between members and providers.

As the COVID-19 outbreak evolves, our teams can play a critical role in providing continued access to high-quality healthcare. By providing care virtually, and in-person when needed, direct primary care reduces the burden on the healthcare system.

Contact Us

• If you are a Premise Health member with questions, call your health center.
• If you are a Premise Health client with questions, please contact your director of client operations.
• For media inquiries, please contact [email protected].

Premise Health is the leading direct healthcare provider offering onsite wellness centers, as well as nearsite and virtual access points. For the latest COVID-19 information from Premise Health, click here.

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