Q&A: How a Brooklyn Clinic Developed Its Virtual Care Strategy

June 10, 2021 - As the nation eases itself out of the pandemic, healthcare providers are adjusting to a new reality that mixes in-person care with telehealth. Many are approaching these hybrid healthcare models with a bit of trepidation, struggling to determine what works on a virtual care platform and what needs to be done in the office.

Brooklyn-based Oula announced an expansion of its virtual care platform in May. The prenatal clinic, which offers midwife services and obstetric care, had planned on offering telehealth all along, since it opened its doors in late 2019, but COVID-19 magnified the need to create a hybrid strategy.

“We’re rethinking our role as care providers to extend beyond the visits themselves, leveraging technology to make the team accessible, information easy to understand, and to ensure our patients feel supported and respected at all times,” Joanne Schneider, the clinic’s chief experience officer, said in a press release. “The traditional patient portal provides bare bones access to health records but falls short of really arming patients with what they need to feel connected to their care.”

Oula’s journey is representative of a lot of small, forward-thinking clinics and practices looking to find their niche in this new value-based care environment. mHealthIntelligence recently sat down (virtually) with clinic co-founder and CEO Adrianne Nickerson for a Q&A about that process.

Q. How much of Oula's business was in-person and how much was virtual before the pandemic?

READ MORE: Canadian Study Highlights Value of Telehealth Access for Postpartum Care

Adrianne: We didn’t start seeing patients until December 2020 (the company launched in December 2019), so we were still in the process of jump-starting our business when the pandemic hit a few months later. Patients were using our virtual platform from the beginning, so when the pandemic started affecting our in-person consultations, we realized how essential it was to have both forms of business complement each other and to incorporate the option for telehealth and virtual appointments. We continued to form our virtual care strategy around what was needed most from patients during a critical time in their lives, and therefore added more features to strengthen connections between patients and our clinical care teams. 

Q. How did the pandemic change your telehealth/digital health strategy?

Adrianne: Prenatal care hasn’t changed much in nearly 100 years, so when we began incubating Oula pre-pandemic, virtual care was a critical component of our intended care model. For us, it was essential to transform a care experience that can typically be inconvenient and time-intensive into one that provides women with access to care when and where they need it. The pandemic further reinforced the need to give women options, as it became more apparent that the right balance of telehealth and in-person care wasn’t the same for everyone. As a result, we focused on flexibility and choice in our virtual care strategy.

Q. What are the benefits to your patients of a virtual care platform? How does this benefit your clinical care team?

Adrianne: Traditionally, prenatal care is focused on what happens during discreet clinical appointments – but pregnancy itself doesn’t fit neatly into those pre-scheduled slots. The main benefit of our virtual care platform is in stitching together the experience between visits and keeping women connected to their care team at all times. For example, our ‘Message a Midwife’ feature allows patients to directly reach midwives with questions, so they don’t need to wait until their next appointment to get answers.

READ MORE: HHS Unveils Telehealth Grants to Address Rural Maternal, Obstetrics Care

In addition, our upcoming remote ‘check-in’ feature will prompt patients to reflect on their experiences at different stages of pregnancy, including their mental health and feelings of respect and autonomy. This is especially important during the fourth trimester and postpartum, so our care team uses these remote ‘check-ins’ to continue supporting mothers after the baby has arrived – particularly throughout those critical first weeks.

Finally, our virtual care platform is also beneficial to patients who are looking for more education and guidance during the care planning process. We really honed in on the educational features within our portal to support confident, informed decision-making.

Q. What challenges or barriers did you face in developing this platform?

Adrianne: There are hundreds of websites and apps, all packed with information meant to help women during pregnancy. We were really conscious of not wanting to add to that noise. As a result, our biggest challenge in creating our care plan feature was in making sure that it helped distill the disparate information out there and present it in a new way that was actually helpful to women during the decision-making process. 

Q. How do you balance virtual and in-person care? How important is it to you to have a hybrid platform that allows for both in-person and virtual care?

READ MORE: A Small Medical Group Uses Telehealth to Redesign Care Management

Adrianne: A core aspect of our hybrid model is to support stronger, more collaborative communication with patients. By combining in-person appointments with telehealth and virtual care coordination, we believe we’re able to provide access to care when and how people need it. Therefore we find it very important, if not essential, to incorporate both digital and in-person care to best serve patient needs.

In terms of balancing virtual and in-person care, we work directly with patients to determine their care preferences (digital vs. in-person), then personalize plans to accommodate them. Although certain appointments are necessary to have in-person, we believe ‘striking the right balance’ between digital vs. in-person care differs from patient to patient. Therefore, we aim to personalize care and meet unique patient needs by providing both options. 

Q. Is virtual care sustainable for you? Do payers recognize the value of these services in a virtual format?

Adrianne: Virtual care is definitely sustainable, and building it into our care model from the beginning is one of the biggest reasons why it works for us. In our conversations with payers, virtual care has been an important differentiating point as they recognize the appetite from consumers for accessing care in multiple modalities. 

Q. How will your telehealth/digital health strategy evolve? What's on the horizon in terms of using new technologies, launching new programs or reaching out to new patients/populations?

Adrianne: We are constantly communicating with our patients about how we can better support them, and technology is always one of the tools we consider to improve overall patient experience. In the near-term, we will be focusing on digital tools that enable our providers to spend more time with patients, as supporting human connection throughout the pregnancy journey is what matters most to us.