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Small Healthcare Businesses Struggling to Leverage Remote and Virtual Care During COVID-19


Small healthcare businesses must manage remote and virtual care models with appropriate support, training, reimbursement, and incentive models.

Madhavan Parthasarathy, M.D., Ph.D.

Madhavan Parthasarathy, M.D., Ph.D.

The use of remote and virtual care (RVC) models has increased since the COVID-19 pandemic struck. But how has using such technology impacted small healthcare businesses?

Findings of a recent study suggest small physician practices cannot harness RVC developments and consider it incompatible with business survival during and after COVID-19.

“If small healthcare firms cannot compete with RVC (or synergistically integrate RVC platforms into their current business practices) and eventually become nonoperational, the resulting damage to traditional healthcare services may be severe, particularly for critical care delivery and other important services that RVC cannot effectively replace,” Madhavan Parthasarathy, M.D., Ph.D., and a team of investigators wrote.

Parthasarathy and the team aimed to assess the perceptions of small healthcare businesses regarding the impact of RVC on their sustainability during COVID-19, as well as gauge their perceptions of their current levels of adoption of and satisfaction with RVC models and analyze how well that aligned with their perceptions of the current business scenario. Further they wanted to determine whether such perceptions influenced the view of their midterm sustainability.

The team conducted a focus group study with eight healthcare experts through Zoom — four entrepreneurs familiar with the healthcare environment in Colorado, two physicians, and two executive health faculty members. The Zoom call centered around the impact of RVC on the sustainability of small physician offices, clinics, and pharmacies during COVID-19. While those on the supported the notion that RVC adoption was posing a challenge to small healthcare businesses, they also believed clinics would likely not only benefit from but also be able to rapidly integrate RVC into their business practices more than physicians and pharmacies. The experts felt small local pharmacies would be negatively impacted during the pandemic because consumers can visit online pharmacies and avoid waiting at a physical location.

Following the focus group, a consulting firm sampled 445 small healthcare businesses in Colorado — 135 clinics, 141 physician offices, and 169 pharmacies — to validate the expert presumptions. Only 282 businesses responded to the survey and 270 were included in the final analysis.

The survey consisted of 11 questions about the current sustainability of the business in the subsequent one to three years. Respondents also answered whether they were satisfied with the current state of the business and current remote care practices.

Satisfaction with RVC and the current business scenario had direct, significant, and positive effects on respondents’ view of their midterm sustainability. The interaction term of satisfaction with RVC and current business scenario was significant and positive for clinics (P=.02), significant and negative for physician offices (P=.05), and not significant for pharmacies (P=.76). Such variations indicated that although clinics positively perceived use of RVC with their current business scenario, the opposite was true for small physician offices.

“While it is clear that the future of healthcare depends on these transformative models, the complexity lies in managing these models with appropriate support, training, reimbursement, and incentive models for small businesses, while meeting the expectations and demands of patient-centric healthcare delivery,” Parthasarathy and the team concluded.

The study, “Impact of Remote and Virtual Care Models on the Sustainability of Small Health Care Businesses: Perceptual Analysis of Small Clinics, Physician Offices, and Pharmacies in Colorado,” was published in the Journal of Medical Internet Research.

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