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Back to School – Virtual Care Education for Students, Residents and Practitioners

August 22, 2018

Back to School – Virtual Care Education for Students, Residents and Practitioners

As a new school year approaches, students will be gearing up to begin (or continue) studying medicine. This is an exciting time for them. No matter how great their institution, and no matter how dedicated their studies, there is still one thing missing from their schooling: virtual care education.

Dr. Ide’s Experience

As a mentor through the Yale School of Medicine alumni program, I recently showed the Zipnosis platform to my mentee. She was impressed by the technology and underlying clinical integrity (a big pat on the back is due to our engineering and clinical teams). What I primarily took away from the conversation was that she had not been exposed to any form of telemedicine or virtual care as part of her studies. As technology becomes a more integral part of care delivery, I believe it’s a disservice to medical students not to expose them to these care delivery channels.

It’s not just students that are feeling the lack of training in telemedicine and virtual care. Active healthcare practitioners also need access to training on how to be effective in delivering care online. A study by the AAFP’s Graham Center found that education was one of the top two barriers to physicians using virtual care technology in their practice.

Virtual care – whether video, chat, store-and-forward or some other modality we haven’t even dreamed of yet – is an increasingly important element in care delivery. And, this trend is only going to continue. That means this gap in education and training needs to be closed.

Closing the Virtual Care Education Gap

Back in 2016, the AMA announced their backing for undergraduate and graduate students to be trained on how to use telemedicine. More recently, our chief medical information officer Kevin Smith was involved in developing a telemedicine accreditation program through the Clear Health Quality Institute.

Both these things are steps in the right direction, but we believe it needs to go further. What we need is a comprehensive, standardized curriculum around online care delivery. Dr. Kevin Fickenscher of CREO Strategic Solutions agrees, stating, “There is a need to define the core curriculum for training clinicians at all levels in the appropriate use of tele-technologies to support effective care delivery. Simply placing clinicians into telehealth environments without sufficient training is akin to having radiologists use MRI scanners or surgeons using robotics without requiring training. And, the training is not just about the technology. It’s also about the way we communicate, how patients respond, the use of informatics, the use of social media and a whole array of considerations which are important for educating the health care virtualist.”

While it’s crucial the standard of care remains the same regardless of care delivery channel, setting clear standards around virtual care is vital to ensuring it is safe and effective. These standards will also increase providers’ comfort with delivering care online and give patients a more consistent experience.

What About Medical Virtualists?

One idea around how to train healthcare providers on using virtual care technologies is the concept of a “medical virtualist” specialty. This idea sprang from an opinion piece in JAMA last November. Shortly after it came out, we published a rebuttal. The long and short of our stance on the idea is that every provider will need to be able to deliver care via virtual care / telemedicine technology in the future.

Likewise, Dr. Fickenscher rebutted the original opinion piece, calling for a virtualist training of all clinicians working in telecare environments in a post on the Health Affairs blog. He noted that while a virtualist specialty will likely be worthwhile in the longer term, “basic virtualist knowledge will become a requirement for all practitioners.”

In our opinion, focusing on a new specialty at this point could leave a large portion of providers without the tools or knowledge they need. Right now, we need to find ways to effectively train everyone—from pre-med students to practicing providers—on virtual care delivery, rather than building out the infrastructure needed for an entirely new specialty.

What’s Next for Virtual Care Education?

No one can fully see the future, but the demand for virtual care education is increasing. That means schools – both undergrad and graduate, health systems, virtual care companies and other stakeholders need to collaborate on developing channels and standards for virtual care education.

Leading the Charge in Virtual Care Education

One of the first distributed or virtual universities in the nation is Fielding Graduate University, established in 1973 as a not-for-profit university focused on graduate education. Fielding has taken up the challenge of developing a “Health Care Virtualist Certificate” program focused on training health care professionals who will be working in virtual environments. The unique character of the program is that Fielding is bringing together the leadership and expertise of a number of schools by forming an educational collaborative of like-minded universities. These schools intend to work together to form a unified curriculum and training program in virtual health. Each school’s unique expertise will create a composite program to provide a premier educational experience for clinicians. To date, the University of North Dakota, noted for its expertise in rural health, and the Regenstrief Institute, an internationally known informatics program, are participating with Fielding in the collaborative. It is anticipated that a certificate program will be available for enrollment in early 2019, with the intent to offer a Masters level program in the near future and a doctorate program over the longer term.

We’re very excited about what the future holds for virtual care, and how we can help encourage and support educating both this and the next generation of healthcare providers on the uses and benefits of virtual care. We’ve shared some of our thoughts on why virtual care education is important. Next time around, we’ll offer up more specifics on the things we think are important for all providers to learn about providing care online.


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