When I was asked to write about Stanford’s new online primary care program I had no idea I'd become a patient while doing research for the story.
At the time, I knew little about the program called ClickWell Care or how it differed from an urgent care or a teledoc. Then a serious allergy attack stopped me in my tracks. I needed to be seen by a primary care doctor quickly, and the fastest way to do so was to see a ClickWell Care physician.
As a writer, now patient, I learned that the ClickWell Care program enables patients to interact with their Stanford primary care physician and wellness coaches through free video and phone visits. Most appointments are virtual appointments, but patients also have the option to see their ClickWell primary care doctor in person when needed.
The program was designed for 18-40 year olds — an age group that’s known to visit ERs and urgent care clinics more frequently than primary care physicians. To encourage this age group to see primary care physicians more often, ClickWell Care was made to be convenient. The program offers extended hours and same-day appointments; users can make appointments, message their doctor and access their records via the Stanford MyHealth mobile app; and patients can work with a ClickWell Care wellness coach to address specific health concerns.
Recently, I spoke with ClickWell Care creators Sumbul Ahmad Desai, MD, and Lauren Cheung, MD, MBA, to learn more about the features of and inspiration behind the program.
What’s the history of ClickWell Care, and how did it get its start?
In 2014, Stanford launched its own accountable care organization to provide care for Stanford University, Stanford Health Care, and Stanford Children’s Health employees and their dependents. When we looked at the data from the program after its initial 6 months, we found that 20 percent of the members didn’t choose a primary care physician. These patients used health care less and were hospitalized less often than members that chose a primary care physician, but they visited the emergency department and urgent care centers more. When we looked at these data more closely, we found that most of these patients were in the 18-30 year old age range.
When we saw this, we realized a large group of our patients wasn’t getting proper care. To find out what they needed, we conducted focus groups. These groups helped us identify some barriers to getting care such as, the hours a clinic was open, the inconvenience of getting to an office, and the difficulty in getting an appointment. Based on their feedback, we realized that we needed to design a clinic that focused on delivering complete health in a way that was convenient and easy for our patients.
Is this program unique to Stanford, or do other programs like it exist?
There are other telemedicine programs offered throughout the country, both in health systems and in the direct-to-consumer space, however the ClickWell Care program is unique in its focus on longitudinal comprehensive care. We offer not only clinical care but clinical care combined with wellness coaching in a way that’s as convenient to the patient as possible. We’re also happy to do as much of a patient’s care virtually as we can but know there are times when our patients need to see us in-person. The combination of virtual visits, in-person visits and wellness coaching is really what sets us apart.
What’s the patient response to the program and is it what you expected?
Patients have been really excited about the program, and we’ve had great positive feedback. We’ve had patients tell us that this model of care makes traditional models of care feel outdated and others who have expressed that they feel more supported in this primary care environment than they ever did in the past with traditional clinics. We’ve also had great success with the wellness coaching program and it’s helped a lot of people achieve their health goals.
We’re not too surprised with the positive feedback we’ve gotten. When we designed the clinic, we asked patients what they wanted and built a clinic that met those needs. One of the things that did surprise us is the importance of the relationship between the physician and the patient. Most people think that young patients don’t care which doctor they see, but we’ve found that that isn’t true. We work on building strong relationships with our patients and it’s something they’ve really appreciated.
What is the biggest benefit of this program to patients?
That’s a tough question to answer as we think there are a lot of benefits in the program. We think the biggest benefit of being part of this program is having a primary care team that works together to create a personalized and individualized health plan that focuses on overall wellness and provides the resources for patients to achieve this.
Are you conducting any studies on the effectiveness of the program?
We are. We’re currently studying every aspect of the clinic including the quality of virtual visits compared to in-person visits, patient satisfaction, outcomes, utilization, and cost.
Previously: At Medicine X, designers offer their take on why patient-centered design is top priority, Why technology won’t destroy the doctor-patient relationship and Telemedicine takes root in the Midwest
Photo by Judit Klein