COVID-19 Exposes Gaps in Primary Care Systems

The US healthcare system is one of the highest-cost environments in the world. But the high cost does not translate to better outcomes or healthcare quality. In 2019 the US ranked in 30th place out of 89 countries measured by factors that contribute to overall health[1]. US healthcare spending was $3.6 trillion or $11,172 per person in 2018[2]. Healthcare represented 17.7% of the US GDP in 2018.

The US healthcare system has created one of the greatest inequities in the world for its citizens to access and afford healthcare. This issue was magnified by COVID-19 as the ability to deliver effective care and pandemic surveillance monitoring drove healthcare organizations to quickly adapt telehealth and other digital technologies to deliver primary care and remotely monitor patients. In many cases, the immature or first-version telehealth solutions were lacking needed functionality, especially remote patient monitoring, but healthcare organizations implemented solutions that met their needs. Primary care physicians needed to create revenue streams to support their clinics. It has been said that necessity is the mother of invention, and physicians quickly learned to use telehealth and other digital technologies to survive. Telehealth adoption was not a high-growth technology market before the virus but has emerged as a high-growth healthcare technology segment since March of 2020. Telehealth growth in 2020 is expected to rise 65%[3]. Much of this growth is also related to CMS adopting higher levels of reimbursement for telehealth.

Telehealth, Remote Patient Monitoring, and Digital Patient Engagement Are Transformers

Once patients experienced telehealth services, they quickly realized how easily they could receive care in the convenience of their homes. They no longer had to drive to a clinic (perhaps several miles away in bad traffic) or be exposed to other sick patients in the clinic waiting rooms. The emergence of remote monitoring devices also improved the ability of clinicians to monitor the health status of high-risk patients. Remote patient monitoring provided by smart watches and solutions from companies such as Rimidi[4] are evolving to close the gap in telehealth services for matching the efficacy of clinic visits. Patient engagement services supported by application devices for scheduling primary care, accessing care guidance instructions, reviewing a personal health record, conducting medication refills, and directly communicating with care providers via email or text messaging are functional examples that need to be integrated into all patient portals.

Retail healthcare services are also quickly emerging that will support lower-level primary care services with increased convenience for access and much lower service costs. Walmart, Walgreens, and CVS are quickly driving more convenient and affordable healthcare services for consumers. These companies will be using digital technologies to deliver their new primary care services.

Another company to watch is Ro[5]. Ro just received $200 million is additional funding to continue to grow their remote and homecare services. Digital service capabilities will now be the focus of healthcare providers to meet consumer demand. The number of healthcare organization clinics will decline.

Patient-Focused Healthcare Rules

Digital technologies supporting primary care have established a new model for delivering services that truly meets the needs of most patients. These technologies are driving new methods for delivering and supporting patient care. They are also driving new primary care delivery services from emerging vendors and from retail healthcare giants. Patient-focused healthcare is no longer just a platitude espoused by healthcare organizations; it is now the platform that will ensure long term viability for the provider organizations who can successfully implement these emerging primary care models. Digital technologies that extend telehealth, remote patient monitoring, and patient engagement services will be a required component of healthcare organization strategies moving forward. Perhaps unnecessary clinics can be sold to help fund digital technology implementations.

Emerging Companies and Retail Health

The vendors that use digital technology platforms to provide primary care services are represented by the following companies:

Healthcare organizations that cannot provide competitive digital services with the above companies are likely to lose most of their primary care service markets.

Success Factors

  1. Evaluate telehealth solutions relative to intuitive design for both physicians and patients for easy access and operations.
  2. Investigate the ability of the telehealth solution to integrate remote patient monitoring devices into the environment to better support the telehealth encounter.
  3. Expand patient engagement services to enhance the ability to schedule and prepare for telehealth services with required treatment guidelines and instructions.


COVID-19 has been both a disaster and blessing to US healthcare. The blessing emerged in the form of primary care physicians adopting telehealth and other digital health services to provide basic and preventive care services to patients who were restricted in their ability to travel outside their homes. Patients receiving remote care services are unlikely to revert to the old care paradigm of traveling to a clinic to receive most primary care. The continuing advancement of technologies such as smart watches, speech recognition (e.g., the ability to recognize people who may have COVID-19 from their voice patterns), and mobile applications that can be used to help consumers identify potential health issues and provide corresponding treatment guidance and physician connections will add an addition layer of capabilities to digital health capabilities. Healthcare organizations need to continue to focus on extending their digital healthcare services to remain competitive in the primary care markets. Time to put on your sunglasses; the patient-focused future looks bright.






     Photo Credit: Adobe Stock, Andrey Popov