Karen Loftus (Host): This is Community Connect: presented by Tampa General Hospital. I'm Karen Loftus. Joining me is Jordan Clark, the Director of Ambulatory Business Operations and Integration at Tampa General Hospital. A big part of Jordan's work is around expanding access to care and developing and executing innovative models of healthcare delivery, which includes virtual healthcare, which we're talking about today. Welcome to the podcast, Jordan.

Jordan Clark: Thank you so much, Karen, for having me here. I'm so excited to actually be a part of a podcast and with this topic too.

Host: We are glad to have you here. So, technology and healthcare are inseparable. As technology advances, it's crucial to stay ahead of the curve in using the latest advances to improve access to care for everyone and improve patient outcomes. That's where virtual healthcare enters the chat. For starters, what does virtual healthcare encompass, and is that term interchangeable with telehealth and telemedicine?

Jordan Clark: Got it. So, think of them as related but slightly different. Telemedicine traditionally refers to the actual clinical encounter, a physician or clinician evaluating and then treating a patient simply remotely, right?

Telehealth is broader than that. So, it can include telemedicine, but also remote patient monitoring, patient education, secure messaging, and care coordination, other services that really are delivered but with enabled care technology. When I use virtual care, as an even broader operating concept, this is really what it is. So, how can I use technology to deliver healthcare differently? Now, sometimes that's a physician speaking with a patient at home. Sometimes it's a neurologist delivering healthcare remotely into an inpatient setting halfway across the state. Sometimes a patient entering into a community hub where we have a virtual health center and connected to a specialist who physically isn't located there in that community but is somewhere else at one of our facilities delivering that care to the patient.

So, I would encourage you not really to think about that as virtual care as simply like FaceTime with your doctor. It's really a lot more than that. It's becoming an additional front door into the healthcare ecosystem, connecting that provider to a patient, and then being able to do what technology simply allows us to do more efficiently, more seamlessly, and more conveniently for the patient.

Host: Now, I know I became familiar with virtual healthcare during the COVID-19 pandemic, and so did a lot of others. How did that moment accelerate virtual care, and where's the continued growth from here?

Jordan Clark: COVID literally compressed probably a decade of healthcare transformation into a matter of months. COVID forced people to realize that, "Hey, like, there's other ways of delivering medicine and we really have to get creative in really figuring how do we battle communicable disease during this point." Literally, during COVID, more than 28 million Medicare beneficiaries, that is like literally two in five, used telehealth during the first year of the pandemic. That is roughly 88 times more telehealth services than during the previous year.

So, simply based off of natural need and natural demand for utilizing care services remotely, when we look at even pre-COVID metrics, right, 71.4% of physicians actually reported using telehealth in their practices weekly. And that's compared to only 25% when we look at 2018 Medicare data.

So, you can see that the use of virtual care, and I'm using virtual care specifically because it's all of it, right? RPM, you know, doing those visits, those encounters using the technology and tools, it became not just a temporary COVID solution. It became a part of the normal healthcare infrastructure. Whether in-person or virtual, it allowed people to determine really what is going to be the best, what is going to be the most convenient and the most effective in delivering the care in the best way possible.

Host: Yeah. Just exponentially accelerated out of necessity, and it's clearly stuck.

Jordan Clark: Yep. So, when you ask about the next five to 10 years, the future of healthcare, I wouldn't think about it as just virtual versus in-person. It's really hybrid. I think health systems will increasingly determine—and really, this is the right way to do it—which part of the patient's journey actually requires a building and which part does not. A patient might start at home digitally. They might receive an initial assessment virtually, have diagnostics performed close to home, they can see a specialist virtually and then have a remote monitoring visit or devices dispatched to their home afterwards for, like, ongoing care.

So, you see there's kind of a hybrid way that this would work, and we see it in several other industries that have really digitized their front doors, digitized the way they deliver their products and their services, like the banking industry, for example. Twenty years ago, banking was an in-person thing. You went in with your cash, you handed it, you went in to get your cash, and you were handed it. But now, if a bank or a financial institution, even in investing, don't have a digital platform or a means to actually conduct business digitally, you'd think that they're not up to par. They're not able to compete in this market.

Host: I think it's important that you called out the different facets of it to explain how it is more than just a FaceTime with your doctor.

Jordan Clark: Yeah. I know.

Host: I feel like that resonated with me.

Jordan Clark: Absolutely. Absolutely. COVID taught healthcare how to conduct a virtual visit. The next decade is about building a virtual health system. Literally just last year, I'll just add this, we had a provider actually, I think out of Georgia in July of 2025, actually do a robotic surgery, like telesurgery remotely in France from Georgia.

Host: Wow.

Jordan Clark: Literally 4,000 miles away. So, that's just showing you, like, that's the next evolution of where virtual healthcare delivery can go.

Host: Wow. Okay. So, who is a good candidate for virtual healthcare, and are there situations where an in-person visit is maybe still the better option?

Jordan Clark: That's a question that we get all the time. And I think it just depends on the kind of care that needs to be delivered. I think virtual care works extremely well when the primary clinical need is conversation, observation, assessment, and decision-making. That's the cleanest, clearest way that you can see that having that audio-visual interaction, that encounter with the provider is advantageous because now you don't have to pick up and go somewhere. Now, you can address your symptoms more proactively than reactively, right? You can address things just in a really much more efficient way, and by the way, from anywhere.

So, I think the thing is really creating a health system, where the teams and the personnel that use these tools are informed on the ways and the delivery modes that are most appropriate given the patient and their needs. So, virtual care isn't appropriate for everything.

And I just want to, like, say that very blanketly. If someone has symptoms suggesting emergency medical care, they need an emergency evaluation that's hand on. But it doesn't have to compete with the physical care. Virtual care doesn't. Good virtual care is really just when physical care is needed and can seamlessly be transitioned to virtual for the purposes of delivering that care.

And I would probably think about it more so in that way. And that's how integrated health systems like TGH actually have a strategic advantage because we have all the higher acuity downstream providers and services to really meet the needs of anything that could come up from a virtual encounter, and then transition that patient seamlessly into those downstream services.

Host: So, we've talked a lot about what virtual healthcare is for, but some people listening might not have experienced this firsthand. So, it might be helpful to shine some light on the unknown. Can you walk us through a virtual appointment from start to finish so people can know what to expect?

Jordan Clark: Gotcha. Now, there's a lot of different models and ways that this has been set up. Some healthcare systems use apps, some have it fully integrated into the regular application that their EHR has, like myChart, for example, in our case at TGH. But really, the experience just should be remarkably simple. It should feel that way. And that's what we've definitely strived to do here at TGH.

It should be you open the health systems app or digital front door, you select the type of care you need, and just basically provide some basic information about your symptoms and medical history. That's how you kick it off. Once you hit connect, you're casted into a waiting room, waiting on a provider to come into that same secure portal to have that audio-visual consult.

It's always going to be with a licensed physician. It's going to be one of our TGH physicians or a physician that's board-certified and credentialed as a TGH physician. The provider conducts essentially the same clinical process they would in an in-office visit, the history, the virtual assessment like I mentioned before, medication reviews, and then all the clinical decision-making that needs to happen after that. Depending on the condition, they might prescribe medication. They can still, since they're documenting in that EHR, place the same orders and all the downstream recommendations for follow-up care that they would normally do in an in-person visit.

So ideally, all of that information also during this encounter becomes part of your longitudinal medical record. So if you need access to additional services, access to additional care, the team has a full basis upon which to move forward with your care, within our system.

Host: Even after hearing that, I'm sure some people might be hesitant still. Can you address some of the common concerns that you've heard working in this space?

Jordan Clark: Yeah. There's tons of concerns from both sides that people—

Host: It's the unknown, right?

Jordan Clark: Yes. Like, it's exactly that. You know, like people ask something as basic as like, "Can the doctor really evaluate me without being in the room?" And the answer is absolutely yes. I like to ask people this actually. Think about the last time that you went to an in-person visit, and just think about at your primary care doctor, how many times did the provider actually touch you physically?

Host: Not that much.

Jordan Clark: When you really think about it, they don't really touch you that much at all.

Host: Aside from like vitals that you get when you walk in, or we're talking separate from that?

Jordan Clark: No, that is exactly it. The only time you're really touched is if you get vitals, or which by the way, you can now completely do remotely. And we'll talk about that here in a second. But a significant amount of medicine really just begins with listening to the patient, observing them, and understanding their history, and any provider will tell you that.

The clinician also, who is on these encounters, will know the limits of the virtual visit. So if they are seeing that this patient requires more a higher acuity care or a higher level of care that requires in-person touch, feel, testing, whatever it might be, the patient is now easily redirected to that appropriate site.

Now, the second concern that people talk about is technology. Like they assume they have to be really sophisticated and savvy with tech to be able to do a virtual visit. But really, it's the same things. Increasingly, we're seeing that, like, the workflows we're able to develop, the front doors that we're able to create, really, you use the same thing. The smartphone, the tablet, it's on apps. My grandma is using Facebook, right? And if you can use Facebook, you can do a virtual visit. That's my answer to that one.

Host: Okay.

Jordan Clark: The third piece is virtual care lesser healthcare? And I think that's where health systems really have to be intentional because that's kind of a misnomer, right? Virtual care should never be, and it isn't here at TGH, disconnected from quality standards, credentialed providers who are board-certified, and like I said before, the documentation existing and whether it's physically being documented like into the record officially or being fed into the record through an API or some kind of HL7 feed, the data must be back in that longitudinal health record for the patient.

Host: Those are three really good points to call out, and hopefully that resonates with some of our listeners and answers some of their hesitations. You've been in this space for some time. You've seen the growth firsthand. What impact have you seen virtual healthcare have on access to care and especially for people who may face barriers, maybe transportation, work schedules, mobility challenges?

Jordan Clark: I would say that this is probably the most impactful component, that virtual health can bring to the conversation really, like, healthcare traditionally assumes that patients come to us. But think about the assumptions built into that model You need transportation. You need time away from work if you're a working person, you're a working mom, you may need childcare, right? You may need the physical ability to travel. If you're disabled, you're in a wheelchair, if you, you know, have a broken leg, if you just were in a motor vehicle accident, right? And what if you're in a rural community where around you for the next 200, 300, 400 miles is nothing? You're in a healthcare desert. No access to providers, right? So, virtual care begins actually by removing that geographical barrier from the equation. It's just that simple. And that's particularly important in a state like Florida where we have major academic health systems coupled with rapidly growing populations and really being spread out now even more so. We look at places like Babcock Ranch. We look at places in Central Florida that are significantly rural areas and are actually quite underserved communities that are sitting in those healthcare deserts. This is how virtual healthcare can really have a big impact because it extends that world-class healthcare that you hear us talking about beyond the four walls of that big 1,010-bed hospital that we have down on Davis Island. It allows us to bring healthcare to patients that wouldn't ordinarily have it, and even if they did have access to that, would not have access to the kind of specialties, subspecialties, expertise, and just the gamut of what TGH and organizations like academic health systems like us can do for patients.

Host: It can be a game-changer for a lot of people.

Jordan Clark: Absolutely. Absolutely.

Host: All right, Jordan. Thank you so much for coming on our podcast and sharing this information with our listeners.

That has been Jordan Clark. For more information, please visit tgh.org/virtualhealth. If you enjoyed this episode, please be sure to like, subscribe, and follow Community Connect presented by TGH on your favorite podcast platform. I'm Karen Loftus, and this is Community Connect presented by TGH. Thanks for listening.

Disclaimer: The content and information provided in our podcasts is for informational and educational purposes only and is not a substitute for professional medical care. Consult a qualified medical professional for diagnosis and treatment of any medical condition.