Newswise — CLEVELAND – The COVID-19 pandemic has caused an extreme and immediate rise in the use of virtual healthcare. By April of 2020, telemedicine visits accounted for 13 percent of all medical claims, compared with 0.15 percent in April of 2019. This is an 86-fold increase. In “Ensuring Quality in the Era of Virtual Care,” published this month in the Journal of the American Medical Association (JAMA), the authors discuss the growing popularity of virtual care in an environment that has had limited discussions about its quality and trade-offs.

For instance, while current virtual encounters, such as for prescription refills or mental health counseling are broadly accepted, clinical practices that accompany a conventional in-office visit, such as recording blood pressure, may not generalize to the virtual setting. It’s a system that can increase timeliness at the expense of effectiveness.

The viewpoint piece from Peter J. Pronovost, MD, PhD, Chief Quality & Clinical Transformation Officer at University Hospitals and Professor, Department of Anesthesiology and Critical Care Medicine, School of Medicine and School of Nursing, Case Western Reserve University, and Kurt R. Herzer, MD, PhD, MSc, Senior Advisor for the Center for Medicaid and Medicare Services and Adjunct Assistant Professor at Johns Hopkins Medicine, states that increased responsibility accompanies an increase in virtual care appointments.

The highest priorities of medicine are to avoid patient harm and deliver evidence-based care. In 2001, the Institute of Medicine described high-quality care as being safe, effective, efficient, timely, patient centered, and equitable. The viewpoint published in JAMA uses that framework to assess the current state and challenges of virtual care.

The piece suggests three principles to guide development going forward.

“We determined virtual care should achieve comparable safety and effectiveness to traditional care,” said Dr. Pronovost. “Secondly, it should accomplish a net increase in efficiency within the health care system. And third, virtual care should be respectful of patient preferences and values and not exacerbate health care disparities within a population.”

As a variety of wearables, remote medical devices and mobile apps enable more virtual care, physicians’ fundamental duty to patients remains unchanged. To ensure virtual healthcare is not only prevalent, but also successful, health systems, health plans, and health technology companies should ultimately demonstrate that it represents an effective, efficient, and equitable contribution to the U.S. health care system.

You can read the full article “Ensuring Quality in the Era of Virtual Care” in JAMA by clicking here.


About University Hospitals / Cleveland, Ohio Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 19 hospitals (including 4 joint ventures), more than 50 health centers and outpatient facilities, and 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship academic medical center, University Hospitals Cleveland Medical Center, located in Cleveland’s University Circle, is affiliated with Case Western Reserve University School of Medicine. The main campus also includes University Hospitals Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; University Hospitals MacDonald Women's Hospital, Ohio's only hospital for women; University Hospitals Harrington Heart & Vascular Institute, a high-volume national referral center for complex cardiovascular procedures; and University Hospitals Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, including cancer, pediatrics, women's health, orthopedics, radiology, neuroscience, cardiology and cardiovascular surgery, digestive health, transplantation and urology. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to Harrington Discovery Institute, part of The Harrington Project for Discovery & Development. UH is one of the largest employers in Northeast Ohio with 28,000 physicians and employees. Advancing the Science of Health and the Art of Compassion is UH’s vision for benefitting its patients into the future, and the organization’s unwavering mission is To Heal. To Teach. To Discover. Follow UH on LinkedIn, Facebook @UniversityHospitals and Twitter @UHhospitals. For more information, visit


Journal Link: Journal of the American Medical Association