Industry-Leading Antibiotic Stewardship in Virtual Care at The Transcarent Clinic

By Roxana Cham, MD, Medical Director of Clinical Quality and Safety, Transcarent

The promise of high-quality care and the best, personalized Member engagement are at the core of our health and care organization, and they converge with our emphasis on evidence-based virtual care delivery. This commitment to helping our Members achieve their best health feeds our culture as clinicians and our priority of antibiotic stewardship at Transcarent.

Our industry-leading antibiotic stewardship program was one of the first quality initiatives implemented at the Transcarent Clinic and set the stage for our culture of excellence and quality in virtual care. We believe that tracking and measuring prescription practices should be prioritized by any quality healthcare organization, especially when it comes to prescribing antibiotics via virtual care. It’s reported that antibiotic resistance affects 2.8 million people ¹ annually and the inappropriate prescribing of antibiotics is a major contributor to this issue. In fact, The Centers for Disease Control and Prevention estimates that about 30 percent of outpatient antibiotic prescriptions are unnecessarily prescribed.²

At the Transcarent Clinic we have achieved an antibiotic prescription rate of just 23 percent for respiratory infections³, as compared to the estimated national average of 36 percent⁴ . Despite the presumption that less antibiotic prescriptions correlate to unsatisfied patients, 96 percent of our Members rated the Transcarent Clinic with 5 stars for a 4.8/5 satisfaction rating⁵.

In many instances our Members do not end up getting the antibiotic prescription that they expected to receive when they initiated their visit. However, instead they walk away with the satisfaction of a better understanding of how to best care for their diagnosis and long-term health.

Some healthcare stakeholders have raised concerns regarding how virtual care delivery may contribute to the issue of overprescribing antibiotics, as certain studies indicate higher prescription rates via virtual care vs. in-person care. While this may be a valid concern regarding some virtual care organizations, it is not true of the Transcarent Clinic. We see our virtual care delivery model as an advantage as it allows us to put our proprietary technology to work to ensure the delivery of high-quality care and Member engagement.

Our systems were built to inherently support prescribing best practices. Not only do we follow the CDC protocol for “Antibiotic Stewardship in Outpatient Telemedicine,” but we have implemented our own prescribing policies and technology to ensure our clinicians are following evidence-based best practice standards and are effectively engaging Members on their journey, by:

• Setting appropriate Member expectations, including a Member-facing landing page for antibiotic stewardship and patient education on appropriate use of antibiotics during the intake process.

• Supporting clinicians with clinical decision tools to make a proper diagnosis and provide appropriate treatment options beyond antibiotics.

• Focusing on patient education and anticipatory guidance in every visit and encouraging frequent follow-up for reassessment.

• Prioritizing our robust quality assurance program that focuses on antibiotic stewardship, allowing us to make rapid and ongoing improvements to all of the above.

We combine smart technology and automated clinical support tools that align with diagnostic standards of evidence-based medicine to assist clinicians in appropriate triage, diagnosing bacterial versus viral infections, and guiding appropriate treatment decisions. Antibiotic stewardship education is woven into our process of engaging Members, beginning with intake and extending through clinician support for effective communication and care plans that reinforce ongoing stewardship and evidence-based treatment beyond antibiotics. It's easy for Members to follow-up with our clinicians which helps them feel confident in their care plan as they know they can instantly access a second visit, if needed.

Our system tracks, audits, and measures prescription rates based on direct data from visit transcripts, a more accurate and efficient way to compile data. We leverage our technology to source and analyze the actual visit data instead of relying on clinician notes. After all, we can’t improve what we don’t measure, and we are always working towards better with our industry-leading objective quality metrics.

As the One Place for Health and Care, we are setting new standards for quality-care delivery, Member engagement, and the integration of technology into the care journey to give Members care experiences that they trust and love to use. When we say, “high-quality care,” we mean it, and our antibiotic stewardship success is another example of our commitment.

¹ 2019 Antibiotic Resistance Threats Report | CDC

² Measuring Outpatient Antibiotic Prescribing (cdc.gov)

³ Transcarent Book of Business

⁴ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9879865/

⁵ Transcarent Book of Business