The Strategic Case for Rebuilding Population Health Through Digital Access

Healthcare leaders continue to treat virtual care as a product line, a convenience feature, or a downstream add-on to traditional services. This framing is not only operationally short-sighted, it is structurally unsustainable. In the absence of deeper integration and infrastructure-level design, virtual care will remain fractured, under-leveraged, and unequipped to support the demands of a population health-driven future.

The pandemic temporarily upended barriers to telehealth use, but most of the health system response defaulted to lifting existing care models into video formats. That is not transformation. As the federal flexibilities extended under the Consolidated Appropriations Act of 2023 begin to narrow, and as payment models shift further toward accountability, the space for strategic redesign is narrowing.

What health systems need now is a virtual-first architecture designed for continuity, scale, and equity. This is not just a matter of adding technology. It is a question of redefining infrastructure. According to the most recent Kaufman Hall report on health system digital transformation, only 14 percent of provider executives say their organizations are “fully prepared” to scale digital care delivery across their enterprise. The majority remain trapped in hybrid operating models that fracture care coordination and deepen workforce strain.

The design failure is predictable. Most health systems are still aligning digital services to preexisting workflows rather than starting with patient-centered care journeys. As the National Academy of Medicine has emphasized, digital health equity is now a prerequisite for health equity. Treating virtual care as secondary or discretionary undercuts the promise of longitudinal engagement, particularly for rural, underinsured, and high-need populations who face structural access barriers. These populations do not need another app. They need a care platform that starts where they are and moves with them.

Regulatory gaps remain a major friction point. The current state-level patchwork of licensure requirements continues to block continuity across state lines, particularly for specialists and behavioral health services. Medicare’s telehealth waivers, which extend through the end of 2024, offer temporary relief but not long-term clarity. Without congressional action to address cross-state licensure, payment parity tied to quality, and broadband access as a core public health investment, virtual care models will remain constrained by policy, not potential.

But regulatory uncertainty is not an excuse for strategic delay. Digital transformation must be treated as infrastructure, not innovation theater. The McKinsey Health Institute points to care navigation, longitudinal engagement, and system integration as the core pillars of effective virtual health models. These are not speculative bets. They are proven operational levers that reduce avoidable utilization, increase patient activation, and rebalance in-person capacity.

To get there, governance matters. Virtual care must be defined not by pilot programs but by a durable strategy that aligns technology deployment with clinical and financial goals. That means rethinking capital investment, performance metrics, and accountability structures. Most importantly, it means starting not with software, but with the patient’s lived context. When virtual-first care models are designed from that vantage point, they become not just access points, but infrastructure for engagement.

In the upcoming interview, Michael Dalton, CEO of Ovatient, outlines a virtual-first care philosophy rooted in exactly that premise. Dalton has built his company through health system partnerships, not around them. His perspective is shaped by years of public policy work, value-based contracting, and direct operational leadership. He brings clarity to what has become a confusing landscape, where digital health tools proliferate, but care continuity falters.

Dalton argues for a governance-led, equity-driven approach that treats virtual care as a core feature of the population health stack. Not an app, not a service line, but a fully integrated platform. For health systems confronting labor shortages, margin compression, and care fragmentation, this shift is not optional. It is a strategic imperative.

The next phase of virtual care is about infrastructure. It is about building systems that meet patients where they are, move with them, and hold together across encounters and environments. The leaders who understand that distinction will define the next era of healthcare delivery. Those who do not will be left with systems that do less, cost more, and serve fewer.