Michael Dalton on Rebuilding Population Health Through Digital Access

To move from transactional interactions to transformational population health infrastructure, virtual care must evolve beyond episodic visits into something more relational, integrated and connected to the services in a patient’s community. I like to say that it must be virtual-first, not virtual only. This is a crucial distinction. This means first redesigning care pathways to where the patient is located and how they can get excellent care at that place, not just at that moment, but over time. We have to start with our patients’ lived context, and not our historical clinical workflows. That means intentionally designing common care journeys that prioritize longitudinal engagement, particularly for patients with complex conditions or where access to care is a challenge for them. Then align your technology with the care pathways, not the other way around. Too often, digital tools or infrastructure are layered on top of legacy workflows, which deepens fragmentation rather than addressing it.

A scalable population health infrastructure starts with the premise that virtual care isn’t a sidecar to traditional care—it’s a fully capable entry point and navigation system that should connect people to the right care, in the right setting, at the right time. Make every virtual care encounter an opportunity to triage and navigate patients to the right resources and care setting. At Ovatient, we do all this while also understanding, respecting and working within the policies and processes the health systems we serve have established that are informed by decades of service to their communities. That is why we say we were built for health systems, by health systems. We innovate from within an organization.

It starts with rethinking what we measure and defining what matters most up front. Too often, virtual care ROI is assessed through the lens of visit volume or utilization alone. But the real value lies in clinical outcomes, access equity and patient satisfaction and activation. This is especially true among high-cost, high-need populations who often fall through the cracks. To align investment with value, virtual care models, in general, must be designed with both measurement and accountability in mind. From building feedback loops into the clinical workflow, capturing not just patient satisfaction but health outcomes, engagement over time and care continuity. Those are tactical steps that really drive alignment. We’ve also found that a powerful and essential piece of this is our integration with Epic, which enables virtual care that is connected and coordinated within a health system.

As you scale your services, you should see that by creating access for patients who prefer virtual care, you will create additional capacity to care for patients who prefer and require to be seen in person.

We have a unique opportunity right now to redefine what “access” means—and policy is an important lever that can either accelerate or stall that redefinition. The next-generation virtual health ecosystem will require alignment across three key areas:
■ payment parity that’s tied to value, not volume;
■ licensure reform that makes care follow the patient, not just the provider; and
■ public investment in broadband and digital literacy to close the equity gap.

Public-private partnerships have a big role to play, especially when it comes to infrastructure. We need to treat digital access the way we’ve treated roads, electricity, or clean water. These are public goods that are foundational to wellbeing. That’s where partnership models that blend innovation, local knowledge and long-term accountability can be especially powerful.

I have been emphasizing how we can’t rely solely on goodwill but must have good governance in place. That includes clearly defining what success looks like—not just financially, but clinically and operationally—and aligning governance structures to those goals. Because virtual care models, especially virtual-first models that are predicated on building models of care continuity, are still relatively immature and are unchartered territory for many health systems, I would emphasize that it’s incredibly important to have clarity of purpose and understand your why. Moreover, truly start with the patient in mind, including where and how are they receiving their care. Starting from the patient’s vantage point should anchor every discussion. This makes for some spirited debate as well as a fair share of “Aha” moments. Leadership within the health system must clearly communicate why virtual-first care is important and complementary, not competitive.

Balancing innovation and compliance is not a zero-sum game. In fact, some of the most exciting virtual care innovations I’ve seen are happening because teams are building with long-term, sustainable integration in mind. Effective governance doesn’t just review performance—it shapes culture. It sends a signal that we’re not building tech for tech’s sake but designing care and using meaningful technology that meets people, both providers and patients alike, where they are and evolves alongside them. When you lead with that kind of clarity, the rest—compliance, alignment, sustainability—has a strong foundation to stand on. We are only going to move at the speed of trust and having a strong governance model is an imperative to help do so.