Why We Shared Our Data on COVID-19’s Impact on Ambulatory Visits

At Phreesia, we have witnessed a much less well-publicized race in ambulatory care—a race to deliver care safely during the pandemic to everyone else.
Clinical Operations

Hospitals across the country are in a well-publicized race to prepare for surges of COVID-19 patients. The speed at which they can acquire PPE, ventilators and redeploy their workforce will determine the number of patients and healthcare workers who live or die.

At Phreesia, we have witnessed a much less well-publicized race in ambulatory care—a race to deliver care safely during the pandemic to everyone else. In order to bring attention to the critical role ambulatory care plays in the national COVID-19 effort and to highlight troubling trends—most notably a dramatic drop in visit volume—we collaborated with researchers from Harvard University and the Commonwealth Fund to analyze data from Phreesia’s network and present a snapshot of what’s happening in ambulatory care.

That newly published report, “What Impact Has COVID-19 Had on Outpatient Visits?” which we co-authored, leverages our data to illustrate significant drops in in-person visits across the country. Additionally, the data showed a marked increase in telehealth visits, although not enough to offset the decline in in-person visits.

This is the first time Phreesia has published data on visit volume across our network. Over the past two months, we have witnessed and admired the dedication of our practices to the communities they serve. They are working 24/7 to re-organize their care model and provide patients with continuity and access to care. We felt compelled to use our data to shed light on these trends and the challenges these providers are facing.

Ambulatory providers’ pivotal role is to care for everyone with COVID-19 who doesn’t need to be hospitalized and those with any other health need, critical or mundane, that can’t wait for the pandemic to pass. As the virus spreads, elderly patients still fall and break hips, young children must be immunized and referred for early intervention, and the chronically ill must receive regular maintenance care. In fact, more than ever, it is critical that those with chronic conditions not end up hospitalized due to disruptions in their care.

The speed at which ambulatory care providers transition their care model will have a measurable impact on health outcomes. And ambulatory care has an additional burden to bear. When CMS called for cancelling all non-urgent visits, revenue plummeted, leaving many medical practices and FQHCs furloughing employees and running out of cash while racing to save lives.

We are honored to support ambulatory providers’ frontline efforts. We have focused on providing our network with tools to pre-screen patients for COVID-19 risk factors, scale telemedicine, adapt to zero-contact workflows and communicate to patients to make sure they can access the care they need.

It’s clear to us that in addition to technology solutions, practices need effective policies to support their ability to deliver care through this crisis. It is our hope that by collaborating with the Commonwealth Fund and Harvard University, we can help to advance those policy changes, including expanding telemedicine services, increasing financial assistance for outpatient practices, and defining safety protocols for in-person visits and procedures.

We remain committed to supporting medical practices in their response to COVID-19.


David Linetsky, Senior Vice President, Life Sciences; and Hilary Hatch, PhD, Clinical Psychologist, Vice President, Clinical Engagement