Culturally Competent Care and Virtual Primary Care

What is culturally competent care?

The American Hospital Association defines culturally competent health care as “the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients’ social, cultural and linguistic needs.”[1]

Delivering care that is culturally competent goes far beyond language capabilities. It means adapting the way that clinical care is accessed and provided to meet the unique personal and environmental needs of each person. This includes race, ethnicity, nationality, language, gender, physical and mental ability, sexual orientation, occupation and much more. It also means considering the impact of social determinants of health.[2] Patients have varying levels of health and risk because of differential access to education, food, neighborhood safety, community and economic security.

Culturally competent care is sensitive and considers a whole person when delivering treatment, which allows for better health outcomes, a more comfortable and safer patient experience, and more equitable distribution of quality care.

Virtual primary care can support DEIB in employee benefits

In traditional primary care, patients often struggle to find care that is easy to access, affordable and comprehensive. With virtual primary care, employees can access ongoing, patient centered care. VPC doctors spend more time with patients and work to understand all the factors that make up a patient’s health journey through clinical risk assessments and trust-based conversation. Virtual primary care allows patients to form a strong relationship with their doctor, regardless of location, access to transportation or financial means.

Building a virtual primary care practice that serves all people

Building a virtual primary care practice that delivers culturally competent care involves working to understand every patient’s unique experience, designing a solution for equity of access, providing a safe and inclusive clinical environment, and building a system to continually monitor and assess the efficacy of care.

Understanding Each Patient: Meeting patients where they are means taking the time to learn about them and their preferences. Virtual primary care practices need to spend time with new patients to learn about their medical history, type of home environment and support system, concerns and needs, and safely record that data for incorporation into the care plan. It is important when learning about a patient to make them feel psychologically safe before asking for details to protect personal and health information and to be aware of the potential for bias in data.
Designing for Access Equity: Patients need to be able to access virtual primary care from different modalities, including phone, app or website based on their preference and comfort level. Not all patients will have the same level of technology, broadband or access to a private space to conduct a health visit. Access should also consider providing resources for different language requirements, differences in vision and hearing abilities and all levels of reading and health education. Practices should also consider expanding hours of operation to support patients with unique scheduling requirements.
Providing a Safe and Inclusive Clinical Environment There are many components to creating a clinical environment that delivers culturally competent care. First, virtual primary care practices should strive to have a diverse group of providers with broad experience and areas of expertise. Second, doctors and other members of the care team should receive routine training on diversity, equity, inclusion and belonging. Examples of this include helping providers understand the importance of using patient directed pronouns or the implications of religious status on certain treatment pathways. Third, the care team should use practices like motivational interviewing to understand a patient’s lived reality and capacity for managing personal health. Finally, virtual primary care practices should work with patients between visits with the provider to deliver hand-held support in using health benefits and accessing necessary resources to secure follow-up care as needed.
Building a System of Assessment: Practices should have a robust quality assurance process whereby doctors and care team members are routinely assessed for quality of clinical guidance and “phone-side” manner. Virtual primary care practices should also create a set of standards by which care is measured to ensure it meets the requirements of cultural and personal sensitivity.[3]