Virtual urgent care is not simply a button for video communication. In this context the difficult task is how people are routed. It is the process of deciding who is safe to manage through messages, who needs a provider immediately and who is in a condition that requires an emergency room. Telehealth is expected to reach 25-30% of medical visits in the US by the end of 2026 and many of those needs are sudden and not planned. According to Patient Care Online, telehealth may represent up to 30% of US medical visits by 2026. If a practice is considering virtual visits on the same day, the important questions to answer are about how to route patients clinically rather than how to share a screen.
Why the video button is the easy 10%
To create a link is simple – every vendor of telehealth services can place a button on a website – but a patient who clicks that button at 8 p.m. could have a question about a prescription or could have pain in their chest. On that account the technology used to connect the call is not complex. The logic that determines what happens before, during and after that call is where virtual urgent care is successful or unsuccessful.
Real-world virtual urgent care is dependent on triage and safety protocols rather than just the availability of video. As a study in the International Journal of Integrated Care describes, outcomes in an integrated system depend on how patients are directed to the correct level of care and how providers follow up. In this model the button is the small portion of the work that is easy to do. By contrast the routing of patients is the remaining 90% of the work.
Trust, not technology, is the real barrier
It is important to identify why patients are hesitant before discussing routing. It is not because of the software. According to Whereby’s 2026 virtual care report, 41% of patients say they do not have trust in the system, which prevents them from using telehealth. Patients are concerned that a virtual visit is not as good as an in person visit, that a provider will miss something or that the system will move them between many people.
A triage process that is designed well is the tool that gains that trust. When a system routes a patient quickly and accurately to a message or a live provider, the patient sees that the system is capable. If the system places them in a general video line for a problem that is serious enough for an emergency room, the patient sees the opposite. Routing is not only a way to keep patients safe. It is a tool for building trust.
The three-lane model
The most clear way to understand on demand virtual care is as a system with three lanes. In this system there is a clear decision about which lane a patient is in.
- Async self-serve. Those are issues that are well defined and not severe, like a picture of a skin change, a set of questions about a urinary tract infection or a question about medicine. The patient sends information and a provider is able to respond when they are free – this is the lane with the most capacity and the lowest cost.
- Live-now. Those are issues that need a provider to look at them in real time but are safe for telehealth. Examples are symptoms of a cold or flu, injuries that are not major or follow up talks. The patient is connected to a provider without delay.
- Escalate. Those are situations with dangerous signs that need a person to be seen in an office or an emergency room. The task of the system here is to see the dangerous sign and tell the patient where to go safely and quickly.
The value is not found in just having three lanes – it is found in the rules that put a patient in the right lane before a provider spends their time. And a large portion of visits to an emergency department are suitable for telehealth – this is why it is important to sort them correctly. Research in The American Journal of Emergency Medicine estimated how many emergency department visits in the US can be done via telehealth, which shows that much of the sudden demand for care is manageable virtually if the routing is done well.
Red-flag rules and safety-netting
The part of virtual urgent care that is not glamorous is the safety net – this consists of the clear rules that find dangerous symptoms and the follow up work that confirms the patient is getting better.
Safety-netting is made of two parts in practice – first, there are strict criteria for dangerous signs that move a patient out of the message or video lanes and toward an emergency room, which include pain in the chest, trouble with breathing, signs of a stroke and other similar issues. There is a structured way to follow up – this is a message or a call to check if the problem is gone or if it is worse. If this step is skipped, a service that is meant to be convenient becomes a risk. To build this into the system is what makes on demand care something that can be supported.
In this context intake forms with a specific structure are important. A process for intake that is organized functions as the initial layer for sorting patients. It is the tool that gathers necessary data, identifies indicators of high risk and directs the patient to the correct care path before a medical professional is present.
Staffing the live-now lane without an overnight shift you can’t afford
As for groups with 2-50 providers, the most frequent concern is the provision of staff. It is not possible to employ a team solely for night hours and it is not required. There are a few practical approaches:
- Push volume to async. By moving patient volume to asynchronous methods, you ensure that every case handled without real time interaction is a case that does not require an immediate clinician.
- Pool provider availability. With the pooling of provider availability, any clinician who is free can take a case from the immediate queue instead of working during a fixed period.
- Set clear hours for live-now. If you establish specific hours for immediate visits, you can direct requests made after hours to asynchronous systems or provide instructions for escalation.
- Use waitlists and standby slots. To manage resources, use waitlists and standby positions so that a request for a virtual visit can fill the time of a canceled physical appointment.
The objective is for the number of staff to be equal to the actual severity of patient needs, rather than having a provider wait for work that is not there.
What to measure
It is not possible to improve the direction of patients if you do not record data. There are three measurements that indicate if virtual urgent care is effective:
- Leakage to the ER. For instances where patients go to the emergency room, you must track how many people seen virtually go to a hospital soon after. If many patients do this, it is likely that the initial sorting is insufficient or there are problems in the escalation process.
- Callback and re-contact rates. By tracking rates of callbacks and repeat contacts, you can see how often a patient returns for the same problem – this identifies instances where the patient was sent to the wrong care path.
- Time-to-provider. In the immediate queue, the time a patient waits for a provider is a key factor. When wait times are long, the confidence that patients have in the service is reduced.
And you should monitor those factors from the start – they ensure that the direction of patients is a consistent procedure that you can adjust based on data rather than intuition.
Where a platform fits
As it is difficult to combine logic for routing, structured intake, asynchronous workflows, live workflows and follow up from separate tools, many practices look for integrated platforms – those systems manage intake, scheduling, multiple visit types and communication in a single location – this is better than connecting a video application to a form tool and a messaging service.
Because of this factor, white label telehealth platforms are popular with small and medium practices. A single system that is proven to work, like the technology Healee uses for over 1M+ patients in more than 200 clinics, handles the logic for intake, routing and follow up for your brand. On this system you adjust existing paths instead of creating new technical foundations.
To perform virtual urgent care well, you must view it as a sorting service that uses video. If you are deciding whether to provide virtual visits on the same day, start by asking questions about routing and then select the tools. For an example of how the path from intake to escalation is managed, you can request a demo.
Sources:
- Telehealth May Represent Up to 30% of US Medical Visits by 2026 – Patient Care Online, 2024
- Estimating the Proportion of Telehealth-Able US Emergency Department Visits – The American Journal of Emergency Medicine, 2024
- Virtual Urgent Care in an Integrated Value-Based Healthcare System – International Journal of Integrated Care (PMC), 2024
- 35 Stats for the Future of Virtual Care in 2026 – Whereby, 2026