When Advocate Health launched its virtual care program in North Carolina in 2023, leaders quickly recognized they had the opportunity to lay the foundation for a fundamentally different model to deliver care.
By 2024, the system was prepared to expand this model into its Wisconsin and Illinois markets. While Advocate Health had standard virtual care programs operating across the enterprise, leaders recognized an opportunity to consolidate its legacy virtual care services and rebuild them under one structure using shared learnings, best practices and operational efficiencies that had emerged over time.
“We had individuals doing the same type of work across our enterprise, but they weren’t connected in terms of being in the same meetings or learning from one another,” said Brian Kersten, MD, an internist and senior medical director of Enterprise Virtual Services Group at Advocate Health. “That was when we realized that we needed to bring this under one leadership structure.”
Advocate Health went all in on recruitment, hiring and onboarding to bring these virtual operations under one structure. The organization’s Virtual Services Group officially launched at the start of 2025, the same day the Illinois and Wisconsin virtual care services went live.
The Virtual Service Group functions as a family medicine practice comprised of a virtual workforce of physicians and nonphysician providers. The group has virtual urgent care, primary care, practice support and wellness programs, including weight management, cognitive and memory health, and sleep medicine. There is also an analogous structure on the pediatric side.
Additionally, the enterprise Virtual Services Group has established a more calculated, scalable structure for the organization’s approach to virtual care, while also paving a new avenue for growth across the system.
“Many organizations look at growth from an overall workforce perspective in which the traditional challenge is if you add clinicians, you have to build more buildings,” Dr. Kersten said. “This helps support the broader strategy by supporting clinics or creating models in a way that doesn’t require additional capital costs.”
Advocate Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Improving access, expanding care
The Virtual Services Group has already had a significant impact on improving patient access across Advocate Health’s markets, including for more medically complex patients.
“Our ability to take care of more complex patients has surprised us in a really good way,” said Dr. Kersten. “We've been able to be very nimble working with some of our facility and home health partners to step up and help patients.”
At the same time, the Virtual Services Group has broadened Advocate Health’s ability to extend care to regions where recruitment and staffing challenges can make access to care more difficult.
“It can be hard to fill brick-and-mortar rural health positions, but by offering a care model that doesn't have borders, any clinician can build their panel with a certain percentage of patients that live in rural markets,” Dr. Kersten explained. “It really helps our ability to reach more patients.”
The virtual model allows physicians to care for these patients across broader geographic regions without needing to relocate. And it offers patients in underserved or rural communities better access to high-quality, consistent care.
Covering physician inboxes to reduce stress
The virtual care model has been a consistent Best Place to Care win for physicians. That is because these virtual clinicians also help support covering in-baskets when physicians are out on vacation or extended leave.
In fact, one physician who was recently out of the office for three weeks, had someone cover for them, noting “this was an amazing experience for me. She did a perfect job managing my results and inbox messages.”
“This is the first time I’ve come back from any time off without it taking days—or even a week—to catch up,” the doctor said. “I appreciate this so much. It allowed me to return to my regular practice schedule without any delays or risk of falling behind. I believe in the future it will reduce my stress in anticipation of taking any time off.”
Recruitment and retention advantages
As the Virtual Services Group has expanded its care capabilities, it has also reshaped Advocate Health’s recruitment and retention strategy.
This borderless nature of virtual care has significantly widened the organization’s recruitment footprint for physicians and other health professionals.
“Someone may say, ‘I really would like to work for Advocate Health, but I don't live close enough to any of its locations,’ or they ask themselves how they can connect with an organization that’s doing innovative work. Our virtual team offers them that opportunity,” said Dr. Kersten. “There’s a fairly broad geography we can recruit from, which is a gamechanger for our team.”
Of course, the organization has been intentional about the type of physicians it recruits to this program. For example, the Virtual Services Group is not currently hiring new graduates. Instead, the group is focused on experienced physicians who have already developed strong clinical judgement through years of in-person practice.
“There is an art of medicine that needs to be developed within a clinic setting first,” said Dr. Kersten. “We want individuals who have that in-person experience.”
According to Dr. Kersten, many of these experienced physicians are seeking innovative and alternative ways to practice medicine in today’s healthcare landscape. One of the biggest draws is that physicians and other health professionals within the Virtual Services Group work virtually full time.
“This is not a hybrid approach where you’ll spend one or two days in a clinic and another three days virtual,” described Dr. Kersten. “It was a conscious decision for us to take that approach.”
This fully virtual structure has appealed to physicians looking for greater flexibility and a more sustainable practice model without sacrificing meaningful patient care and connection.
At the same time, the virtual model has become a major retention tool for the organization.
“We have a number of individuals who may have had to leave our organization for different reasons, but they love working for Advocate. So, we have this opportunity for them to stay with us,” explained Dr. Kersten. “There are so many instances where we would have lost great clinicians, but our program allowed them to stay with us.”
Building culture in a virtual workforce
While the virtual care model has transformed staffing and recruitment efforts, Advocate Health leaders recognize that virtual care still requires significant operational and cultural investment to support physicians effectively.
“You have to invest in the staffing to support the clinicians,” Dr. Kersten said. “It's not a completely lean model. You need the support teams.”
That includes building structures and processes for communication, collaboration and professional connection among physicians and other health professionals who may never work together in person on a daily basis.
Additionally, one of the biggest challenges of building a virtual physician workforce is establishing and nurturing a culture of connection and collaboration.
“We are doing everything we can where geographically feasible to bring folks together,” said Dr. Kersten. “We are intentional about bringing individuals together who are interested in and able to create in-person collaboration.”
Recently, the virtual primary care leader who lives in North Carolina spent a week in Wisconsin and Illinois hosting in-person gatherings for the virtual teams. Leaders also work to maintain strong connectivity through monthly clinician meetings that bring providers together around shared experiences and operational priorities.
“Even though we may not be physically close, we’re all on the same call together, talking about the same wins, the same challenges and how we can address problems together,” Dr. Kersten shared.
For the physicians who provide virtual support services for in-person clinics, the organization has taken additional steps to ensure they feel integrated into the clinical teams.
“Even though they are remote, they are working hand-in-hand with the clinics and seeing their overflow patients,” said Dr. Kersten. “So, we want to make sure they feel like they’re part of the clinic. That’s something we did on day one and made sure was part of our playbook.”
Flexibility has also become a defining feature of the program’s physician experience. The virtual primary care model currently offers hours from 6 a.m. to 11 p.m., seven days a week. This allows physicians to have greater flexibility to choose schedules that align with their personal lives and preferred work styles.
Closing gaps in healthcare
With continuous improvement guiding the strategy, the Virtual Care Group plans to expand, while maintaining a strong focus on quality, safety and the patient experience.
“Our road map also includes other areas of capabilities,” shared Dr. Kersten. “If we can deliver care 95% of the time fully in the home without having to handoff anywhere else, what can we do about the other 5% if a patient wants a remote-only experience but we have to refer them to specialist or service lab work?”
To help close these gaps, the group is testing alternative different capabilities such as clinical teams traveling to a patients’ homes if they need phlebotomy services.
The pediatric team is also preparing to launch a digital diagnostic tool capable of transmitting video and audio to physicians, allowing them to remotely evaluate a child’s ears or listen to their heart or lung sounds during a virtual visit.
Those innovations reflect a broader goal of making virtual care more comprehensive and seamless for patients while continuing to push beyond basic telehealth capabilities.
“In many ways, virtual care is table stakes, so our goal is to do it well and continue to improve,” Dr. Kersten said. “But we are also looking forward at what’s next. It’s important for us to maintain the core element of what we have created, while continuing to innovate above and beyond.”
For guidance on improving patient care through virtual healthcare delivery, check out the AMA STEPS Forward® toolkit “Telehealth Integration and Optimization.”
AMA STEPS Forward offers real-world solutions to common challenges in healthcare today. Explore a variety of innovative, physician-developed resources designed to help prevent physician burnout, optimize workflows, improve well-being and enhance patient care.
