"Connected Access": Titrating the Right Dose of Access in the Digital Age

The concept of access to health care has been dominated by the visit-based paradigm. However, with the advent of telehealth, wearables, and mobile applications, much of the information that is exchanged at the time of the provider encounter can be transmitted virtually. This calls for a reconceptualization of access that is not so heavily reliant on "the visit." We have proposed a concept of connected access that is "dose related," based on the expertise of the provider and the channel through which a patient and a provider communicate. Particularly relevant to chronic care, the intensity of access can be titrated according to the needs of the patient at different points in time as clinical needs change. To function optimally, this model requires value-based payment and a new care model that occurs at the intersection of team medicine, virtual care, self-care, and traditional visit-based care. Made possible through connected technologies, "Connected access" fulfills the vision articulated in the "Crossing the Quality Chasm" report (2001) that care is based on continuous healing relationships; hence, the health care system should be available at all times.