Wolf&Grayson EditorialVirtual care has become a central component of modern healthcare delivery. Over the past decade, telehealth platforms, remote monitoring tools, and digital communication channels have moved from experimental pilots to essential infrastructure for health systems. However, many organizations still struggle to achieve meaningful scale, and that’s largely due to poor operational foundations.
“Virtual care doesn’t scale because of platforms. It scales because of the discipline, operating models, aligned reimbursements, strategy and measurable quality architecture,” says Eric C. Gardner, Vice President of Operations at Leidos. Gardner has spent more than two decades leading transformation across federal healthcare systems, enterprise health organizations, and early-stage healthcare companies, with experience spanning military health readiness programs, large payer-provider organizations, and high-growth healthcare ventures.
During his tenure as Senior Vice President and Chief Innovation and Transformation Officer at WellMed, Gardner confronted this challenge directly as the COVID-19 pandemic forced healthcare systems to rapidly expand remote access to services. The organization served a large senior population, many of whom lacked broadband access or digital literacy. Without a solution, thousands of patients risked losing access to routine care. Gardner and his team developed a rotating tablet deployment model that paired 4G LTE (Long Term Evolution) connectivity with a simplified interface designed for older adults. The devices were distributed across markets, and used to conduct virtual annual wellness visits and chronic care management.
With a roughly $1 million investment in devices and connectivity, the program enabled hundreds of thousands of visits and generated approximately $500 million in revenue tied to risk-adjusted annual wellness exams. “Technology is about 20% of it,” Gardner says. “The other 80% is operational execution.” That execution includes workflow alignment, logistical discipline, clinical protocols, and incentives that encourage both providers and patients to adopt new care models. Without those elements in place, even the most advanced platforms struggle to deliver consistent results.
Designing Workflows That Providers Can Sustain
As virtual care volumes expand, operational bottlenecks quickly emerge. Gardner identifies workflow architecture as the first and most common challenge, followed by staffing models, documentation and reimbursement alignment, and finally technology integration.
One operational change proved particularly effective in increasing adoption among physicians and care teams. Instead of requiring clinicians to alternate constantly between in-person and virtual visits, Gardner introduced a session-bundling model. Providers dedicated roughly 20% of their schedule to virtual care, typically equivalent to one full day per week or several half-day sessions. During those blocks, clinicians focused entirely on virtual visits while support staff handled care coordination, patient outreach, and follow-up tasks.
“If providers are bouncing between face-to-face appointments and virtual sessions, the experience breaks down,” Gardner says. “Appointments run over, patients sit in waiting rooms online, and the quality of service drops.” Grouping visits by care modality allowed clinicians to concentrate fully on the patient interaction, while giving support teams time to address administrative and coordination responsibilities. The model also improved physician acceptance. Many clinicians appreciated the flexibility of conducting a portion of their work remotely, which helped maintain productivity while improving work-life balance.
Choosing the Right Use Cases for Rapid Scale
Health systems aiming to scale virtual care within a short time frame must also select the right clinical use cases. Gardner recommends focusing on services where virtual interactions naturally support continuity of care. Chronic disease management is often the most effective starting point. After an annual wellness visit, providers can schedule follow-up appointments virtually to monitor conditions such as diabetes or hypertension and ensure treatment plans remain on track.
Behavioral health services represent another major opportunity, alongside post-discharge follow-ups and medication reconciliation visits. Many communities face severe shortages of mental health professionals, particularly in rural or underserved areas, and virtual platforms allow providers in major metropolitan centers to extend care into these regions. Patients leaving the hospital also often face complex medication regimens, and timely virtual check-ins can help identify conflicts, clarify prescriptions, and prevent complications or readmissions.
Gardner emphasizes the importance of centralized scheduling and standardized protocols for determining which appointments qualify for virtual care. Care navigation teams also play a crucial role in maintaining patient engagement between visits. To track progress, Gardner monitors several core metrics each week: virtual visit utilization, no-show rates, annual wellness visit completion, risk adjustment factor performance, and patient satisfaction scores.
AI Will Expand Capacity but Requires Guardrails
Looking ahead, Gardner believes artificial intelligence (AI) will significantly accelerate the scalability of virtual care. AI-powered intake systems and clinical summaries can help physicians quickly understand a patient’s history before a consultation begins. “These tools can review patient records and provide a concise synopsis before the visit,” Gardner says. “Providers can see recent history, long-term trends, and key conditions without spending hours reviewing charts.”
AI-driven care navigation may also guide patients through chronic disease management outside clinical visits. Chat-based systems trained on clinical pathways can help answer questions, reinforce treatment plans, and provide ongoing education. Remote monitoring technologies are expanding the possibilities even further. Sensors and connected devices allow care teams to track patient health in real time, alerting clinicians when intervention may be required.
Despite these advancements, Gardner emphasizes the importance of maintaining human oversight. “You have to keep a human in the loop,” he says. “That’s how you build trust with providers and ensure the technology improves outcomes rather than creating new risks.”
Building the Infrastructure for Scalable Care
As healthcare organizations confront workforce shortages and rising demand, scalable care delivery models will become increasingly essential. Virtual care offers a powerful path forward, but only when supported by disciplined operations and aligned incentives. With the right structure in place, digital tools can extend care beyond clinic walls while improving both efficiency and patient outcomes.
Follow Eric C. Gardner on LinkedIn or visit his website for more insights.
