Designing and Operationalizing a Virtual Healthcare Clinic

Written on July 31, 2025 as an assignment for MHST 622: Understanding Organizations, a course in the Master of Nursing program at Athabasca University.

            The world is rapidly changing, and healthcare is changing with it, particularly in the context of rapid technological advancement changing the way organizations are structured (Bersin, 2016). These changes were particularly accelerated by the COVID-19 pandemic, which prompted the introduction and proliferation of in-person working structures shifting to virtual environments, including shifting healthcare delivery from physical hospitals and physician offices to virtual services such as telehealth and video conference appointments (Lund et al., 2021; Vallee & Arutkin, 2024; Webster, 2020). The World Health Organization emphasized virtual health technologies in a 2019 report, recognizing their usefulness toward solving many sustainability issues that have been increasing urgently in healthcare at a global scale (Vallee & Arutkin, 2024). These issues include prevalence of chronic diseases, staffing shortages, financial resource limitations, patient access issues in remote regions, and hospital capacity and overcrowding. As Vallee and Arutkin succinctly state in their article on the rise of virtual healthcare, “Through the power of technology and telehealth capabilities, healthcare services could be available anytime, anywhere, offering unprecedented convenience and ease of access” (2024, p. 2). By breaking down barriers of access, virtual healthcare delivery models also allow better personalization of care to diverse patient populations, improved monitoring of patient health, and improves efficiency to allow more patients to be cared for (Kuwaiti et al., 2023; Vallee & Arutkin, 2024; Webster, 2020). With the added power of artificial intelligence, the scope and capacity of what can be assessed, monitored, diagnosed, and treated through virtual clinics has grown exponentially, offering a critical opportunity for new approaches to healthcare delivery (Kuwaiti et al., 2023). With this contextual background, I will outline and discuss the design and implementation of a new virtual healthcare clinic: the Virtu-Health eClinic.

Virtu-Health eClinic Overview

The Virtu-Health eClinic is a virtual organization that is operated under a hybrid social structure of workflows, communications, and interrelated activities between employees. Based on its hybrid structure, the eClinic has some teams that operate on a simple structure such as the front-line physicians and nurses providing direct patient care, as well as some teams that operate on a functional structure such as the analysts and engineers maintaining the digital technologies employed in the clinic (Ahmady, Mehrpour, & Nikooravesh, 2016). In order to effectively navigate the hybrid structures, the eClinic is operationalized from a mechanistic form approach whereby roles are clearly delineated and differentiated to avoid confusion and inefficiencies, communication channels are formalized to ensure accurate documentation and continuity of care, and decision-making is centralized to the leader regarding the resources and operations of the clinic (Ahmady, Mehrpour, & Nikooravesh, 2016).

Mission Statement & Values

The mission statement of the Virtu-Health eClinic will read as follows: The Virtu-Health eClinic is a leader in providing innovative, cutting edge, evidence-based virtual health care services to patients across the lifespan in Ontario, Canada. With digital health technologies and world-class teams of healthcare practitioners, we assess, diagnose, monitor, and treat our patients through accessible, affordable and sustainable approaches that can be accessed remotely to support our patients, even at a distance.

Mission statements allow the public to understand the company’s self-perception, “identity, uniqueness and competitive advantage” based on which components are emphasized (Fitzsimmons, Qin & Heffron, 2022, p. 210). Firstly, the mission statement outlines who the customers of the eClinic are, as well as the geographic region in which the clinic operates, which in this case is dependent on the geographic region where the patients live, since the clinic’s virtual nature is not in itself bound by geography. Secondly, there is a logical focus in the mission statement on digital technologies offering cutting-edge modalities for various elements of patient care, coupled with the self-conceptualization of competency in evidence-based care delivery, both contributing to the competitive advantage (Fitzsimmons, Qin & Heffron, 2022, p. 210). There is also an emphasis on sustainability, accessibility, and affordability, reflecting the eClinic’s concern for public image by demonstrating an understanding of the socioeconomic landscape of modern Ontario, which is important for an organization that is based on treating and caring for people (Fitzsimmons, Qin & Heffron, 2022, p. 210). Finally, the mission statement also addresses the healthcare teams that will be providing care at the clinic, labeling them as world-class to demonstrate the value placed by the organization on the skills and competencies of its employees.

            The values of the Virtu-Health eClinic values are aligned to the mission statement: Innovation, Access, Equity, and Teamwork. Innovation is related to the digital health technologies utilized at the clinic; given its virtual nature, these are the core of what differentiates the eClinic from traditional in-person clinics, and are thus a foundational value. Access refers to the accessibility offered by remote, virtual care delivery services, ensuring that people do not exhibit physical barriers to health care. Equity is tied to access, and to support equitable access, the clinic will also have technical support teams that help bridge learning curves and gaps for patients who have challenges utilizing technology. Finally, teamwork is associated with the various teams that operate the clinic, including back-end technical operations and front-line care delivery; the cooperation and collaboration of teams is fundamental for the smooth operations of the clinic and accomplishment of the outlined mission.

Organizational Chart & Work Design

            As previously mentioned, the Virtu-Health eClinic operates on a hybrid model of an overarching hierarchical structure within which collaborative teams exist. Since the organization is virtual, all of the employees work remotely, with their connectivity primarily driven through digital means, such as Microsoft Teams meetings, emails, and chat boards. The members of the Virtu-Health eClinic include the Clinic Director, a Technical Lead and Clinical Lead each leading their team of specialized staff, as displayed in Figure 1: Virtu-Health eClinic Organizational Chart.

Figure 1

Virtu-Health eClinic Organizational Chart

In the organizational chart, the solid straight lines indicate the hierarchical reporting structure, while the broken dotted lines indicate consultation pathways. Double-headed arrows indicate bidirectional flow of power representative of collaborative flow of information and team-based decision making. The existing hierarchy for responsibilities and decision-making is evident from the chart, with the most important roles indicated at the top (Ahmady, Mehrpour, & Nikooravesh, 2016). For the Virtu-Health eClinic, this is the Clinical Director and the two leads who report to the Director: Technical Lead and Clinical Lead. The Clinic Director has the ultimate oversight of the clinic, but due to their distance in the chart from the staff at lower levels, the Director may not be familiar with the nuances of clinic functions and operations. These lower level staff instead report to the Technical Lead and Clinical Lead, depending on their roles, and the Leads can gather and process information from those levels to provide counsel and advisory to the Director, who is further removed. The Technical Lead manages the team of Analysts and Engineers, whose responsibilities are focused on data collection and processing, device and digital software maintenance. Engineers, given their advanced qualifications, are also responsible for consulting with external vendors or product owners when needed for troubleshooting or acquiring new products. The Clinical Lead manages the team of Nurses and Physicians, ensuring that they are meeting best practice guidelines and supporting clinic workflows. The Technical Lead and Clinical Lead work collaboratively to support clinic operations from the perspective of their specialty, ensuring that the digital aspects of the clinic align with and support the patient care delivery needs and evidence-based practice. Nurses and Physicians work collaboratively at the front-facing patient care positions. Physicians also have the added role of consulting to interdisciplinary care teams both internal and external to the organization, such as specialized care services, physiotherapists, dieticians, etc. These interdisciplinary teams will then follow up with the Nurses regarding patient appointments and results, and the Nurses will bring those details to the Physicians as needed through their collaborative communication pathways.

Clinic Leadership & Teams

            As mentioned, the clinic leadership team is composed of the Director, the Technical Lead, and the Clinical Lead. The Clinic Director for the Virtu-Health eClinic is Dr. Hillary Marks. Dr. Marks brings expertise from her professional background in family medicine, a Master degree in digital health technologies, and a Bachelor of business administration. The Technical Lead is Matthew Connors, a prolific software engineer specializing in digital health technologies. Connors has held various management positions on digital operations teams across both healthcare and telecommunications companies. The Clinical Lead is Nancy Fields, a nurse practitioner from one of America’s most advanced smart hospitals, bringing innovative insights for modern patient care delivery and evidence-based practice standards to the eClinic.

            This leadership team was selected in part based on their technical qualifications and past experiences, but also in part due to their complementary leadership styles. Dr. Marks, the Clinic Director, operates from a transactional leadership style. She is results-driven and rule-based, as she has demonstrated in some of her previous roles as a leader in other organizations. The transactional leadership style encompasses two principles: contingent reward and management-by-exception (Lai, 2011). Regarding the former principle, Dr. Marks expects particular outcomes or deliverables from employees and rewards them in exchange. Regarding the latter principle, she is attentive to errors and failure, and actively intervenes when problems arise and issues make their way up the hierarchy to her attention (Lai, 2011). These traits allow her to be effective as a Clinic Director, ensuring productivity and ongoing viability of the organization from a resource perspective. However, while she is the primary decision-maker for the clinic, she does receive advisory counsel and shares in many decisions with the Technical and Clinical Lead, both of whom were chosen in part due to their transformational leadership styles. Transformational leaders, like Connors and Fields, take a more decentralized approach to team oversight, preferring to be facilitative rather than directive with their staff, thus creating open environments for innovation, collaboration, and exchange of ideas (Sayyadi & Provitera, 2021). By overseeing their individual teams with this approach, Connors and Fields are able to motivate their teams to develop solutions and proactively seek opportunities for growth, while still maintaining a defensive strategy for preserving financial and human resources of the organization (Sayyadi & Provitera, 2021). Although the leadership styles among members of the leadership team may be contrasting, some researchers suggest that a combination of transactional and transformational leadership styles may actually result in the best outcomes for the organization, offering multiple dimensions of operational efficacy (Lai, 2011).

Communication

            Like in all organizations, communication skills are essential for leaders at the eClinic to ensure information is disseminated appropriately and clearly, mitigate uncertainty or confusion, and address employee needs and concerns (Bauer & Erdogan, 2012). The leadership team of the eClinic is dedicated to practicing the following five strategies for strong communication.

1. Avoid the use of acronyms.

Using acronyms in team settings can be a source of confusion, misunderstanding of concepts, and alienation for individuals who may not be familiar with the same interpretations of acronyms as the speaker (Bauer & Erdogan, 2012). Instead, leaders of the eClinic will speak or write out acronyms, unless the acronym is explained at the beginning of each interaction or email so that all participants can refer to the correct meaning of the acronym.

2. Limit multitasking during meetings.

            Multitasking during meetings, while it may seem efficient, is actually a barrier to communication for several reasons. Multitasking during meetings is distracting for both the message sender and receiver, it can be perceived as disrespectful by others, and it limits the capacity of interaction and attention that is given to the meeting issue (Hanke, 2024). Instead, leaders of the eClinic will schedule separate working time for other tasks, so that they can remain attentive to their meetings, promoting better communication environments.

3. Listen to understand, not only to respond.

            This is a key principle of active listening and requires the leaders of the eClinic to open their minds to the meaning of the message they are receiving when communicating with others (Samra & Baynton, 2011). By being too quick to respond, leaders run the risk of making assumptions or making decisions based on incomplete or misunderstood information (Samra & Baynton, 2011). It is important for the leadership team to pause and reflect on the messages they are receiving and understand the issue before responding.

4. Ask clarifying questions.

            Similar to listening to understand, asking clarifying questions can also be an effective strategy for preventing misunderstandings or misinterpretation of information (Bauer & Erdogan, 2012). The leadership team has the opportunity to create a culture of open communication at the eClinic by practicing asking clarifying questions without fear or shame, but rather with the recognition that clarification is an opportunity for improvement.

5. Summarize meetings and follow up with summary & next steps emails.

            Summarizing in meetings is a strategic approach to ensuring everyone is aligned and feels heard, preventing conversations from becoming circular and inefficient, and allows the teams to address misunderstandings or confusion (Gupta, 2024). Following up with a written format, like email, is effective at documenting decisions and providing a reference for the future.

Teamwork

            Establishing strong virtual teams will be essential for the operationalization of the Virtu-Health eClinic. One of the teams that will function in the clinic is the Clinical Team composed of Nurses and Physicians, led by the Clinical Lead, Fields. The Clinical Team is, of course, vital to the clinic since they are the patient-facing agents who provide health care to the patients and who carry out the elements of the mission statement related to patient care: provides innovative, cutting edge, evidence-based virtual health care services to patients across the lifespan in Ontario, Canada. This team’s functions will be supported by strategic actions including a leader selected for their competency and experience in digital health delivery and management, carefully selected team members who are technologically savvy to be able to operate the virtual clinic technologies, provision of high-quality equipment, and policies and procedures that clearly outlines roles and responsibilities and support effective clinic operations (Ford, Piccolo & Ford, 2016). Establishing trust among team members and between team members and their leader will also be a foundational element for their effective functioning, especially in the remote work context where there is a greater reliance on the self-discipline and motivation of workers due to reduced visibility compared to in-person work (Ford, Piccolo & Ford, 2016). Members of the Clinical Team will all be required to live within Ontario, Canada, which alleviates the time zone considerations that are common with remote work, but investing in clear and effective communication pathways, such as video conferencing software, commitment to specific response times, and back-up planning for system failures are foundational considerations for the eClinic (Ford, Piccolo & Ford, 2016).

Case Scenario: Managing Disagreement

            On the first day the eClinic opens, the Clinical Lead is hosting a virtual meeting with the Clinical Team to develop a framework for allowing student nurses to consolidate with preceptors at the eClinic. In the meeting, two nurses begin to have a heated debate related to how student nurses should be mentored. This case scenario depicts a situation of conflicting opinions, which the Clinical Lead should navigate in a manner that upholds the values of the eClinic organization, including innovation, equity, and teamwork. The approach that the Clinical Lead takes in this scenario will set a tone and precedent for the teamwork and employee motivation at the clinic (Rahbi, Khalid & Khan, 2017). As such, it is important for the Lead to exercise attributes of their transformational leadership style and foster a culture of learning and sharing of ideas in a productive manner (Sayyadi & Provitera, 2021). Acknowledging that variability in approaches may exist is important, while also encouraging staff to support their ideas with evidence in order to drive high-quality practices. Following the sharing of different approaches to mentoring student nurses and locating evidence, the Lead can then facilitate the team through a democratic process of shared decision-making to develop a guideline for the eClinic’s future practices that is supported by the team (Rahbi, Khalid & Khan, 2017).

Recruitment Strategies

Image 1

Virtu-Health eClinic Job Ad for Nurses and Physicians

            As a virtual company, leveraging virtual platforms for job searching, such as Indeed, GlassDoor, and even social media, is a logical recruitment strategy. Additionally, the digital approach to recruitment aligns with the aim of attracting clinical staff (nurses and physicians) who are both competent practitioners as well as digitally active and tech savvy to have an interest in virtual care delivery. Digital job ads are also cheaper than print ads, while still having a greater reach, being more accessible and more attractive (Mahjoub & Kruyen, 2021). Given these benefits of virtual ads, the expectation is that the eClinic will be exposed to a quantifiably large applicant pool, but also considering the quality of that pool based on the competencies required for the role, including digital experience and efficiency, and competencies as outlined by the applicant’s respective licensing body (Mahjoub & Kruyen, 2021). To compete with the abundance of attention-grabbing content on digital platforms, the job ad has been designed in an eye-catching manner (Image 1) that can easily be shared between networks. The pertinent information for applying is easy to locate on the ad, and the values of the organization are clearly stated to draw the interest of candidates who will align with and support those values. The Ads will be posted across the mentioned digital and social media platforms on a weekly basis throughout August and September 2025, until the closing date mentioned on the ad. The same approach will be utilized to hire for the Technical Team, with an aim at attracting digitally savvy analysts and engineers with experience in virtual healthcare technologies, with an ad that focuses on opportunities for innovation and industry revolutionizing applications of technology.

Social Media Policy

            Social media is an inevitable part of modern life, and can even offer useful opportunities, such as in the recruitment strategy mentioned. However, it also brings with it privacy concerns, distraction and work interruption issues, and considerations around boundaries between public and private lives (Majid & Kouser, 2019; Roberston & Kee, 2017). It is prudent, then, for the eClinic to develop a Social Media Policy that addresses these concerns in a supportive way for employees to refer to. Social media use in the workplace has been linked to higher job satisfaction for employees, and more satisfied employees are more likely to contribute positively toward organizational goals. Using social media as a social networking tool can also be beneficial for team building, especially in a virtual organization where employees are not having the kind of frequent in-person interactions and proximity that they would in a physical office space (Roberston & Kee, 2017). As such, the Social Media Policy should not entirely eliminate usage of social media during working hours (Roberston & Kee, 2017). Instead, the Policy will indicate that social media should not interrupt or delay the provision of safe, quality patient care, or the completion of initiatives or projects, and that if this becomes an issue for particular employees, their social media utilization during working hours may be monitored and investigated. Additionally, to address privacy concerns and safe social media use, the Policy will require employees to participate in an annual social media training program that reiterates principles of the Policy, provides the latest guidance and strategies for online security at work, and supports a continued culture of appropriate engagement with online resources and tools at the organization (Majid & Kouser, 2019). The Policy will indicate the organization’s stance that education and understanding of the risks associated with social media use will be more effective for staff engagement and compliance with safety principles than banning social media at work.

Quality of Care Delivery

            Delivery of evidence-based, high-quality healthcare is a pillar of the Virtu-Health eClinic mission statement, and is expected to be supported by all of its staff members, including the patient-facing nurses and physicians as well as the technical team as they introduce and maintain health care technologies in the clinic. Evidence-based practice is important for the clinic to drive and ensure quality of care because it combines the best and latest information and knowledge in healthcare with dynamic, individualized, and holistic patient care considerations (McKibbon, 1998). To ensure that staff, particularly the Clinical Team, are equipped and prepared to uphold evidence-based practice and quality of care, training and refreshers will be provided for all clinic technologies. At the leadership level, decision-making will prioritize literature and best practice guidelines support, and continuing education for staff will also be incentivized and supported by the organization through various programs.

Summary

            The Virtu-Health eClinic will be a modern, high-tech, virtual approach to health care delivery that operates on values of innovation, access, equity, and teamwork. The organization structure is overarchingly hybrid between its hierarchical levels of Director and Leads, and its collaborative Technical and Clinical Teams that operate in a more democratic style. Information needed for decision-making is fed upward to the Director through the Technical and Clinical Leads, and outcomes of decisions trickle downward to the Analysts and Engineers of the Technical Team and the patient-facing Nurses and Physicians of the Clinical Team. In this organization, the leadership team is diverse in expertise, experience, as well as leadership style, offering a functional and effective mix of transactional and transformational leadership to ensure the organization is meeting its goals and outcomes, as well as to promote staff satisfaction, team building, and innovation. Driven by modern considerations and with an acute awareness of the current social context, the virtual clinic not only leverages technology for health care delivery, but also for connectivity in both recruitment approaches and social media use of its employees. Overall, the eClinic offers a new and exciting way for patients in Ontario to access high-quality, evidence-based health care regardless of their proximity to a care center.

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