While there’s a lot of talk about how telehealth visits need to be integrated with EMRs, I’m not aware of any well thought-out model for doing so. In the absence of such standardized models, I thought it worth looking at the approach taken by American Well, one of a growing list of telehealth firms which are not owned by a pre-existing provider organization. (Other examples of such telemedicine companies include MD Live, Teladoc and Doctor on Demand.)
American Well is now working with more than 170 health plans and health systems to streamline and integrate the telehealth process with provider workflows. To support these partners, it has created an enterprise telehealth platform designed to connect with providers’ clinical information systems, according to Craig Bagley, director of sales engineering for the firm.
Bagley, who recently hosted a webinar on EMR/telehealth integration for AW, said its system was designed to let providers offer telehealth consults labeled with their own brand name. Using its system, patients move through as follows, he said:
- First, new patients sign up and enter their insurance information and demographics, which are entered into AW’s system.
- Next, they are automatically connected to the provider’s EMR system. At that point, they can review their clinical history, schedule visits and get notifications. They can also contact their doctor(s).
- At this point, they enter the telehealth system’s virtual “waiting room.” Behind the scenes, doctors can view the patients who are in the waiting room, and if they click on a patient name, they can review patient information collected from the EMR, as well as the reason for the visit.
Now, I’m not presenting this model as perfect. Ultimately, providers will need their EMR vendors to support virtual visits directly, and find ways to characterize and store the video content generated by such visits as well. This is becoming steadily more important as telemedicine deployments hit their stride in provider organizations.
True, it looks like AW’s approach helps providers move in this direction, but only somewhat. While it may do a good job of connecting patients and physicians to existing clinical information, it doesn’t sound as though it actually does “integrate” notes from the telehealth consult in any meaningful way.
Not only that, there are definitely security questions that might arise when considering a rollout of this technology. To be fair, I’m not privy to the details of how AW’s platform is deployed, but there’s always HIPAA concerns that come up when an outside vendor like AW interacts with your EMR. Of course, you may be handing off clinical information to far less healthcare-focused vendors under some business associate contracts, but still, it’s a consideration.
And no matter how elegant AW’s workaround is – if “workaround” is a fair word – it’s still not enough yet. It’s going to be a while before players in this category serve as any kind of a substitute for EMR-based conferencing technology which can document such visits dynamically.
Nonetheless, I was interested to see where AW is headed. It looks like we’re just at the start of the enterprise-level telemedicine system, but it’s still a much-needed step.