For quite some time, we’ve given relatively little attention to the problem of integrating telehealth encounter data with more-traditional records generated by EHRs. Though the volume of telehealth-based care has been increasing, as an industry we’ve managed to sidestep the problem of documenting such care uniformly or even automating the documentation.
Prior to the pandemic, this might have made some sense. On the one hand, it’s never smart to let incompatible forms of data pile up, as there may very well be a time when you need a comprehensive view of a patient’s history. On the other, if the unique attributes of telehealth – such as its convenience and lowered cost of delivery – make it worth conducting, maybe it’s ok if we figure out later how to go back and gather in whatever data gets left aside.
This, at least, seems to have been the compromise under which healthcare organizations have been operating under for quite some time now. Even as giants like the Cleveland Clinic put telehealth at the center of their plans, I’ve seen little sign that such organizations have devoted much energy to the telehealth data problem.
Of course, referring to the “the telehealth data problem” glosses over the fact that there’s no single commonly-held agreement on what this problem is. In my mind, for example, the idea that my providers have a recording of my video visits but don’t make use of it represents a lost opportunity…of some kind. But until we develop, say, some super-smart AI technology that gathers nuanced insights from the videosuper-smart AI technology that gathers nuanced insights from the video, do we really need to do more than archive it for now? My sense is that most providers have decided to let the issue drop, at least for now.
That being said, in the wake of the pandemic, I suspect we’ll need to rethink this issue. With all but the most critical care being delivered virtually, telehealth data is has become standard patient information rather than an aside. What’s more, this could be the case for quite some time. How long is anyone’s guess, but we’re already well past the “flash in the pan” stage of things.
If the COVID-driven telehealth surge was smaller, or shorter in duration, we might still have been able to get by siphoning off essential data from these encounters in a related EHR note. Under the current circumstances, however, it probably won’t work to treat telehealth documentation as an afterthought. Yes, this is a lousy time to think about what we’re missing but it’s still where we’re at.
Obviously, it could take some time to develop new approaches to documenting telehealth appropriately. After all, we’re talking about a thorny set of clinical, technical and administrative problems here for which we have few if any cut-and-dried answers.
We still need to tackle these issues ASAP, though, ideally before the COVID-19 crisis is over. If we’re going to rebuild the healthcare system in its wake, we need a firm place to stand, and that means we’ll need a clear picture of how our exploding volume virtual contacts with patients really worked. No doubt we’ll be writing a lot more about telehealth data and in particular it’s relationship and integrations with the EHR going forward. What was once a nice to have is now going to become an essential part of a healthcare organization’s telehealth efforts.