In this Telehealth Feature Series, we’re going to cover the long list of potential telehealth features available today. As you’re considering your own approach to telehealth, we will provide you a look at all the possible features telehealth companies are offering on the market. Plus, we’ll offer our insight into the nuances of each feature so you can select the right telehealth company or companies you use. Not all telehealth is created equal, so taking the time to understand all the possible features and options is worth the effort.
The next feature we’re going to cover is Clinical Documentation Tools.
Many reading this might be wondering why a telehealth platform needs clinical documentation tools. Shouldn’t the EHR be the place where all the clinical documentation is done? The short answer is yes, the EHR will be the final resting spot for clinical documentation for all but the direct to consumer telehealth vendors. I don’t ever see a day where a telehealth solution would basically build the EHR into their telehealth solution. At least not for a doctor that already has an EHR. However, that doesn’t mean that the telehealth vendor couldn’t provide clinical documentation tools that could help the doctor with their documentation requirements.
One of the sad things about telehealth is that it doesn’t change the clinical documentation requirements for doctors at all. In fact, the doctor has to document a bit more on a telehealth visit to acknowledge the location of the visit. This is part of why the Telehealth Value Equation never made sense until COVID-19 made in-person visits impossible.
Unfortunately, telehealth companies haven’t done much to help improve this situation. The most I’ve seen is the opportunity for a doctor to export some sort of summary from the telehealth vendor or to capture an image during the telehealth visit. While this can help a little, it doesn’t really improve the documentation process for clinicians.
In our EHR Telehealth Series we’ve seen a few more progressive efforts to improve the clinical documentation process during a telehealth visit by EHR vendors. It makes sense that an EHR vendor can do deep integrations between the telehealth software and their clinical documentation. Although, most of the benefits have come from the digital intake forms process that collects data from the patient rather than from the telehealth visit itself.
What does the future look like for clinical documentation tools in telehealth?
I documented back in April where I think all of this is headed when I wrote about the Auto Documentation Telehealth Solution that will make a telehealth company the big winner in the telehealth market. This still hasn’t come to fruition fully, but everyone I’ve talked to is at least keeping an eye on it and some are more proactively trying to integrate it.
The broad term most use for this technology is ambient clinical voice. In the exam room situation, you’d use microphones in the exam room which collect the audio from the visit, apply voice recognition, NLP, etc and produce the EHR documentation needed for the visit. Sounds dreamy right? I don’t know a single doctor that wouldn’t love for technology to take the documentation piece off their hands.
Of course, there are challenges with ambient clinical voice. Not the least of which is paying for the connected microphones in the exam room and the process of informing the patient that they’re being listened to by an AI documentation bot essentially. Companies like Saykara have made this easier by just using an iOS device to record the visit and create the documentation. However, there’s still the process to inform the patient of what’s happening. With telehealth, this isn’t an issue since the patient assumes they’re going to be on camera. This is the real opportunity that telehealth presents to ambient clinical voice technology. The auto documentation could just happen seamlessly during the telehealth visit.
The reality is that I don’t see any telehealth companies building this technology on their own just like no one built their own voice recognition software (at least they don’t now), but used an outside vendor. A slew of third party vendors are working on an ambient clinical voice solution with Nuance’s DAX product currently leading the pack. However, there are a lot of other companies working on this as well including: Saykara, Google Health, M*Modal (3M), Amazon Healthcare, and likely many more that haven’t made their information public yet. The challenge for telehealth companies is deciding on which company is going to win the race to ambient clinical voice auto documentation.
The other question here is if this technology can really replace or at least augment significantly a physician’s documentation workflow. I’ve gotten a lot of mixed reactions when I talk to doctors, product managers, and other experts about it. They all agree that we’re close, but there’s not a firm consensus that it’s there and will work for all doctors yet. In many ways it reminds me of the early days of voice recognition. In the beginning of voice recognition, a super user did great with voice recognition after training the voice engine and paying for high quality microphones, but it didn’t work well for most people. Now, voice recognition works with little training out of the box and a wide variety of technology. It feels like this is where we’re at with ambient clinical voice technology too. It’s getting close and works for power users, but isn’t quite ready for mainstream consumption and integration.
While the jury is still out on ambient clinical voice, I haven’t met anyone that doesn’t see the potential of this technology and how it will change so many things for the better. Although, I’d also argue that it would have had much slower adoption if telehealth hadn’t exploded first. Now that telehealth has much wider adoption, ambient clinical voice documentation can easily layer itself on a telehealth visit and more easily illustrate the benefits of the technology to clinicians. Then, assuming it works well for telehealth visits, doctors will be begging for microphones in the exam room to have the same documentation experience in person.