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 EHR Integration.
In the 15 years I’ve been writing about health IT and EHR/EMRs, I’ve learned one thing really well. EHR integrations are all over the place. They’re like magic when they work. They’re one of the most frustrating things when they don’t work.
In all these years, I will say that EHR integrations have gotten better. If COVID hadn’t hit, I was actually working on a whole series of articles on EHR integrations and how EHR vendors often screw their customers in order to lock them in. The most basic way is EHR vendors charge a large integration fee. In many cases, the PM vendor and the EHR vendor are charging integration fees. It’s messy and the sad underbelly of EHR integration. Can they integrate? Yes. Will it cost you? Yes.
This is why the topic of EHR integration is going to be a real challenge when it comes to telehealth. As we’ve seen in our EHR Telehealth Series, every EHR vendor is getting involved in the telehealth space. While many have been generous with telehealth thanks to COVID, I think in the next 2 years we’re going to see most EHR vendors turn telehealth into a revenue center for their organization. Some may include it in their overarching update and licensing fee so that it’s largely invisible to their customers, but it will be there. This will pit EHR vendors in competition with third part telehealth vendors.
This certainly isn’t the first time that EHR vendors have competed with companies that are often their partners. Talk to the data center companies and the EHR consulting companies for some really simple examples. As competitors, it will be interesting to see how much EHR vendors allow a third party telehealth vendor to integrate with their EHR and PM. We’ve seen that this integration really is key to most healthcare organization’s telehealth efforts. A few small ambulatory clinics might be able to flintstone a telehealth solution that’s not integrated with their EHR, but most will want a deep EHR integration.
Here’s a look at the three areas we see Telehealth being integrated into EHR and PM software:
Practice Management (PM) Integration with Telehealth
Needless to say, healthcare organizations want a seamless and simple process for scheduling telehealth visits right in their practice management software. They don’t want to manage separate calendars. They don’t want their front desk staff to have to go into a separate system to invite the patient to the telehealth visit. They want one calendar for all the patient visits whether it’s in person or via telehealth.
This is the number one integration that every healthcare organization wants. If you don’t have it, it’s probably going to be a problem. As part of this integration, there generally needs to be some way to communicate to the patient where they need to go and what they need to do for their telehealth appointment. This integration is a tricky one since sometimes it’s done from the PM/EHR system and sometimes the EHR system pushes data to the telehealth system which notifies the patient the details of the visit. In other cases a third party messaging system is used for communication with the patient. Plus, this needs to take into account collecting the patient information and forms before the visit and how that will be integrated into the EHR.
EHR Documentation Integration
Unfortunately, I’ve seen very few telehealth solutions (even those from EHR vendors) that have integrated EHR documentation into their telehealth platform. In most cases, this is basically a 2nd screen type of experience for doctors. Some have integrated the patient feedback into the documentation and some allow for things like taking pictures that are inserted into the record, but otherwise we haven’t seen much documentation integrated between EHR and telehealth.
Back in April 2020, I suggested that telehealth vendors that integrated auto documentation using ambient clinical voice technology would be the big winners. The only announcement we’ve seen in this regard is Microsoft’s Epic EHR integration with Nuance’s DAX solution and Microsoft Teams. It’s still too early too know if they’ve cracked the nut, but we’ll be watching. Telehealth is the perfect opportunity to try ambient clinical voice documentation.
Medical Billing Integration
This integration has been one of the most interesting ones to watch. In many cases, telehealth vendors have chosen not to get in this space. They rely on the healthcare organization’s existing billing systems to be able to handle all of the insurance and patient billing. In some ways this makes a lot of sense. Why replicate systems?
That said, a few telehealth vendors have integrated their own payment systems into their telehealth platform. The thinking is that they have the patient’s attention and so they should take the opportunity to collect the patient portion of the telehealth visit. If you don’t, we all know how collecting from patients can be. Of course, to do this well, you need a good integration with the billing system to both know what to charge the patient and to record any patient payments that are made.
As telehealth finds its long term place in healthcare, it’s going to be really interesting to see what happens and what doesn’t happen with EHR integrations. My guess is that they’ll be all over the place. It’s unfortunate, but don’t be surprised if every EHR vendor and every telehealth company manages these integrations differently. Also, be sure to ask what costs are associated with these integrations. It’s easy for a salesperson to tell you that they integrate with your EHR and not share how much it will actually cost and in what ways they actually integrate. Don’t assume that it’s free and that it will integrate the way you think it should integrate. That’s a recipe for disappointment.