October 09, 2020 – Telehealth is increasingly becoming an option for remote patient care. But with clinician burden — most of which is caused by excessive health IT use — quickly mounting, clinical experts are looking for ways to streamline telehealth use into the clinician workflow. Telehealth and EHR integration could be the key for accomplishing this.
With EHR adoption at an all-time high, it’s optimal for clinicians to utilize telehealth solutions in the same workflow.
Ninety-six percent of non-federal acute care hospitals have possession of an EHR certified by the US Department of Health & Human Services (HHS), according to The Office of the National Coordinator for Health Information Technology (ONC).
Streamlining virtual care in an EHR system that is already coordinating care for patients, tracking progress, and storing patient data, makes virtual care easier for clinicians, while also conveniently boosting patient care.
Integrating telehealth into the EHR system can help providers improve clinical workflows. Most telehealth providers now design solutions that integrate into common EHR systems, which enhances patient care and increases interoperability.
When the platforms are intertwined, EHR systems and telehealth solutions can streamline patient care in one single workflow.
The ideal telehealth experience should be similar to a virtual visit in the office, not equivalent to FaceTiming with a family member.
“You want something that is embedded within the EHR system that’s not much different than checking in a patient as if they were showing up at the office,” Dillon Miller, MD, medical director of Blue Ridge Medical Group, said in an interview with EHRIntelligence.
With an integrated telehealth solution, it’s easy for the front office to get the patient checked in and for the nurse to interact with the patient, said Miller, who utilizes athenahealth’s integrated solution.
“It was more intuitive than when we were trying to utilize other video modalities such as Skype, Zoom, or FaceTime, which are really not designed to be utilized in a clinic space. When we started using this solution, it made our day much easier than before.”
Both providers and patients benefit significantly from EHR telehealth integration.
Integrating a telehealth platform into the EHR and patient portal reduces clinician burden and eases documentation. And when patients have easy access to telehealth, it can reduce travel for patients and enhance patient flexibility.
“It’s opened up a great opportunity to be more consumer centric, to understand the kind of inconvenience and difficulty that even coming to the clinic sometimes brings to families,” David West, MD, medical director of health informatics at Nemours Children’s Health System, said in an interview with EHRIntelligence.
An integrated solution does not require multiple clicks to bounce between documentation and video screens. This decreases cognitive workflow and reduces clinician burden.
“If you can deliver the value that’s necessary for that child’s care without necessarily making them disrupt or having them disrupt their lives less, that is a good outcome and certainly creates better engagement with patients and physicians,” continued West.
“It means more when the physician says, ‘You really do need to come in’ there’s now more significance to that statement about what type of data one has to gather to appropriately care for that child.”
Furthermore, EHR integration automates data entry, and it eliminates the need to enter the same patient information more than once. After the telehealth visit is over, the clinician creates a summary of the visit. Without integration, the clinician must enter the same information into the EHR and via the disparate telehealth platform.
The patient can also schedule a future appointment with a front desk employee by staying on the video chat after completing the visit.
“It’s much more like a traditional clinic experience except they’re doing it from their couch, home, or work,” said Miller.
Although telehealth use became more prevalent in 2020 due to coronavirus, telehealth integration is not a recent development.
Epic integrated telehealth into its patient portal in August 2019. The 2019 collaboration with Amwell — known at the time as American Well — added to Epic’s past efforts to support client telehealth services. In January 2018, the company also partnered with Zoom to integrate a cloud-based telehealth video service.
Before Epic, Cerner partnered with Amwell in late 2016 to integrate telehealth into its patient portal, HealtheLife. Once COVID-19 hit, Cerner offered expanded telehealth capabilities for its users to help lessen the spread of the virus. The company utilized its already existing Cerner Patient Observer (CPO) solution for face-to-face communication between the provider and patient while limiting exposure to the virus.
As a response to COVID-19, athenahealth integrated a new telehealth solution, athenaTelehealth, into its EHR system. The solution allows for enhanced telehealth visits on a single platform. It also permits the user to move through multiple workflows, such as scheduling, video conferencing, patient messaging, EHR documentation, and billing.
In 2017, Allscripts partnered with Vidyo.io to integrate its telehealth platform into the Allscripts patient portal. The integration increased accessibility and communication between Allscripts users and patients. Due to COVID-19, Allscripts developed a virtual triage tool to screen patients from their respective homes.
In 2017, MEDITECH announced telehealth integration into its patient portal, called Virtual Visits. In 2020, MEDITECH offered a complimentary six-month period of its Scheduled Virtual Visits software to its customers. The vendor also enabled Virtual Visits across all of its platforms to ensure telehealth to its customers.
For telehealth optimization to continue to grow providers need to adapt and have a willingness to learn the new technology — just like clinicians did for EHR systems.
“When we started implementing electronic health record systems, there were physicians that didn’t feel like they were comfortable utilizing the computer to interact with patients and they felt that paper charts were a better option,” Miller, the doctor from Blue Ridge Medical, said.
“Over time, physicians realized EHRs are a helpful tool in the office and we’ll find that telehealth has a similar impact that will become a standard of care for us. Patients will schedule with specific doctor’s offices that have the telehealth option.”