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The EHR and telehealth: A bright future

The electronic health record (EHR) is the primary workflow hub for nearly every clinician, and it is a central part of their daily routine.

EHRs store medical information and create a comprehensive patient history that can be easily shared by all providers involved in a patient’s care. It is clear that EHRs improve patient safety and overall quality of care by tracking health information over time, reduce the likelihood of medication errors and harmful drug interactions, eliminate duplicate testing, enable faster and more accurate diagnoses, and improve treatment plans. EHRs also help clinicians identify patients who are due for preventive visits or screenings, identify and manage high risk patients, and measure how patients compare against certain quality benchmarks. While it is a topic of heated debate, many believe that EHRs have made the practice of medicine more efficient by reducing some paperwork and automating some workflows [1].

According to Avizia’s 2016 research report, “Closing the Telehealth Gap” 72 percent of hospitals indicate that they are using telehealth. However, the vast majority of those respondents are not offering telehealth services through their EHR, but delivering them via a separate application or solution. This is not unusual, since telehealth is a rapidly evolving modality of care that has only recently become mainstream, and EHR vendors are known for being “fast followers”, not “first movers” when it comes to innovation.

Today, most EHRs and telehealth systems integrate data, transporting patient demographic, financial, medical and visit information back and forth between systems using protocols like HL7. Unfortunately, most EHR and telehealth platforms maintain unique dialects of the HL7 language, so it takes armies of expensive programmers to build and maintain those data “handshakes” between the systems. Even when these linkages exist, providers and patients are often asked to enter duplicate information in both systems, which slows down the process of care, creates inefficiency, introduces the possibility of data entry error, and creates confusion around what is the true source of data on a patient. For example, during a virtual visit, a patient may forget to add a medication to their list, or type in the wrong dosage.  Or the clinician may need to simultaneously open up the EHR to review a patient’s medication history or lab results. After a patient visit, a clinician may need to document the encounter twice — once in the telehealth platform so it can be seen by the patient, and again in the EHR so it can be part of the longitudinal medical record.

These redundancies and inefficiencies create a fragmented experience for both providers and patients, and are often cited as reasons why they are hesitant to adopt these new technologies. In fact, in Avizia’s research report, hospital executives cited clinician resistance as the main barrier to telehealth adoption.

Moving telehealth toward the future

Today, Avizia is streamlining the process for securely exchanging information between our telehealth solution and every EHR in the marketplace.  Through strategic integration partnerships with companies like Redox Healthcare, Kno2, LifeIMAGE and Ambra Health, Avizia is redefining how systems talk to each other, reducing the time to implementation from months to weeks, and in some cases to days.  We support every data integration type (including FHIR) with every EHR in the market place. As a result of these partnerships, critical data flows more freely between the systems, so providers and patients don’t need to re-enter data, saving valuable time and reducing the risk of data entry errors. 

The future of EHRs and telehealth starts now

With telehealth on the cusp of becoming commonplace, providers today unfortunately must still live in two systems when delivering virtual care. With so many health systems beginning to embrace virtual care, it is increasingly important for the delivery of telehealth services to be deeply integrated into EHRs.

Avizia is committed to improving the way EHRs and related clinical systems integrate together to improve the telehealth clinical workflow.  For those of you old enough (or wise enough!) to remember Intel’s famous “Intel Inside” branding strategy of the 1990s, Avizia is on a mission to become the “Avizia Inside” platform solution for EHR-based telehealth. Our vision is a bold yet humble one; to be the biggest and best telehealth company on the planet.  We are presently working with a handful of mutual customers and select major EHR companies to set the new standard for seamless telehealth workflow integration.

With an established reputation as a “first mover” and innovator in the telehealth industry, today Avizia powers the telehealth programs of eight of the top ten integrated delivery networks in the US, and our software, secure mobile applications, and hardware are used by over 400 clients in 36 countries around the globe.  In Avizia, EHR companies will find a strong partner leveraging robust API libraries, software development kits (SDKs) and integration “gateways” to quickly deliver cutting edge virtual health solutions to their customers.  The resulting partnership will streamline the process of delivering virtual care, and improve the experience for both patients and providers.

Whether they are performing a peer-to-peer specialty consultation or an unscheduled consumer-based virtual visit, clinicians won’t need to operate in multiple systems.  They will have immediate access to a comprehensive view of a patient’s medical history, leading to faster, more accurate diagnoses and treatment plans – which will ultimately lower the cost of care and drive better patient outcomes. They will see the telehealth appointment on their daily calendar or receive an alert on their mobile device for an urgent consult request; they can review the patient’s chart and launch the visit all from within their EHR. Once the visit is complete, the provider can document their findings in the EHR and bill through the EHR’s revenue cycle management modules.

Patients will have the convenience of a virtual visit, and an experience that highlights the best characteristics of an in-person or “brick-and-mortar” office visit (e.g. face to face time with your provider) while removing all the worst characteristics of those dreaded visits (e.g. missing work or school, dealing with traffic, expensive parking, long waits in the waiting room sitting beside another sick patient). Patients can seamlessly access the Avizia platform via their health system’s own portal, schedule future virtual visits or conduct an urgent visit, upload pertinent information and update their health data as needed.  They can pay their copay online, and the Avizia solution analyzes their internet connectivity strength and their camera and audio sources to ensure they are working properly. Once the virtual visit is complete, their visit notes and care instructions are available for download, and their prescriptions are sent automatically to their chosen pharmacy. 

With the Avizia-enabled, EHR integrated platform, detailed operational data is collected on every telehealth visit. By combining this operational data with other demographic, clinical, financial, and contractual data sources, Avizia’s robust data analytics platform will give executives, telehealth program managers and clinical teams tremendous insights into program performance.  These insights support a variety of clinical performance and quality improvement initiatives, patient and provider satisfaction initiatives, program marketing and promotional efforts, return on investment (ROI) analyses, business development activities, and payer contract negotiations.

Take your first step

As you evaluate and select a telehealth platform, assess whether your telehealth solution partner understands what it takes to ensure program success.  Do they offer just technology, or do they support the change management approach that is necessary to deliver a successful telehealth program? Be sure they can support an enterprise approach across multiple specialties and locations of care (e.g. ED, NICU, Post Acute Care, Clinic, Home) and can scale up as your clinical and business needs evolve. And be sure they don’t require you to “rip and replace” systems, but maximize any investments you’ve already made in your enterprise systems, whether that be your EHR or your videoconferencing platform. And finally, work with a telehealth solution partner who is committed to rolling up their sleeves and working alongside your various internal teams and your EHR vendor to deliver a solution that both your providers and your patients will be excited to use every day.