From what I’ve read, many providers would like to deliver telemedicine consults through their EMR platform. This makes sense, as doing so would probably include the ability to document such visits in the same way as face-to-face encounters. It would also make it far easier to merge notes from telehealth visits into existing records of traditional care.
Unfortunately, there’s little reason to believe that this will be possible anytime soon. If nothing else, vendors won’t face too much pressure from providers until the health insurers routinely pay for such care. Or one could argue that until providers are living on value-based care models, they have little incentive to aggressively push care to lower-cost channels like telemedicine. Either way, EMR vendors aren’t likely to focus on this issue in the near term.
But I’d argue that providers have strong reasons to add EMR support to their telemedicine efforts. If they don’t take the bull by the horns now, and train patients to see video visits as legitimate and worthwhile, they are unlikely to leverage telehealth fully when it becomes central to the delivery of care. And that means, in part, that providers must document video consults and integrate that data into their EMR anyway they can. After all, patients are already beginning to understand that it data doesn’t appear in their electronic record, it probably isn’t important to their health.
It seems to me that the lagging EMR support for telemedicine visits springs in part from how they grew up. Just the other day, I had a video visit with a primary care doc working for one of the major direct-to-consumer telehealth services. And his comments gave me some insight into how this issue has evolved.
As sometimes happens, I ended up straying from discussion of my health needs to comment on HIT issues with the visit, notably to complain about the fact that I had to reenter my long list of daily meds every time I sought help from that service. He agreed that it was a problem, but also pointed out that the service’s founders have assumed that their users would almost exclusively be seeking one-off urgent care. In fact, he noted, none of the data collected during the visit is formatted in a way that can be digested easily by an EMR, another result of the assumption that clients would not need a longitudinal record of their telemedical care.
Admittedly, this service is in a different business than hospital or ambulatory care providers with a substantial brick-and-mortar presence. But my guess is that the assumptions upon which the direct-to-consumer businesses were founded are still shared by some traditional providers.
As a patient, I urge providers to give serious thought to better documenting telehealth today, rather than waiting for the vendors to get their act together on that front. If your clinicians are managing relationships by a video visits today, they will be soon. And when that happens I want a coherent record of my digital care to be available. Letting all that data fall through the cracks just doesn’t make sense.