Telehealth Integration in EHR to Assist Over-burdened Providers

Background

The United States Department of Health and Human Services announced unprecedented steps to expand Americans’ access to telehealth services during the COVID-19 outbreak including –

• Expanded Medicare coverage for telehealth visits
• Waiver of potential HIPAA penalties for good faith use of telehealth during the emergency
• Reduction or waivers for telehealth visits paid by federal healthcare programs

A US-based workgroup of the COVID-19 Healthcare Coalition conducted a Telehealth Impact Study of roughly 1,600 healthcare providers

Over 95% of U.S. hospitals use a certified EHR platform, and the benefits of implementing this technology include better continuity of care, simplified data collection, lowered overheads, and reduced mortality rates for the chronically ill, all while maintaining the highest standards of security and privacy. The high-pressure environment brought upon by the pandemic called for a solution that would ease the burden on providers, not require additional efforts of adoption, and met the mandated requirements.

Thus, integrating the EHR system with a telehealth platform was the best way to help organizations make the most of this technology, which could drastically improve clinical workflows.

Problem Statement

The pandemic outbreak mandated distancing between providers and their patients who switched to organized/unorganized telehealth solutions. It resulted in complications for providers who had to shuffle between multiple tools to drive their consultations. It also raised serious concerns about the quality of care delivery and patient safety.

From the providers’ side, the challenges were manifold. These makeshift video conferencing tools were not designed to serve the needs such as –

• Communicating with patients who don’t speak the same language
• The additional workload of entering the same patient information more than once
• Toggling back and forth with the EHR to access patient information while on the call
• Coordinating with the patient separately for further consultations

By integrating telehealth into the EHR, the goal was to merge aspects of patient care – safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity into a single, robust technology.

Building a solution that –

• Worked with their existing EHR
• Simplified documentation between appointments
• Included pre-appointment responses from the patient to help providers prep in advance
• Aided multilingual communication
• Helped providers make the most of the window between appointments
• Triggered follow-up steps required post-consultation

UX Strategy

The Minimum Viable Product (MVP) strategy is a design approach that’s used to create a viable, basic solution in a short span. It is an iterative process based on constant user feedback and remains user-focused throughout. It aims to tackle problems or address needs in unique ways. It is an opportunity to set a benchmark in the industry. Here’s how the MVP process panned out for this project – 

Process

User Journey

1. Pre-consultation phase
   The provider receives a notification for the upcoming appointment well in time along with the patient’s details. This helps in reviewing the details beforehand and lets the provider be prepared for the consultation.
2. Active consultation phase
   The provision to run translations and transcriptions of the conversation in real-time is very helpful as the provider can concentrate on the conversation and not be distracted. Plus, the AI assistant proffers relevant reports so that the provider does not have to pause the conversation to do it.
3. Post-consultation phase
   The summary and video recording of the consultation are made available for the provider to review, if required. This ensures that the provider does not have to recall details of the call later which helps reduce documentation errors.

Ideation & Design – Key highlights