Becker's Hospital Review

11 Executive Briefing American Well uses telehealth to improve people's access to quality care. Through our partnerships with the nation's largest health systems, insurers, employers, and retailers, and our award-winning telehealth Exchan- geTM, we connect millions of Americans to the doctors they trust for live video visits. Through the power of telehealth, we help patients get the care they need in a timely fashion, and help doctors be there for their patients. We build technologies to make healthcare go where people need it most. For more on how we are changing healthcare delivery through telehealth, visit AmericanWell.com. American Well and the Exchange are registered trademarks or trademarks of American Well Corporation in the United States and other countries. All other trademarks used herein are the property of their respective owners. brokerage engine for managing supply and demand, eligibility and claims integration and the ability to connect providers with other providers for consults. Enhancing the provider workflow Physician adoption of telehealth is one of the keys to successful telehealth for any health system. Health systems need provider champions on board to spread the word to other physicians and make the experience as positive as possible for providers. To encourage physician adoption of telehealth, Nemours wanted to streamline the telehealth provider workflow; one way to do that was through EHR integration. Since integrating our Epic system with CareConnect, Nemours has seen an increase in physician adoption of telehealth. Below is an example of how seamless the provider workflow is with integration in place: An integrated telehealth experience allows the physician to practice solely within the telehealth platform. Once logged in to the platform, the physician can see incoming patient requests and patients in the virtual waiting room. Before the video portion of the visit, the physician can view the patient's medical record, which has been pulled into the platform from the EHR. During the visit, the physician documents directly within the telehealth platform, and once the visit is complete, a visit summary is sent from the telehealth platform to the EHR. Both systems communicate with one another through a bidirectional integration workflow, and the physician only needs to work within one platform. Delivering better care With the physician workflow streamlined, doctors can provide their patients with more complete, effective care. Physicians have the patient's medical record right within the platform they're treating the patient on, allowing them to spend more time talking to and treating the patient. Patients typically don't notice a difference in their telehealth visit until the end of the visit, when they can access and view the telehealth visit summary within their patient portal. Without integration, the patient could only view the telehealth visit summary within the telehealth platform, separate from the rest of their medical history. Integrating our Epic system with Nemours CareConnect has also helped improve how primary care is organized and delivered to the patient's medical home. Many of Nemours' telehealth visits in the five states we serve — Florida, Delaware, Pennsylvania, Maryland and New Jersey — occur outside the patient's medical home for either research, specialty care or urgent care. Nemours CareConnect offers an integrated approach where our visit details and results are shared electronically with the patient's primary care physician and their Pediatric Medical home. Improving data collection From a reporting and analytics perspective, anything that is documented outside a health system's EHR system is difficult to track. This is especially true for reporting and billing reconciliations for all commercial payers as well as Medicare and Medicaid. If the telehealth encounter is integrated within the EHR, this facilitates data collection and billing for the health system. This also becomes more important when use cases expand beyond urgent care to conditions that require better continuity of care, as ours have. Being able to collect data within the EHR for long-term telehealth outcomes will make payment and billing easier for healthcare organizations, payers and providers. Nemours has expanded telehealth to pediatric obesity treatment, asthma management and clinical trials. Managing patient information within the EHR is critical for proper treatment with these clinical applications. Strategies for implementation Nemours decided to launch telehealth first and implement the EHR integration later. This approach gave us time to learn about our telehealth platform — what was working and what wasn't working — and develop a more robust telehealth strategy. It also allowed us time to market internally and gain physician buy-in within our health system. Outside of the technical decision-making process, there are other considerations that come into play in order to get a telehealth program off the ground — areas like marketing, naming the service and configuring the platform workflow. Making the foundational decisions first before moving into the integration process will put your health system in a better position to meet the overall goals set for your telehealth service. Keeping goals in mind: telehealth for improved care delivery At Nemours, we found that implementing telehealth is an intricate process with a lot of moving parts. For your implementation to be successful, you should make a commitment to making it part of the way you deliver care — and EHR integration should be a key part of your roadmap to long-term telehealth success. n

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