EHR Integration for Virtual Care: (Part 1) – Basic Lingo

Health Consulting

Many virtual care platforms claim to be EHR integrated.  But often, there are many versions of this truth.  As many provider groups are currently looking for telehealth solutions that are EHR integrated, we wanted to provide some clarity around the fundamental elements that define EHR integration.

First, keep in mind that integrating to a single EHR system requires a combination of business agreements and technical capabilities.  Both the owners of the EHR system, the EHR vendor and the connecting application must agree on what data is accessed, when, how and by whom.  This is a cumbersome business partnership process.  Repeating this process for the plethora of EHR solutions is not realistic.  As a result, it is important to ask “what EHRs are you currently integrated with?”…because a single virtual care platform certainly will not be integrated to all EHR systems.

Next, it’s important to understand the nature of the integration.  Not all integrations are created equal.  Basic levels of integration can simply be EHR data scrapes from the previous day that are sent to virtual care system.  This may be limiting to providers seeing more acute patients that need more frequent management.  The other option is real-time data access that allows access to data on either side as it is entered.  Terms like “future release” and “on our roadmap” are not guarantees and depending on the relationship with the EHR vendor, application providers may have limited data control.  References of other customers’ user experiences, who are similar in size and specialty, are important to review.

Last, the direction of the data flow from application to EHR system is another important factor defining the extent of EHR integration.  Here are the three types and how that may affect a physician’s workflow:

  • Uni-directional: Here data flows from application to the EHR as directed by the EHR vendor and must be verified by the EHR vendor before becoming part of the record.  This may cause delays in data access for providers needing data more quickly.

  • Bi-directional: Here data within the virtual care system and the EHR communicate in a way that allows providers to interact with a single system without the need for duplicating information entry.  This helps with faster diagnosing and lower prescribing errors.  However, this option is technically more cumbersome to maintain and may cost more.

  • API-Based: Here data flows similar to how a website works, with no permanent connections. It has the benefits of bi-directional data flow with easier sign-on and maintenance – which equals lower cost.  API-based solutions are new but are becoming more standard,  especially after the new data interoperability laws passed earlier this year.  But try to look for FHIR-based API solutions as they are becoming the standard in the healthcare industry.

The key to integration is to make the solution be as frictionless for the provider to use as it would be to see a typical patient in person. The richer the integration, the more likely the providers are going to use it.  At the same time, we should not let perfection prevent progress and start with a pragmatic approach to ensure that the solution will receive buy-in.

Our next blog will discuss EHR integration further by highlighting the top workflow areas where EHR integration is key. Stay tuned!

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