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A new telemedicine system adds potential duplication to existing systems in the clinic: 

  • Patients may have a virtual visit scheduled in the telemedicine system and an in-person visit scheduled in the regular system. 
  • Patients pay through the telemedicine system, and their payments must be reconciled with the regular payment system. 
  • Patient demographics are stored in both the telemedicine system and EMR. If a patient updates their demographics in the telemedicine system, it must be synchronized with EMR. 
  • Patient allergies, medications, medical histories, and preferred pharmacies are stored in multiple systems. 
  • A provider could electronically send prescriptions from the telemedicine system or their existing e-prescribe solution. 

After the patient completes a store-and-forward telemedicine visit, a summary of their encounter and updated medications must be uploaded to the EMR so that the continuity of care requirement is met. 

Although there are quite a few items and workflows as listed above that could potentially be duplicated, there is a solution here. The solution is to fully electronically integrate the telemedicine software with the clinic’s existing systems. By using HL7, FHIR, APIs, and other methods, a fully integrated telemedicine application will keep itself in sync with the clinic’s existing systems. This includes things like pulling in patient demographics when needed, updating patient encounter notes and medications, updating billing, posting virtual follow up appointments in the scheduling system, etc. Hence, when the telemedicine solution is fully integrated into the clinic’s workflows and systems, many friction points can be eliminated. 

Transitioning from an in-person-only private practice to a hybrid practice that also accepts telemedicine patients requires changes in work processes and technology. Oftentimes existing systems must be evaluated to see whether they fit with this new way of doing business. It may be that some existing systems, such as patient portal messaging or billing, do not fit into the new organizational workflow. In that case, these systems must either be upgraded/modified, replaced with another system, or, when functionality is already accomplished by other systems, eliminated.