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Telehealth challenges: Where does the data go?

There are an abundance of challenges of telehealth, but perhaps the most concerning to experts is not knowing where data resides and the lack of interoperability.

BOSTON -- One of the telehealth challenges facing physicians who do virtual visits with patients between healthcare facilities is how they document patient encounters and knowing where that documentation lives.

Wendy Cofran, CIO at the Natick VNA in Massachusetts, said at the mHealth + Telehealth World Congress conference that interoperability is the overriding challenge facing telehealth.

Joel Reich, interim chief medical officer at Commonwealth Care Alliance in Boston concurred: "It's just one more example of different parts of the health system working in different directions. It's going back to the comments on interoperability ... but also everyone's comments around where's the data going."

Examining telehealth challenges

Reich used the example of a $49 consult with a doctor somewhere through a telehealth provider.

"Where is that data going?" he said. "In most cases it's not certain it's going into your patient record. So are we really helping the health system along? Comprehensive care along?"

We're continuing to develop and disrupt in a silo.
Wendy CofranCIO, Natick VNA

While there's no denying that telehealth offers many benefits to patients, if telehealth continues to evolve in this way, the benefits will not be achieved because "we're continuing to develop and disrupt in a silo," Cofran said.

She added that, "telehealth will really give us a chance to give care where we need to give care. If we can't share that data to the providers ... then it's one more effort in a silo that isn't going anywhere and I think that's the biggest problem or hurdle that I see right now."

Cofran and Reich are not the only ones to speak out about how the lack of interoperability is affecting telehealth.

In a video interview with SearchHealthIT at the mHealth + Telehealth World Congress conference, Iris Berman, vice president of telehealth services at Northwell Health in Great Neck, N.Y., shared her firsthand experience with telehealth challenges, in particular, the lack of interoperability in telehealth.

She explained that at her facility there was a home care program that needed to get information from diabetic patients' glucose monitors. However, the glucose monitors the patients were using didn't work with the software that the information needed to get sent to.

In the video, David Pauer, director of wellness at the Cleveland Clinic Employee Health Plan in Ohio, said his healthcare organization has had a similar experience because they have had to use multiple different platforms for their multiple needs.

Vendors and providers are responsible

Cofran urges people within the healthcare and health IT community to keep applying pressure on vendors to make interoperability a priority and necessity when it comes to their technologies.

"We have to really start to push back on our vendors to say we need to be able to move that data," Cofran said. "It's just as important of a feature as it is for [a vendor's technology] to be able to tell me how much weight [a patient is] gaining."

Cofran added that interoperability needs to be "just as important as any other device in [a healthcare organization's] toolkit."

To the vendors, interoperability is a huge programming expense, Cofran explained. On top of that expense, vendors also need to pay attention to regulations, as well as maintain cybersecurity, she said. There is little motivation or incentive for vendors to work on these telehealth challenges.

Reich chimed in that providers are part of the problem too.

"People blame the EHR vendors for not being interoperable but ... as much of the fault is on all of us in provider groups, hospital systems who don't want anybody else poking around in their files," he said.

Cofran said that "the technology is already out there. Other industries are doing it. ... I don't think healthcare is paying attention."

Next Steps

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This was last published in October 2017

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