Telehealth: The Wild West

By Jim Tate, Chief Product Officer, MediVisum Telehealth Solutions
Twitter: @jimtate
Host of The Tate Chronicles – #TateDispatches

In the early days of EHR adoption providers found it almost impossible to decide which system to purchase. There were no standards regarding the functionality that should be included. It was the Wild West and without a consensus definition of what made up a “Complete EHR” providers were in a sea of confusion and disappointment. This was settled with the rise of the CCHIT and then ONC Certification programs that brought clarification and simplification to the process of EHR selection. At least we could compare apples to apples.

Now providers find themselves in a similar situation as they look for a “Complete Telehealth” solution. The COVID-19 pandemic created an immediate need for telehealth functionality and many providers grabbed the first tool they could find. Many of these applications were never built to support clinical workflows. Due to the federal government’s Emergency Declaration and subsequent relaxation of HIPAA requirements providers began to use applications that offered essentially no security for protected health information. Some of these products do not even have the capability to document the encounter much less generate a report.

In full disclosure let me reveal that I am involved in a telehealth company ( just as I have been involved in supplying support to over 300 health information technology vendors. My purpose today is not to promote any specific application but rather to raise the issue of standards around telehealth security and functionality. The need for a stand-alone vs. integrated solution depends on the specific use case and workflow but the underlying functionality is the same. Telehealth is here to stay, for general encounters as well as numerous niche use cases like home health, Annual Wellness Visits, Track and Trace, COVID-19 screening, and many more.

Beyond the narrow scope of telehealth let us not forget the related domains of Remote Patient Monitoring and Chronic Care Management. But let’s not put the cart before the horse. Below is my list of minimum requirements for a “Complete Telehealth” application that is both provider AND patient friendly.

Components of a Complete Telehealth System

  • HIPAA compliant – HITRUST certified – Fully encrypted
  • Real time audio/video
  • Web-based with no app to download or configure
  • Support of Apple/iOS, Android, and Windows device
  • Session tracking and audit logging
  • Scheduled and on-demand encounters
  • Automated patient reminders (SMS and email)
  • Ability to document patient consent
  • File transfer
  • Multi-lingual
  • Multiple participants in session
  • Custom Forms (Covid-19, Behavioral Health, Annual Wellness, etc.)
  • Clinical documentation tools
  • Screen image capture
  • Screen share
  • Encounter report

There are a few other items I would add on my own personal telehealth wish list such as patient risk scoring and practice analytics, but for now I’ll stick to what I have outlined so far in the list above. Let the buyer beware, it is the Wild West out there. Let’s create a consensus as to what providers need from telehealth technology now and going forward. Comments and suggestions for modifications to the list are welcomed and appreciated. Feel free to contact me at

Join me on Wednesday June 10th at 1 PM EST for a free webinar where we will be discussing telehealth topics and demonstrating a robust solution. Register for this event.

This article was originally published on Jim Tate’s LinkedIn and is republished here with permission.