A comprehensive guide to Telemedicine software
Introduction
Telemedicine has finally gone mainstream. The pandemic was the tipping point and served to accelerate the adoption of telemedicine across the industry. Given the unique circumstances brought on by the pandemic most healthcare organisations were forced to adopt ad-hoc telemedicine solutions overnight with many resorting to using Zoom and Skype. Telemedicine adoption skyrocketed and Epic estimated that visits jumped from 1% to 69%.
And telemedicine also proved to be highly effective. There are various studies which underscore the effectiveness of telehealth services
- One study on followup visits “Patient and clinician experiences with telehealth for patient follow-up care”, noted that a majority of clinicians reported that no change in the overall quality of the visit and the majority of patients preferred the convenience of Virtual Video Visits over office visits.
- Another study of Press Ganey patient satisfaction survey outcomes from video and in-person encounters at a single-institution concluded that 'Patient satisfaction with video visits is high and is not a barrier toward a paradigm shift away from traditional in-person clinic visits'
Post pandemic it is clear that telemedicine adoption is expected to grow rapidly. Patients love the convenience and the fact that it gives them more control over their time and helps them control costs. For providers, the right telemedicine platform can help increase revenues, improve efficiency and improve patient satisfaction.
A combination of user-friendly telemedicine software solutions, availability of high speed data networks and the availability of health devices, mean that telemedicine is set to play a transformative role in redefining healthcare delivery in the coming decade. Telemedicine software applications have also opened the door for the development of new models of healthcare and now the healthcare industry stands to benefit from innovation that has been unleashed.
What is a telemedicine platform?
Telemedicine is the delivery of healthcare services over a distance using telecommunication technology. From its humble beginnings in the 1950’s telemedicine has evolved rapidly to a point where providers can now effectively treat patients online for a wide range of health conditions and scenarios.
A telemedicine platform is a software solution that brings together all the necessary technology which allows healthcare providers to remotely evaluate, diagnose and treat patients.
A telemedicine platform is a software solution that brings together all the necessary technology which allows healthcare providers to remotely evaluate, diagnose and treat patients. Note that white telehealth is actually broader in scope compared to telemedicine, both telehealth and telemedicine are typically used interchangeably. Hence telehealth software or telehealth platform typically refer to a telemedicine software platform.
While interactive video consultations are currently the most common form of telemedicine, telemedicine technology platforms are typically broader in scope. They typically cover all aspects of patient online consultations and also act as the digital front-door for your healthcare organisation.
Features of a typical telemedicine platform
Digital Front Door
- Patient Registration and Onboarding
- Appointments
- Patient Records and Health Data
- Notifications and Engagement
- Online Payments
Telemedicine and Engagement
- Video Consultations
- Remote Patient Monitoring
- Text Consultations
- Health Device Integrations
Business Operations
- Reports
- Workflows
- Integrations
- Security
What are the benefits of a telemedicine software platform?
As the shift of healthcare services from offline to virtual gathers pace, patients, providers and healthcare organisations stand to reap the benefits.
Telemedicine Software Benefits For Hospitals and Businesses
New healthcare services
Telemedicine is more than interactive video calls. With the right telemedicine software platform, healthcare organisations can create new service offerings that involve asynchronous telemedicine models like text consultations and remote patient monitoring. Many hospitals and healthcare startups are launching these services today, reaping the benefits while future proofing their business.
Generate Subscription Revenues
Digital care plans with subscription billing can open up subscription billing and create a recurring payment stream which offer a significantly higher ROI than in-person visits
Increase revenues
With the right telemedicine software, hospitals, clinics and healthcare startups will be able to implement multi-modal care, blending offline and online visits. Thereby they can increase the number of patient consultations and revenues.
Reduced overhead
Online visits also help reduce office overheads and the best telemedicine platforms typically provide extensive digital front door capabilities that can help improve efficiency with better workflows.
Better healthcare outcomes
With more frequent patient engagement, telemedicine software solutions help drive significant improvement in healthcare outcomes, value based care metrics and patient satisfaction levels.
Compete better
Traditional healthcare businesses like hospitals and clinics and small/medium healthcare startups/services are now facing off against venture funded health startups that burn through large piles of cash to acquire patients. A well developed telemedicine web and mobile platform can help level the playing field, allowing the incumbents to provide the same services without having to compromise on their margins.
Telemedicine Software Benefits For Doctors
Better work life balance
Telemedicine helps healthcare providers achieve a better level of work life balance. The fact that they can effectively evaluate and treat patients remotely, gives them the confidence to unchain themselves from the hospital. Providers get better control over their schedules and can possibly adjust their online consultations in accordance to their availability. Additionally telemedicine software for doctors that provides asynchronous telemedicine capabilities can be extremely beneficial in allowing them to provide the necessary care to patients without the need for real time consultations.
Better insight into patients lives
Online visits allow providers to gain a better understanding of the patient's home environment and these insights can help in more effective treatment.
Telemedicine Software Benefits For Patients
Better accessibility
The ‘tele’ part of telemedicine has truly been a game changer in healthcare. It has opened up a world of care options to patients wherever they are.
Access to specialists
For patients with serious conditions, physically travelling to meet a specialist might not be a viable option. Telemedicine helps these patients get the care they need at the right time.
Convenience
A visit to the doctor would typically require a change in the patients daily routine. Work schedules, caregiver routines or other activities are disrupted to make the time for the visit. Virtual telemedicine visits help minimise this disruption and patients love the convenience.
Reduce costs
A visit to the doctor involves costs - transportation and associated costs. Telemedicine visits done from the comfort of the patients home help eliminate these.
A digital door of convenience
Some telemedicine applications handle a range of digital front door use cases. This provides patients with a single online entry point for everything related to their health and helps simplify their interactions.
Care Plans
The top telemedicine software solutions will provide options for care plans that are tailor made for wellness and preventive care packages, post surgery and chronic care patients. The frequent patient engagement translates into better healthcare outcomes.
Types of Telemedicine Software
There are different types of telemedicine software depending on the intended use case. Telemedicine software can typically be categorised as Synchronous Telemedicine Software, Asynchronous Telemedicine Software and Remote Patient Monitoring Software. Each of these types of telehealth software is suited for specific cases and workflows.
The best telemedicine software platforms usually support Synchronous Telemedicine (Video Consultations), Asynchronous Telemedicine (Text Consultations) and Remote Patient Monitoring, allowing you to choose the best solution for your specific use case.
Synchronous Telemedicine Software
Synchronous Telemedicine Software enables services that happen in real-time with live interactions between the patients and providers via audio and video. Video consultation based telehealth services that gained widespread adoption during the pandemic fall into this category. Real time telemedicine services help maintain the patient-provider relationship and allow the provider to interact face-to-face with patients for the evaluation, diagnosis and treatment of healthcare conditions.
Video consultation services can typically have different workflows:
Appointment Based Video Calls
Video telehealth consultations that are based on pre-booked appointments.
Instant Video Calls
Virtual waiting room based flows, where patients check into a waiting room and are admitted by the provider
Assisted Video Calls
These are telehealth video consultations which are ideal for situations where a care provider is assisting the patient for a call with a remote provider. This might be for video calls done from kiosks or from calls initiated during home visits.
Asynchronous Telemedicine Software
Asynchronous telemedicine software enables store and forward telemedicine services. As the name indicates, asynchronous telemedicine services do not involve a live interaction between patients and providers. There are two common scenarios for asynchronous telemedicine
Patient information is exchanged between providers
one of whom is typically a specialist. This information might include medical imaging and video, reports and health records which then allow the specialist to evaluate the case as per their availability and provide a diagnosis or opinion. Store and forward telemedicine software solutions are ideal for certain specialities like dermatology, ophthalmology and radiology.
Patient-Provider Text Consultations
Store and forward type text consultations between patients and providers are the other common form of asynchronous telemedicine. Text consultations between patients and healthcare providers work well for various specialities and certain patient demographics. They are also ideal for situations where patients are bandwidth restricted and real-time video calls might not be viable. Additionally patients might also prefer text consultations over interactive consultations for privacy reasons.
RPM Telemedicine Software
Remote Patient Monitoring is a type of telemedicine, where patient vitals and other health indicators are tracked remotely using health devices and providers use these inputs to evaluate and treat the patients. Remote Patient Monitoring or RPM software, is ideally suited for Chronic Care Management and is popularly employed for health conditions like Diabetes, COPD, Some of the typical health conditions include diabetes, COPD, asthma, hypertension and cardiology related scenarios like weight and obesity tracking.
Components of a Telemedicine Platform
A telemedicine platform typically involves a number of components that work together to facilitate consultations between patients and providers.
Server Applications
While telemedicine is best experienced on desktops, the convenience factor typically means that most patient telemedicine sessions happen from mobile devices. iOS and Android platforms currently account for almost all the mobile devices in the market and telemedicine consultations work equally well both via web browsers or native iOS and Android applications. Native telehealth mobile apps can sometimes provide a better user experience, but that advantage is being rapidly eliminated by PWA technology. However many telemedicine software companies still provide native mobile apps alongside their telemedicine web applications.
Mobile Telemedicine Apps
While telemedicine is best experienced on desktops, the convenience factor typically means that most patient telemedicine sessions happen from mobile devices. iOS and Android platforms currently account for almost all the mobile devices in the market and telemedicine consultations work equally well both via web browsers or native iOS and Android applications. Native telehealth mobile apps can sometimes provide a better user experience, but that advantage is being rapidly eliminated by PWA technology. However many telemedicine software companies still provide native mobile apps alongside their telemedicine web applications.
Cloud Infrastructure
Telemedicine software typically requires patients and providers to communicate over secure public networks and hence most telemedicine web and mobile applications are cloud based solutions. Cloud based telemedicine software typically rely on popular cloud vendors like AWS, Azure and Google Cloud and are able to scale better and take advantage of the range of pre-build services provided by these vendors.
Real Time Technologies
WebRTC which stands for Web Real-Time Communication is one of the key enabling technologies for telemedicine software applications. WebRTC, originally a project open-sourced by Google, is a technology that allows web browsers and mobile applications to communicate in real-time. All modern browsers now support WebRTC and there are many companies who provide WebRTC based solutions that underpin the services provided by telemedicine software vendors. Additionally most modern telehealth applications use Web Socket technology to provide real-time application functionality.
Health Devices
If the telemedicine software vendor provides remote monitoring capabilities then the telehealth web or mobile applications will typically integrate with one or more health devices. These health devices sometimes work via Bluetooth technology and communicate their readings to the telemedicine platforms mobile app or the devices companion mobile app which in turn syncs with the cloud based server. Some devices include wireless capabilities and directly sync their data to the device vendors cloud.
External Services
Telemedicine applications would typically rely on one or more external services for functionality like SMS, push notifications, email services and webRTC. Additionally they might leverage multiple external services for various parts of their service.
Features of a telemedicine platform
What are the features of a standard telemedicine platform? This section will give you a comprehensive list of features and make it possible for you to do a comparison of telemedicine platforms before choosing one.
Patient Portal
is a web application where your patients can login and securely engage with you for their telemedicine consultations. A patient portal would typically give you the following capabilities:
A Patient Portal is a web application where your patients can login and securely engage with you for their telemedicine consultations. A patient portal would typically give you the following capabilities:
Registration and Login
Patients can register/login for the telehealth services you offer.
Provider Search
Provider listing, profiles and search features that allow patients to find the provider they want to consult with.
Booking Services
Depending on the capabilities of the telemedicine software, the patients will be able to book video consultations, subscribe to care plans or initiate a text consultation
Health Records
Provide access to patient health records.
Access Prescriptions and Lab Orders
Patients should be able to view and download their e-prescriptions and lab orders.
Manage family accounts
Patients can manage associated family accounts.
Patient portals are typically an extension of your website and plugging it in should be straightforward. However if you already have a website, then the telemedicine patient portal would need to be integrated in.
Video Consultations
While Video Consultations are generally just one of the types of telemedicine, they are certainly the most popular. Here are some of the video consultation specific features that should be expected in a top telemedicine software solution:
Support for appointment workflows
Most healthcare businesses follow an appointment based workflow and hence support for video consultation appointments is a key feature. Appointments can be reserved based on a combination of their chosen provider, a specific service that is offered by the provider, a specific time-slot based on the provider calendar and other factors.
Instant Video Calls
Instant video calls are video consultations done without an appointment and might be an ideal situation for integration into an existing solution. They are also convenient for on-demand services or video consultation services that are targeting an elderly patient audience.
Video controls
Basic controls like pause the call, mute the audio, toggle the video, screen share.
Support for multi-user calls
Besides patients and providers, family members, care givers, translators might also need to participate in a telemedicine session.
Notifications and Reminders
Notifications/reminders are key to maximising user engagement and avoiding no-shows.
Intelligent network capabilities
The ability to automatically adjust to low bandwidth environments toggling between video/audio modes.
Text Consultations
Asynchronous consultations that facilitate patient-provider engagement can be an important revenue generating option. Asynchronous Text Consultations can work better than video consultations especially in low bandwidth environments or for use cases where patient privacy is a determining factor. Some of the relevant features to expect in a telemedicine software include support for file uploads, flexible follow-up configurations and ability to set patient expectations.
Patient Records
The patient record obviously sits at the centre of a telemedicine consultation. Some telemedicine software solutions restrict themselves just to providing the video consultation feature and expect customers to use the software in conjunction with the existing EMRs. However most telemedicine software solutions would typically include a comprehensive patient record module and provide options for integration with existing EMRs
Remote Patient Monitoring (RPM) and Care Plans
Remote Patient Monitoring is a type of telemedicine that is currently seeing rapid adoption across the healthcare industry. Some of the top well-rounded telemedicine software applications would cater to the multiple telemedicine types including Remote Patient Monitoring.RPM Telemedicine software will typically include:
Care Plans and Care Teams
RPM Telemedicine software should allow the creation of flexible care plans for various healthcare conditions. The care plans should integrate with health trackers relevant to the healthcare conditions and allow for management by multidisciplinary care teams. The care plans would typically integrate with subscription systems to handle the patient payments.
Healthcare Device Integrations
Telemedicine apps with RPM support will integrate with healthcare devices that are relevant to the care plans, thereby allowing patients to automatically sync their data to the server.
Patient Engagement
RPM software would provide for automated patient engagement in the form of plan adherence, data entry notifications and reminders.
Support for Family Accounts
In the real-world it is common for a single family member to manage the accounts for one or more family members, especially elderly parents and young children. Support for family accounts would therefore be an important feature for telemedicine software applications.
Prescriptions and Lab Orders
During a telemedicine consultation, providers would generate e-prescriptions or lab orders that need to be shared with the patient. Telemedicine software solutions should facilitate:
Creation of e-prescriptions and lab orders
The application should allow the creation of prescriptions or lab orders branded with all the relevant information of the healthcare organisation.
Easy access
Patients should be able to access and download these documents as PDFs via the patient portal or patient mobile app
Integration with databases
The telemedicine software should provide for integration with databases of frequently prescription medications or lab order items, to ensure that providers do not have to enter everything from scratch.
Patient Encounter Notes
Documenting the patient encounter, capturing symptoms, observations, assessments, treatment plans, adding prescriptions, lab orders, appointments and goals are a basic feature expected in telemedicine software applications. Some telemedicine web platforms however restrict themselves only to the video calling with providers expected to use their existing EMRs to document the encounters.
Telemedicine Scheduling Software
Most healthcare organisations choose an appointment based workflow for their telemedicine consultations. Therefore telemedicine appointment scheduling capabilities are a key requirement for telemedicine platforms. Some of the important features include:
Real Time Scheduling
Self scheduling of appointments by patients allowing them to book, cancel and reschedule appointments without any intervention helps reduce overhead costs and increases patient satisfaction and convenience.
Online Telemedicine Appointment Scheduling
Self scheduling of appointments by patients allowing them to book, cancel and reschedule appointments without any intervention helps reduce overhead costs and increases patient satisfaction and convenience.
Appointment Management
Telemedicine software should provide a comprehensive appointment management solution allowing the practice administrator or appointment coordinator to view, confirm, reschedule and cancel appointments.
Appointment Reminders and Notifications
Automated reminders and notifications are a powerful feature that help reduce no-shows and last minute cancellations.
Notifications and Patient Engagement
Automated notifications are a key driver for patient engagement and it is important for telemedicine software to have a robust notification framework. A well rounded telemedicine platform can be expected to provide automated notifications and reminders for all the important application features.
Telemedicine Mobile Apps for Patients and Providers
All major browsers now support webRTC out of the box and are capable of supporting web based telemedicine sessions from both mobile and desktop browsers. However, given that a significant percentage of telemedicine sessions happen on mobile devices, many telemedicine platforms also provide iOS and Android apps for both patients and providers . Mobile apps arguably provide a better user experience. Mobile apps additionally are capable of supporting bluetooth health devices that are typically used with RPM telemedicine programs. In terms of feature set, the native mobile apps will support most of the functionality that is available in the telemedicine web platforms.
Telemedicine Platform APIs
Telemedicine Platform APIs help integrate the telemedicine platform with an existing technology stack. If for example your business has an existing EMR or a patient portal, then the APIs would allow you to integrate the various software solutions together and allow information to flow between them. On the other hand if you are using an all-in-one Telemedicine platform that provides everything your business needs out of the box, then this would not be an important consideration.
Patient Billing
Telemedicine software should also provide the capabilities to handle the billing requirements of your business. This includes creating and processing invoices, billing reports and also handling of credits and discounts related to the telemedicine services provided.
Payment Gateway Integrations
If you are collecting payments from patients for online services, then it would be important that the telemedicine software integrate with a suitable payment gateway. Many telemedicine software platforms would provide a number of preset payment gateway integrations allowing you to choose one that meets your requirements.
Cost of Telemedicine Software
The cost of telemedicine software would depend on your intended use. If you are looking at telemedicine software for a clinic, medical practice or hospital then you would typically use an off the shelf SAAS telemedicine solution that meets your requirements. On the other hand if you are exploring the cost of telehealth software for a telemedicine business or startup, then you could either consider using a white label SAAS telemedicine platform or you could consider a custom developed telemedicine solution.
Cost of Telemedicine Software for Providers
Cloud based telemedicine software solutions would typically meet the needs of individual healthcare providers, clinics and hospitals. These solutions are available on a SAAS model and the pricing is typically based on the number of providers. The cost would typically be between a few dollars per user at the lower end and $100 per user on the upper end. Some software providers might additionally charge a percentage of the revenue from each telemedicine consultation. Other variables to consider would be the level of monthly data usage. Telemedicine software typically uses third party Web RTC providers who provide the underlying video infrastructure. Web RTC service providers usually charge based on the number of video minutes consumed. Accordingly, telemedicine software providers might either choose to include this into the monthly user subscriptions, cap the number of consultations or keep the video minutes separate.
Besides SAAS telemedicine software solutions, you can also consider direct to patient telemedicine businesses that aggregate healthcare providers and provide their services to patients under a single brand. These telemedicine services would typically provide the telemedicine software to healthcare providers and hospitals for free, but they would charge a significant percentage of each telehealth consultation and this would typically vary between 15-40% depending on the vendor. In case you are considering using such a service for your medical practice or hospital, it is also important to note that the patient database would ultimately be owned by the aggregator and they would typically offer their entire range of services to each patient.
Cost of Telemedicine Software for Healthcare Startups
Pricing of telemedicine software for healthcare startups and other healthcare businesses would depend on whether they choose to use a white label telemedicine platform or whether they choose to build it from scratch.
A white label telemedicine platform gives you a number of benefits over the custom development approach:
Minimal time to market
Time to market would typically be a few days or weeks.
Minimal upfront costs
Since there is no significant development, the upfront costs would be limited usually in the form of a setup charge.
Low maintenance costs
A SAAS telemedicine software really shines when it comes to maintenance costs - you don’t have any. Your costs remain fixed and you just pay the fixed subscription price.
No additional costs for version upgrades
SAAS vendors might provide unlimited updates for all future versions or in some cases depending on your deployment model, this might be limited to updates on a specific version and you will need to pay for each upgrade. If you get unlimited updates on all future versions, then you benefit from a steady stream of new feature updates that are added to the platform. While a white label telemedicine software can be a cost effective solution for telemedicine businesses, a custom developed telemedicine app provides the benefit of complete customization. Depending on your business objectives and budget this can be an important factor in making this decision. However developing a telemedicine application, can be an expensive proposition and cost for a basic solution would probably cost upwards of USD 25,000. Additionally given the pace at which the telemedicine market is progressing, ongoing development and maintenance would be a significant cost. Additionally you also need to factor in the time to market.
Summary
Telemedicine has finally gone mainstream and there is a critical mass of patients who are now comfortable with online doctor consultations. Given the rapid adoption and benefits of telemedicine, it is clear that the telemedicine software will play a transformative role in healthcare delivery in the coming years.
Besides providing telemedicine and patient engagement features, telemedicine software typically tackle a range of use cases including addressing digital health front door work flows and various aspects of business operations.
Telemedicine software can be categorised into three types: synchronous telemedicine software, asynchronous telemedicine solutions and remote patient monitoring software. The best telemedicine software solutions will typically address all of these telemedicine types. Telemedicine software will typically provide a range of features that include various forms of Video Consultations (Synchronous telemedicine), Text Consultations (Asynchronous telemedicine), Remote Patient Monitoring and Care Plans, Patient Portals, Mobile Apps for patients and providers, Encounter Notes, Prescription and Lab Order handling and APIs.
The cost of telemedicine software would depend on the target use case. Hospitals, clinics and individual providers can typically use off the shelf SAAS telemedicine solutions. Healthcare startups and other healthcare services can choose to use white label telemedicine solutions supported by API integrations. This provides a low cost option with reduced time to market. Alternatively if customization is a priority requirement, they can choose to custom develop a telemedicine platform.
Technopark, Trivandrum
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