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Video Communications Comes to the EMR

This week we learned of another great example of the type of initiatives underway to integrate communications into the stuff of everyday work life. Epic Systems, a global provider of electronic medical record (EMR) systems, has integrated Vidyo's real-time communication platform into its telehealth and virtual care applications.

With this integration comes the ability for physicians and patients to schedule and conduct video consults from within the Epic portal they're already using for tasks such as accessing patient health information, booking appointments, and reviewing and updating records. This is a particularly notable integration given the rising importance of telehealth in the U.S., not to mention around the world.

The Medical University of South Carolina (MUSC), the oldest medical school in the South and operator of a 750-bed medical center, will be the first healthcare organization to tap into the integration, Vidyo announced this week. MUSC happens to be both an Epic and a Vidyo shop, and has been for several years. This was not a case of serendipity, as I learned in speaking with Michael Haschker, manager of MUSC's telehealth technology and network systems teams.

In mid-2013, MUSC began investigating ways in which it could use telemedicine services to address healthcare disparities in rural South Carolina. MUSC would need to find a video communications technology that could work with low bandwidth typical of the remote communities it would be serving, and Vidyo's platform bubbled to the top. Because Vidyo uses the H.264 video codec rather than older protocols, the platform could easily adapt to and recover from bandwidth fluctuations and intermittent packet loss, Haschker said.

But that wasn't the only plus. At the same time, MUSC had begun using Epic for EMR and was well aware that video inside the EMR would be coming, Haschker said. "We didn't know when, but we knew it would play an important role, and we certainly didn't want to choose a product that was not friendly with our EMR."

So MUSC had Epic provide it a list of products with which it would integrate, Vidyo included. While MUSC had some of those other products in use, "knowing the number of programs and services that could use Vidyo, we thought it prudent to buy that product," Haschker said.

MUSC decided on Vidyo in late 2013, and since deploying the video communications platform in early 2014 has put several telehealth programs in place. As an example, Haschker pointed out a virtual technology consult program, called Virtual Tele Consultation, through which 76 community sites throughout the state connect back to the university in Charleston via the Vidyo platform for physician-to-physician and physician-to-patient consultations. These sessions enable consultations on specialties such as nutrition, post-surgical wound care, pre-surgical evaluations, and neurology, to name a few, he said. As a result of this program and MUSC's other telehealth initiatives, the Vidyo platform gets heavy daily use, he added.

Haschker can control user access privileges and conduct other administrative functions through the Vidyo portal, which can support multiple virtual instances. For MUSC, Haschker has set up a virtual instance for the telehealth programs and another virtual instance for Epic.

This dual-tenancy model allows MUSC to assign one set of licenses to the physicians and community sites using the general telehealth program virtual instance and another set of licenses to those using the Epic virtual instance. Right now MUSC has a 100-user license for the stand-alone telehealth virtual instance and a 150-user license for the Epic virtual instance. "We don't want to affect healthcare except in a positive way ... and so we set up the two tenants so the "licenses don't overrun each other," he added. In other words, use of the Vidyo platform for general telehealth programs won't affect use of the Vidyo platform for communications within Epic.

Epic has enabled its entire EMR suite with Vidyo APIs, said Mark Noble, VP of telehealth business development at Vidyo. The suite comprises Epic MyChart mobile and Web applications for patients, and the Epic Hyperspace, Canto, and Haiku applications for clinician desktops, tablets, and smartphones, respectively.

MUSC will begin with the Vidyo integration in MyChart, running a trial program with the organization's 13,000 employees and then ultimately rolling out to patients, Haschker said. It also plans to take advantage of the Vidyo integration in the Hyperspace desktop portal. Giving physicians the ability to have an interactive, virtual visit with a patient from within the same pane of glass containing all the patient's health records through which they also enter data "will really change the way healthcare is delivered," Haschker said.

The healthcare industry has a lot of learning to do on how to best enable seamless video communications between patients and providers, Haschker said. But here's one thing that MUSC has already learned, a lesson others across industries should heed as well: "Providers have complicated toolsets and we don't need to be adding layers to those toolsets," Haschker said. "We need to let them use what they're comfortable with and enable them with a few 'click-to' features, like video."

MUSC made the smart move of speaking with one of its core solutions providers about integrations capabilities. Are you doing the same?

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