A mid COVID-19 and its many related hardships, the lingering debate in healthcare regarding the legitimacy, safety and potential of telehealth to support and extend clinical care was finally put to rest. Telehealth has now become a mission-critical pipeline through which significant volumes of high-quality care are flowing.
Becker's Hospital Review recently attended Amwell's annual Client Forum event and heard from two of the foremost experts in telehealth, Amwell's co-CEOs and founders: Ido Schoenberg, MD, who also serves as chairman, and Roy Schoenberg, MD, who also serves as president. These telehealth leaders, and brothers, discussed how Amwell's next-generation telehealth platform, Converge, enables transactional and longitudinal healthcare, while strengthening existing patient-provider relationships.
From supplementary to necessity
During the darkest hours of the pandemic, healthcare workers were overwhelmed, which drove leaders across organizations to embrace change. "The entire industry rallied," Dr. Roy Schoenberg said. "Practice rules were rewritten, reimbursement was extended, licensure restrictions were relaxed, HIPAA was suspended and even workflows that were considered critical for telehealth delivery were replaced overnight with the dire need for simplicity, speed and reliability."
Today, a new reality has taken hold. Telehealth is no longer seen as simply an experiment in innovation or an attempt to improve healthcare access. Telehealth has now joined EHRs and claims systems as an essential part of today's healthcare infrastructure. "In 2020, telehealth changed from a supplementary urgent care service used by a few, to a required enablement platform which is an integral part of all healthcare," Dr. Ido Schoenberg said.
The expectations around telehealth reliability, user experience and predictability in terms of integration and operation have now shifted from a "nice to have" to a "must have."
"Simply put, telehealth has got to work. It's got to work well, and it's got to work all the time," Dr. Roy Schoenberg said.
Enter Amwell Converge — A single telehealth platform for the distribution of care
For Amwell, the tectonic shifts in care delivery accelerated by the pandemic represented a new era of opportunity. In response, the company evolved its development plan and created Converge — the next version of the Amwell platform that is designed to advance digital connectivity across the ecosystem and provide a single meeting place for virtual care needs across the care continuum.
"Converge was designed from the ground up with a holistic understanding that the future of care of any given patient will blend physical, digital and automated experiences," Dr. Roy Schoenberg said. "All three will be improved with powerful insights from just-in-time data."
First and foremost, Converge is a single platform with a single codebase. This provides organizations with a unified identity system that supports streamlined and regulatorycompliant exchange of information and services across the care ecosystem between every willing participant. It is also designed to be integrated and embedded in existing digital assets, such as EHRs and patient portals.
"Converge takes full advantage of open APIs for data and functions," Dr. Roy Schoenberg said. "It has standard plug-ins with the likes of Cerner Millennial, Epic, Claims Clearinghouse, Surescripts and more. It strictly adheres to FHIR standards and has the latest in HITRUST and other certifications. This means integration of telehealth with your existing system is no longer a faith-based journey. It's now a known, predictable quantity."
Amwell has recognized that as telehealth innovation accelerates, the company will need to tap into the creativity of others to ensure its offerings stay ahead of the curve. According to Dr. Ido Schoenberg, "We embrace innovators and developers. They are critical players in our ecosystem's race to digitally enable healthcare, so we strive to be as inclusive and diversified as possible."
As a result, Converge is an open platform that will host and operate third-party apps and programs. This open architecture offers diversity of choice and the freedom to innovate on a live platform. It is designed to enable and support, rather than replace providers or distract from the healthcare experience.
Telehealth cornerstone 1: Reliability
Telehealth must stop being a "let's hope it connects and let's hope it's secure" experience. "We want to make the reliability of telehealth an afterthought – it can't be something we worry about," Dr. Roy Schoenberg said. "That means offering a connection between parties that's entirely predictable and then weaving healthcare logic and functionality on top of that."
Converge is built to offer the best video service available on the market today, as well as the flexibility to evolve if better video capabilities come along. To ensure the reliability and stability of the telehealth in-visit experience, Amwell will leverage Twilio's video engine.
In addition to robust video capabilities, Converge offers a simple, intuitive user experience that provides a seamless handoff from portals, EHRs, sites and devices. To enable this, the Converge team has created a design system called Fluid UX that is responsive to the user's environment in terms of function, visualization and interaction. Dr. Ido Schoenberg summarized, "Converge is the most comprehensive version of our Amwell platform and supports the full continuum of care, yet it's the simplest and most user-friendly system we've ever created."
Telehealth cornerstone 2: Relationships
The goal of telehealth is to extend and strengthen provider-patient relationships, rather than dilute them. This can only occur when telehealth blends into care settings and supports the patient and caregiver experience and their ability to connect. This is often easier said than done.
"Converge strengthens from within by surfacing on mission-critical devices used by healthcare providers," said Dr. Roy Schoenberg. "For example, a clinician logged into an EHR system can find, locate and virtually walk into any place where a cart is stationed. They can use clinical apps to shorten the time-to-needle in telestroke, balance the load of a busy emergency room, or manage a patient's psychiatric challenges outside the hectic ICU or ER setting."
Rather than relying solely on scheduled outpatient visits for follow-up care, providers can connect with patients via telehealth. Per Dr. Roy Schoenberg, "The telehealth dialer is another powerful tool that we've incorporated into Converge to help with follow-up visits. The provider simply enters the patient's phone number and initiates a video call with them. There are no downloads, logins, user manuals or patient training. The full Converge experience is launched by a single click on a text message."
Converge's support of relationships also extends outside of care interactions across the hospital, clinic or physician's office. Payers and self-insured employers, for example, can go beyond Amwell's menu of services and access clinical offerings from other organizations that are using the same Converge telehealth operating system.
Telehealth cornerstone 3: Open Innovation
This year, not only did we witness an evolution in how telehealth is used, we experienced a rapid acceleration and acceptance to innovation around digital care.
"As expectations and the corresponding pace of innovation rise, we must embrace a very humbling truth – our own offering will get better, faster and smarter, if we open it up to the innovation and creativity of others," said Dr. Roy Schoenberg. "Our own pace of internal innovation continues fast and furious, but it is indisputable that this technology will reach further if it rises on the collective, collaborative innovation of the many."
As a result, Amwell has decided to open Converge up to others. Whether to serve their own organizations, or to offer innovation to the broader ecosystem, Converge will host and operate applications created by many. This is an important development not only for Amwell but also for the industry, as it means that health systems, health plans and all other healthcare players will be able to pick and choose from a vast array of applications to design a healthcare experience they deem most impactful. It also means that third party innovators now have a platform to extend the reach of their tools.
Just as Converge offers an open architecture for third-party apps, it will also enable clinical experts, leading healthcare institutions and others to author and build digital program templates that can be used by other organizations.
"We're trying to create a dream team from a collection of all-stars like artificial intelligence, machine learning, natural language processing, CRM, behavioral science and telehealth, and then get the best medical practice to play coach," said Dr. Roy Schoenberg.
Conclusion
"Converge allows organizations to use only what they need today, but it also allows them to add an open-ended array of possibilities as their needs evolve and new technologies emerge," Dr. Ido Schoenberg said. "The results are faster and easier deployments, an improved user experience and deeper loyalty."