Telehealth 2023
Integration and Consolidation Drive Telehealth Strategies (A Decision Insights Report)

Methodology note: For this report, KLAS invited each vendor to share their recent wins, which KLAS then validated directly with the customer organizations. The Decision Insights data in this report is based on this information as well as on decisions that KLAS came across organically in our research. The data does not represent all telehealth purchase decisions made within the research window.

Amwell Chosen for Oracle Health (Cerner) Integration, Teladoc Health for Market Maturity, and Caregility for Strong Technology

Across virtual care platforms, customer satisfaction has dipped as use cases and expectations have expanded. Aiming for vendor consolidation, large and midsize organizations often choose a virtual care platform based on its breadth of capabilities and potential inpatient and outpatient use settings. Amwell leads in both selections and replacements. Organizations that chose Amwell did so most often for Oracle Health (Cerner) integration. Reasons for replacement vary and include cost and support or account management struggles. Current Amwell customers often cite concerns with cost, support, and integration, though many customers continue to be optimistic about the new Converge platform. Prospective Teladoc Health InTouch customers often mention their trust in the vendor as a mature, market-leading presence. Historically, live customers have reported strong outcomes for patients (such as quick access to care), but over the last year, customers have seen slower response times and less proactivity from Teladoc. 2023 Best in KLAS winner Caregility was often chosen because of the product’s appeal (either software or hardware). Customers have historically raved about Caregility’s partnership. Over the last few months, several customers have seen dips in the company’s ability to quickly deliver quality updates and innovation, but most express continued trust in the company. Caregility also stands out for fewer reports of nickel-and-diming in comparison with other vendors.

Integration Driving Outpatient Organizations to Replace Video Conferencing Solutions (Especially Cross-Industry) with EMR-Based Tools

Video conferencing solutions become vulnerable to replacement once EMR-based telehealth solutions show sufficient feature parity. Cross-industry solutions—such as Zoom, Vidyo, and Cisco Webex—are especially vulnerable. Provider organizations embraced these reliable, familiar solutions at the start of the pandemic, but they later moved on in search of deeper integration, tech-stack consolidation, and more healthcare-specific workflows. Despite a high number of replacements, Zoom also receives a high number of selections, often due to the system’s ease and reliability. Vidyo has seen a significant drop in healthcare users due to perceptions of high cost and to Epic’s move away from Vidyo as their platform’s main video layer. EMR-based telehealth solutions^‡ see few replacements; decisions about these solutions tend to be tied to overall decisions about the EMR.

‡ For more information on EMR-based telehealth solutions, read KLAS’ EMR-Centric Virtual Care Platforms report.

Amid Industry Shift to EMR-Based Solutions, Healthcare-Focused Doximity Stands Out for Ease of Use and Affordability

Healthcare-focused video conferencing solutions are also vulnerable to being replaced by EMR-based solutions. An exception to the trend, 2023 Best in KLAS winner Doximity has the most selections of any solution in this study, often due to the system’s ease of use and setup, reliability, low cost, and physician familiarity. Midsize and large organizations often use it as a backup solution. Though the system hasn’t historically been integrated with the EMR, some customers have recently validated Epic integration; other organizations specifically use Doximity as a nonintegrated solution. Though a few Updox customers have left for EMR-embedded solutions, the vendor has also seen wins with small and single-doctor clinics, often because these organizations use other functionality from Updox (e.g., faxing, forms, and texts) or because they are looking for EMR integration (e.g., PracticeFusion uses Updox as their exclusive telehealth partner). The Doxy.me customers who decided to replace the solution most often moved to their EMR’s solution to gain deeper integration. Current Doxy.me customers report low levels of integration but also highlight that the solution is inexpensive and fairly easy to use.

Other Vendors Mentioned in Decisions

Vendors at a Glance

Vendor Bottom Lines

Vendors ordered alphabetically

Virtual Care Platforms

Access Telecare

“The product allows patients to have access to an expert, and patients might not otherwise have that access in a remote area. That access is a plus. Providers are also able to get a feel for what the patient is really comprehending and what they aren’t. Our ED physicians look to a specialist from the vendor to be the expert. For the physicians’ day-to-day documentation, they rely heavily on the vendor’s expertise. And the physicians rely on the vendor not only for the obvious symptoms but also for patients that have some questionable statuses going on.” —Analyst

“SOC Telemed isn’t proactive. If we were to consult with a Telemed IQ provider while imaging was being done for a patient, the vendor would wait for us. They are proactive in the sense that they won’t drop our call and make us restart, but they don’t do anything on their end to be proactive. We have to request things from them, and then they will diligently wait for us to return.” —Director

Amwell

“Amwell is forward thinking; they have certain funding to keep them in the market for a long time. The new product, Converge, is built on a modern platform. That platform is going to give us a lot more flexibility in the future. Amwell makes getting things right and acknowledging gaps a priority. That is helpful, and Amwell is going in the right direction. Amwell’s system is easy to use, and Amwell has nice marketing materials that are quite good. The system is easy for my team to configure.” —Manager

“As far as support goes, Amwell hasn’t been very responsive, and I haven’t seen them keep all their promises. The support has gotten better over time, but the vendor is not proactive. We would have to upgrade to the vendor’s new product to get better service.” —Analyst

Bright.md [C]

“The vendor is there for us when we need them. They schedule regular appointments and bring things to our attention that we should know. When I am working with a vendor, I need them to push information to me. I have a portal, and I can go in and dig in. That is all fine and great, but I forget because there are other things that become my priority. I asked Bright.md to send me information in another way, and they did. I appreciated that. I can share information with our administration team, our marketing team, our IT team, and providers quickly.” —Director

“We are having less success with the Bright.md solution. When the tool satisfies patients, it works incredibly well. But when patients get kicked out of the system because their conditions aren’t appropriate, they are extremely dissatisfied. We are finding that out of the modules we have turned on, only about half of them get through. Our concern is that the product has limited use cases. We anticipate being more successful with a video visit where we can have provider interaction; the asynchronous visit is just a narrow use case.” —VP

Caregility

“Things have gone very well with Caregility. The vendor has flexibility and is willing to share their road map with us and partner with us. Caregility works on the things that are important to us and adjusts their timelines, prioritizations, and development sequencing. Caregility Cloud is a nimble, flexible, agile, and cohesive platform for all use cases. If someone can dream of how to use the product, they can build whatever they want.” —Director

“We were told by Caregility that a certain upgrade would be ready to go live, but that was not the case. The upgrade is now supposed to be released soon, but I will not believe anything until I see the upgrade. When I say Caregility takes years to deliver things, I am not just nitpicking. Every development item they tell us about is not even what we request. Additionally, the vendor never meets their initial delivery dates. There are always things that get pushed or cut, but when the vendor does not deliver months of development, something is wrong.” —Analyst

eVisit

“eVisit Platform is a great product that has had a very positive impact on the patient experience. The vendor listens to the feedback that we give them. When we tell eVisit that something may contribute to a better patient experience, they are always willing to see whether they can improve things.” —Director

“I would like to see a better ability for charge capturing and better integration with EMRs. We tried to find a way to integrate the tool with billing and collections. We had high hopes to use eVisit Platform to capture charges, but when we tried, things were a mess.” —Manager

MDLIVE

“MDLIVE can deliver virtual visits in all sorts of ways. The visits can be done over a phone, computer, tablet, or any device a member could use to sign in on an app. Members can choose to just do the visit with a good, old-fashioned telephone call and speak directly to a physician without using software.” —VP

“MDLIVE has not kept all of their promises since they were purchased. Also, they have started charging us for every little thing. They are a pain. MDLIVE’s executives have fallen completely off of the radar. Since they got purchased by Evernorth, who also owns a few other companies, the product that we are using isn’t part of the vendor’s core anymore. So we are just getting whatever leftover resources they want to let us have. They are not paying attention to their healthcare clients any longer.” —Director

Mend

“Mend is a very useful tool, and the team that is currently working on Mend is making some really cool changes and improvements. That is great. I have never worked with a team that is so quick to respond to feedback for technical assistance. The vendor’s support is something I have been extremely satisfied with. I have talked to many people from Mend. The vendor is not afraid to communicate with the individuals using the product.” —Analyst

“Mend isn’t integrated with one of our other products. Now that that product has a better tool for video visits, we will switch to that tool. Mend’s scheduling tool could integrate with our other vendor’s tool, but we don’t have the resources that we would need to make that happen. Mend isn’t aware of different contexts. It won’t link to our patient chart. I think that Mend will fall out of favor. The vendor provided some initial training materials, but we ended up having to do our own end-user training as well. We couldn’t just use what the vendor gave us. That cost us a lot of resources.” —CMIO

Teladoc Health InTouch

“Teladoc Health is such a good partner, and they listen to our needs. The vendor is great about working on our timelines and is committed to our needs. We get high ratings from the vendor and positive comments from our users. The system is integrated with our scheduling system, and that is a necessity. Our physicians can have two monitors on; they can have one with Teladoc’s system and one with the EMR they are documenting in. That works well and is very slick.” —Director

“When InTouch was purchased by Teladoc Health, the vendor’s customization offerings and ability to meet our needs were reduced. I would go so far as to say that our needs are not met by the vendor’s current product like they were before the acquisition. Acquiring another very large company and attempting to standardize things across the industry is natural, but the customer has been impacted negatively.” —Manager

Teladoc Health Licensed Platform

“Teladoc Health has a road map that they give us, and then we get to have input on the road map. We get to sit down and give the vendor feedback on things that are launching soon. There are a few things that we would like the vendor to add to the product. The vendor is so fantastic to work with; the people are just so good. The vendor came on-site to go through what their plans were with us. We regularly meet with a C-level executive.” —Manager

“I think Teladoc Health is more interested in sales. The vendor is heavy on sales and pushes less on strategy. We started managing our own support calls a while back because Teladoc Health’s support team was so bad. In the product, there is a design that sometimes confuses patients. The patients end up in an on-demand space trying to find the right room for their appointment. That makes for a bad user experience.” —Director

Video Conferencing Solutions

Doximity

“We use Dialer for video visits, mostly for our translated visits because we still don’t have a good option for adding translators or family members on our other platform. Dialer is our providers’ favorite videoconferencing platform because the providers feel like the connection with the patient is better when using Dialer. Other platforms have more variables that we can’t control. We like Dialer because we can send a link to the patient via text, and the patient can just click it and jump in. People like that. The system was an easy sell. It doesn’t require an app download, and the users love it from that standpoint. Dialer is so convenient and simple.” —Director

“Doximity’s business model is so focused on providers that it doesn’t have some of the pieces of the puzzle that would make Dialer as scalable and multiuse as other videoconferencing platforms in the market. Dialer cannot be used across multiple workflows, and that has become the key to a good platform. When we get on a video, we should be able to exchange information, bill things, add anybody we want, and get an interpreter. Sadly, Dialer doesn’t fill all those gaps.” —Manager

Doxy.me [A]

“One thing I like about Doxy.me is that the product has a waiting room, and I don’t have to wait on a patient. The product will send me a text when the patient is ready. The product makes telehealth visits easy. The picture and sound quality in Doxy.me are excellent. The product works in real time. We like that we don’t have to initiate each individual patient. The patients come into the queue at their appointment times and wait until we can join them.” —CEO

“Doxy.me is just not changing; they are not evolving. The vendor hasn’t integrated more meeting or voice capabilities in the system that are significantly needed. There was a big upgrade sometime a couple of years ago, but since then, updates have really tapered off, and there hasn’t been a lot of change. We never get any communication when account managers change at Doxy.me, and we don’t even really know who our account manager currently is or whether we even have one. The vendor hasn’t been transparent on how their organizational structure is built to support an organization of our size.” —Director

Microsoft Teams

“I have not noticed any hiccups whatsoever with Teams. The system is pretty good. We have known about any upgrades that have happened. That hasn’t been a problem at any point. Teams is easy. The vendor is working with us to expand. We are still working on some more functionality there, and we are getting close. I don’t know whether we have ever had to contact the web support people for Teams. The system has been so reliable. I would always recommend Microsoft.” —VP

“There is no real integration with Teams for anything. The product is a completely standalone environment. Microsoft has not kept all of their promises, but that is just what Microsoft does. We expect that now.” —Director

Updox [A]

“Updox Telehealth is integrated into our EMR. So when we get faxes, we are able to tell Updox to put certain things in a patient’s chart, and it transfers. Then the same goes for our reminder portion. The solution is integrated into our scheduling system, so it is able to automatically pull who is scheduled and automatically send out reminders. It saves us a lot of time and automates a lot of processes. I am not sure what other programs are out there that would do similar things and connect to our EMR. Updox Telehealth eases a lot of stress from processes we used to have to do manually.” —Manager

“Troubleshooting is a little challenging, and getting support takes longer than I think it should. I had a recent upgrade, and there have been some audio problems. When I ask someone about those problems, I have to wait until the support people get back to me by email, and I have to schedule an appointment. It is hard for me to troubleshoot in a short time frame. And once I send the email, it takes two or three days before I can get an appointment.” —Physician

Vidyo

“If someone were looking to purchase VidyoCloud, I would tell them to make sure it matches their workflow requirements. The system is perfect for simple videoconferencing. Vidyo’s executives are more responsive than their help desk people. The salespeople respond very quickly, and they are pretty up front about what the product can and can’t do.” —Manager

“I would not buy VidyoCloud again if we had the chance. I would be looking for something better, something a little more responsive. The vendor makes changes at their corporate level, but they never look back and see what one change might do to the rest of the platform. Vidyo is just not reliable. I am not happy with them. Vidyo doesn’t keep their promises as well as other vendors do. We don’t know in particular what Vidyo’s changes are going to be until I am told by my colleagues somewhere else. Everything we are getting charged for is too much.” —Analyst

Zoom

“Zoom is reliable with sound connectivity in videos. It has built-in connections to our sound system so that we aren’t troubleshooting every time we connect with other products. With other systems, people have to mess around with settings to get sound and video to work, but we don’t have to do that with Zoom. The system works. I tested out every product we looked at, and Zoom worked the first time. It has the best UI design.” —Director

“I would not renew a contract for Zoom because there are other things available. We have no issues with Zoom, but they haven’t necessarily developed new healthcare-related things along the timeline that we expected. Also, we wish that we could have documents signed within a Zoom session and then be able to save them to the patient’s chart. We would like to have our own personal waiting room or an organizational waiting room. It hasn’t seemed like Zoom’s full effort is in the development of the healthcare section of their business. There are other video vendors out there who have really made strides in being applicable to healthcare and are able to integrate with other peripherals and interface between the medical record. Zoom just doesn’t seem to have put that same amount of effort into that kind of development.” —CMIO

EMR-Centric Virtual Care Platforms

athenahealth

“The main reasons we chose athenahealth Telehealth were the integration, the billing help, and the overall price. We also liked that the system was web based. The fact that athenahealth has done updates every quarter has been very nice; we don’t have to buy a solution and then use the clunky, old solution to download the new solution onto our computer. athenahealth Telehealth looks nice too; it is always great to have something that is nice on the eyes.” —Manager

“athenahealth’s support could be better because getting to the right department to get the vendor’s help is a little painful sometimes. For example, when I couldn’t get athenahealth Telehealth to work, athenahealth told me to create a support ticket. So I created the ticket, but then athenahealth told me that they couldn’t help and that I needed to get ahold of the CSM. I got ahold of the CSM, and the CSM told me I had to create a case for the issue. I have been through multiple people, and everybody has told me that I have to contact someone else, so that has been a little frustrating.” —Manager

eClinicalWorks

“We were able to go from no telehealth options to having 100% telehealth options in days with very little disruption. I am not sure we could have done that with any other system. We were quite lucky that telehealth was part of eClinicalWorks’ offerings. The vendor was proactive with that system.” —Director

“I am finding the telehealth experience with eClinicalWorks to be utterly useless. The logins are difficult. The picture is minuscule with poor resolution. 90% of the time, I ditch healow Telehealth Solutions and use another solution because healow Telehealth Solutions just doesn’t work. I have changed my setup a couple of times, and when I try to use healow Telehealth Solutions, either the microphone or the camera doesn’t work. I have no idea why. It is very hard to find a solution.” —CEO

Elation Health

“The benefit of moving to Elation Health Telehealth was that it was seamlessly integrated into our EMR platform. The product had the robustness of the Zoom backbone with regards to the technology and cost. With the ability to schedule a telehealth visit, we can send the reminder to the patient through Elation Health’s existing reminder system, and then it is just a click of a button to operationalize things on our computer. The integration just is seamless with the Elation Health platform. We had a separate solution before, so this integration has been really helpful.” —CEO

“We have been having a lot of problems with Elation Health’s support, so that is our biggest issue. If an issue is not urgent, the vendor wants us to email them. But getting a response takes days, and the response is really nothing that is going to rectify the situation; the response is just more questions about how to move forward. There have been times when Elation Health has just closed out the tickets before they have even addressed the issues. There have also been one or two times that I have chosen the option that indicates that we need help immediately, and Elation Health just hasn’t replied.” —CEO

Epic

“Epic’s native video visit platform, done with Twilio, works great and is better than the previous third-party middleware solutions we used with Epic Telehealth because it is fully integrated, and we don’t have to deal with two vendors. We have one seamless product, so if there is ever a problem, we just call our Epic person because they should know all the nuances of the problem. If we have all our products through the same vendor, the products are going to work more seamlessly together. We can email Epic’s support team, and they are very responsive if we have a problem. The vendor’s executive involvement is phenomenal.” —CMIO

“Epic keeps promises, but not always on the timeline that I would like. When we rolled out Epic Telehealth, we were looking for a lot of feature parity, and the solution was brand new. Epic was still working on feature parity, and we were led to believe that was going to happen a little bit earlier. Epic keeps saying they will get there and that feature parity is still on their road map, but I would have liked the change to have arrived already.” —Analyst

Greenway Health

“We chose to use Greenway Health Telehealth because it was fully integrated with our EHR, PM system, and portal and because it is so easy to use. We send patients a link with their appointment. They click the link and are put in the waiting room, and then they have the visit. The process is so easy. Patients can use their phones, iPads, laptops, or whatever else has a camera and internet connection.” —CEO

“They were extremely helpful in their sales pitch, but when we actually signed the contract and paid the money, it was very difficult to pin down one person to help us. When we did find someone to help us, they just sent us a video for the training on this brand-new product that we were paying for. It would be nice to have a little more training. The vendor loves to steer us to their training center online, but it is not very easy to find exactly what we are looking for. We have to waste a lot of time finding and watching a video where no one tells us exactly what we are looking for. It would be nice if someone would just show us where to click.” —Analyst

Kareo

“I like that Kareo Telehealth allows us to communicate with patients via text and email. We create templates for the telehealth messages because no-shows can be very common with telehealth since patients are not in the office. Once we implement the text message reminders, things definitely improve because then we can send a reminder the day before and the morning of an appointment and include the unique link that is assigned to only a certain provider. The intake forms are also a positive. I used the vendor’s forms and was able to create unique forms for myself, such as questionnaires and other things that patients could schedule.” —Analyst

“We don’t have support staff. Kareo marketed Kareo Telehealth as an easy-to-set-up platform, and it really isn’t. Setting the system up was not easy. Figuring out why our patients weren’t getting the links took multiple calls, and that issue actually had to do with things that had to be set up. Figuring out all the problems was time consuming. The system wasn’t just one thing Kareo had to put in for us. Setting things up took multiple steps. We are in a day and age when technology needs to work easily because if the vendor is marketing to really small practices, small practices don’t have IT support people sitting in the next room.” —Analyst

NextGen Healthcare

“The platform is very easy to use, not only for physicians but also for receptionists and patients. The product can handle multiparty scenarios. We have a lot of learners, and there are times in our clinic when a supervisor or medical student needs to shadow a telemedicine call. The product works well for those situations. The product would have to combust for it not to continue to do well.” —Director

“We have had different stages in our relationship with NextGen Healthcare. There have been times throughout our relationship when the vendor has been more of a partner, but right now they are more of a vendor. Some of the products are missing the mark for us, and the level of service has declined. The vendor has lost a lot of their experts, so now people at NextGen Healthcare are leaning on scripts because they don’t have a good background in the product. They are very siloed and don’t understand how the product translates into the EHR and PM solutions. When we have issues, it takes a long time to resolve things because we deal with people who have only a feel for the product.” —Director

About This Report

Data for this report comes from two sources: (1) KLAS Decision Insights data and (2) KLAS performance data.

Sample Sizes

Sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.

Product Desginations Used in This Report

• Mostly Ambulatory [A]: Product for which the majority of respondents are associated with ambulatory care.
• Component [C]: Product that typically includes most but not all components that comprise a complete system or that serves only a subset of the market. Bright.md is marked component as they offer an asynchronous virtual care solution.