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Telehealth Ecosystem 2021 Telehealth Ecosystem 2021
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Telehealth Ecosystem 2021
Understanding the Rapidly Evolving Landscape

author - Adam Cherrington
Adam Cherrington
author - Dan Czech
Dan Czech
author - Ciera Walker
Ciera Walker
May 20, 2021 | Read Time: 7  minutes

The COVID-19 pandemic greatly accelerated healthcare delivery organizations’ adoption of telehealth and virtual care technologies. As these organizations scrambled to meet the immediate demand, they quickly implemented solutions that often required few resources and met focused needs. At the same time, vendors quickly pivoted to either develop dedicated telehealth products or add telehealth capabilities to existing offerings, creating a sea of options. This study, along with additional deep-dive content on KLAS’ website, shows which vendors report the broadest telehealth capabilities and aims to help organizations navigate different options as they look to consolidate systems and define their long-term telehealth strategy. For reader ease, links to relevant online content are provided where applicable. Note that the vendor-capability data in this report is based on vendor-reported information.

What Is the Telehealth Ecosystem?

To help healthcare organizations quickly understand the breadth of vendors’ telehealth offerings, KLAS has developed a framework—or ecosystem—meant to guide organizations to vendors who can accommodate their specific care types, use cases, and technical requirements. Vendors were asked to self-report, across four telehealth scenarios, which capabilities are available to customers today and the depth of adoption among their customer base. This self-reported information has not been validated by KLAS. The different capabilities that might be utilized in these telehealth scenarios are grouped into four overarching categories. More details on individual capabilities within each category can be found here.

telehealth scenarios types of telehealth capabilities

Though they may also have additional focuses, in this report, telehealth vendors are grouped by primary focus, and the following sections detail each of the four types of telehealth offerings KLAS measures today. The vendors highlighted within these sections are those for which KLAS has gathered customer experience data. Reported capabilities are also shared from vendors whose performance in telehealth has not been measured by KLAS, but these vendors are not the focus of this study. Additionally, a handful of vendors that are currently measured by KLAS or are common telehealth options did not self-report their capabilities or customer adoption; these vendors are noted below.

types of telehealth vendors

Virtual Care Platforms (Non-EMR): Broadly Deployed Amwell & Teladoc Report Feature-Rich Solutions; swyMed Grows beyond Early Emergent Transport Focus 

Virtual care platform vendors as a whole report the broadest capability sets, with integration a commonly reported area of strength. Early market entrants Amwell and Teladoc Health report high levels of adoption across their customer bases. Amwell, heavily used for scheduled and on-demand visits, reports broad capabilities for front-end technology and communication; adoption of delivery capabilities is shallower. Amwell also reports broad integration capabilities, though in previous research, customers have noted integration struggles. Teladoc Health reports customers most often adopt capabilities for telespecialty consults, and a majority also do scheduled and on-demand visits. Teladoc’s offering stands out for its front-end technology, particularly the hardware. Initially focused on emergent transport, swyMed reports a broad offering with varied use cases for their still-growing customer base. Best in KLAS winner Caregility reports deep adoption for scheduled and on-demand visits as well as telespecialty consultations. Their capability set is more limited than those of more long-standing vendors, especially regarding care delivery and workflows, where Caregility supplements with several third-party partnerships.

depth of adoption vs. breadth of capabilities: virtual care platform (non-emr) vendors

Remote Patient Monitoring: In Still-Emerging Market, Remote Patient Monitoring Vendors—Led by Health Recovery Solutions—Report Surprisingly Broad Capabilities

Remote patient monitoring (RPM) vendors report a broader number of capabilities than expected, having added video visit and other capabilities. Multi-year Best in KLAS winner Health Recovery Solutions reports workflows that allow them to be used for a wide variety of patient conditions/needs, and they report high customer adoption of their video visit capabilities. Philips, whose telehealth capabilities extend beyond RPM, offers capabilities for specific inpatient conditions/needs. Some workflow capabilities are supported through third-party partnerships. Stated adoption is strong for video visits, in addition to RPM capabilities. Vivify Health is a long-standing player in RPM with significant market presence, but they declined to share self-reported capabilities and adoption; information on their clients’ satisfaction can be found in the Telehealth Overview chart.

A Note about Teladoc Health:
Teladoc Health, which merged with Livongo in 2020, has capabilities in chronic disease management that complement telehealth efforts such as remotely monitoring patients with diabetes or other conditions. Their primary customers are employers.

depth of adoption vs. breadth of capabilities: remote patient monitoring vendors

Video Conferencing Platforms: Administrative Workflows Stand Out among Video Conferencing Platforms

Often used behind the scenes with workflows layered on from EMRs or workflow-specific solutions, video conferencing platforms focus on and typically excel at the technical capabilities that enable visits. stands out among these platforms for use across all telehealth scenarios for many patient conditions/needs, and they report integration with most EMR vendors, though in previous research, customers have noted integration struggles. also leads among video conferencing platforms for the number of dedicated administrative workflows in their product (though still modest compared to virtual care platforms and lacking clinical workflows). Microsoft Teams is used most often for scheduled visits and telespecialty consults. It can be quickly purchased and deployed, meaning organizations have the flexibility to use the solution for virtual care across several patient conditions and needs. The solution can be used in a standalone fashion or as the back end for workflow solutions (e.g., EMRs) and integrated with additional systems. Teams is able to connect with user devices, though some gaps exist around tracking/diagnostic devices used to deliver clinical care. Doximity, who has a background providing a medical network for healthcare professionals, focuses solely on scheduled and on-demand visits and is used for various patient conditions/needs; they report fewer dedicated workflows and front-end connectivity capabilities.

depth of adoption vs. breadth of capabilities: video conferencing platform vendors

EMR-Centric Virtual Care Platforms: Epic’s Workflows & Varied Use Cases Lead to Deep Customer Adoption; Ambulatory-Focused NextGen Healthcare Supports Multiple Specialties

EMR-centric vendors are among the most likely to focus on scheduled and on-demand virtual visits. These vendors’ telehealth solutions typically have strong integration, though it often centers around the vendor’s own EMR architecture. Epic stands out for high self-reported customer adoption across a broad variety of patient conditions and for robust workflows. Epic also reports that adoption of telehealth use cases has deepened since KLAS’ 2020 telehealth performance report. NextGen Healthcare’s solution (acquired from OTTO Health in late 2019) focuses on ambulatory practices, which are typically doing scheduled and on-demand virtual visits. The solution supports multiple specialties and complements existing EMR and PM workflows. Due to OTTO Health’s vendor-agnostic history, NextGen Healthcare reports live EMR integrations with athenahealth and Greenway Health (through Greenway’s marketplace) in addition to their own EMR. They are limited today in terms of tracking/diagnostic devices but report many of these on their development road map. Cerner offers several telehealth offerings, including self-developed as well as partner solutions (i.e., Amwell and Raziel Health) to address a variety of telehealth scenarios. Allscripts, athenahealth, eClinicalWorks, Greenway Health, and MEDITECH all quickly released telehealth capabilities in response to the COVID-19 pandemic. KLAS is in the early stages of measuring the customer experience and plans to release a future report specifically on EMR-centric telehealth solutions. (See the Telehealth Overview chart for more details on the reported capabilities of EMR-centric vendors.)

depth of adoption vs. breadth of capabilities: emr-centric virtual care vendors

Other Types of Telehealth Vendors

In addition to the four categories of vendors explored in detail in this report, KLAS is aware of telehealth capabilities offered by patient engagement vendors, specialty-focused telehealth vendors, and others. Patient engagement vendors have often built add-on capabilities for existing patient outreach, patient intake, and interactive patient system solutions. Specialty-focused vendors offer a focused set of capabilities or concentrate on certain specialties (e.g., behavior health, infectious disease, podiatry, pulmonology, rheumatology). Other vendors have highly niche offerings for things like telesitting, chronic care management, or CRM. For more details, see KLAS’ online resources.

Vendors Not Yet Measured in Telehealth

A number of other vendors shared information about their telehealth customer bases, capabilities, and customer adoption. To date, KLAS does not yet have enough customer feedback on these vendors to measure the customer experience. We will continue to interview customers and share their feedback.

depth of adoption vs. breadth of capabilities: vendors not yet measured by klas
telehealth overview

Telehealth Capabilities Index

Telehealth Delivery

Staffing models
Physician network services
Organization-provided physicians

Use cases
Virtual scheduled visits
On-demand/urgent care
Telespecialty consults
Remote patient monitoring

Patient conditions/needs
Primary care
Heart disease
Chronic condition management
Surgical management
Paramedic/emergent transport
Behavioral health
Other (community health center, FQHC, women’s health, etc.)

Front-End Technology and Connectivity

Communication methods
Interactive voice response (IVR)
Two-way video
Multi-way video
Secure email messaging
File/image sharing

Device types
Proprietary devices
Commercial devices
Bring-your-own devices

Inpatient hardware
Video cameras

Tracking/diagnostic devices
Blood pressure monitor
Weight scale
Fall detector/accelerometer
Activity tracker
Medication dispensing
Video/virtual sitter

Connectivity methods for sending data to central hub/devices

Telecommunication methods for sending data to healthcare organization
Managed cellular

Workflow and Content

Clinical workflow capabilities
Command center/overall view of telehealth operations

Administrative workflow capabilities
Intake (patient check-in/registration, may include clinical administrator workflow)
Virtual waiting room
Chatbot (patient self-triage)
Patient co-pay/prepayment
Real-time eligibility verification

Clinical content capabilities
Care plans/pathways
Patient education—text/documents
Patient education—video
Patient education—interactive


Flow of information
Bidirectional EMR integration
Unidirectional EMR integration

Integrated EHRs
Greenway Health
NextGen Healthcare

Interoperability standards supported
Context-aware linking
Proprietary API/SDK

About This Report

This report is designed to give payer, employer, and provider organizations a clear picture of what capabilities vendors offer to meet their core telehealth needs. Most data in this report comes from vendor-reported information.

A limited amount of KLAS performance data is also shared. Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale. A vendor’s sample size for performance data may not reach KLAS’ required threshold of 15 unique respondents; when a vendor’s sample size is less than 15, their score is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. In these cases, vendors are marked throughout the report as “not yet measured in telehealth.”

author - Amanda Wind Smith
Amanda Wind Smith
author - Jess Wallace-Simpson
Jess Wallace-Simpson
author - Robert Ellis
Project Manager
Robert Ellis
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.