Telehealth Performance 2020
Rapid Telehealth Uptake Is a COVID Silver Lining

† While remote patient monitoring (RPM) is part of the broader telehealth landscape, it is not a focus of this report. For more information on RPM vendors, please see KLAS’ ongoing performance data and recent RPM report.
Note: The customer satisfaction details shared throughout this report are intended to help healthcare organizations as they make go-forward telehealth technology decisions. For a list of key questions to consider in the broader effort of building or expanding a complete telehealth strategy, please refer to KLAS’ COVID-19 Telehealth Guide.

No one could have predicted COVID-19, so it is no surprise that all vendors initially struggled to manage the rapid increase in telehealth adoption. Most vendors were able to eventually right the ship, and while the situation was unique, vendors’ responses provide insight into their ability to react to factors outside of their control and continue to help customers be successful moving forward.

Virtual Care Platforms (Non-EMR)

Typically healthcare focused; enable multiple visit types and offer multiple healthcare workflows (e.g., virtual waiting rooms, patient check-in, and scheduling). May include physician network services and proprietary equipment. KLAS ratings come from provider, payer, and employer organizations.

Amwell Has Struggled to Scale amid Multi-Year Growth; Teladoc Health (InTouch) Continues to Meet Needs after Early COVID Missteps

Despite Amwell and Teladoc Health (InTouch) offering some of the broadest solutions on the market, few customers plan to use their solutions to meet all telehealth needs going forward. Customer satisfaction with Amwell, who recently announced a partnership with Google Cloud, has steadily declined since 2018 as Amwell has struggled to scale to growth and maintain adequate support. The physician and patient experience is generally positive; outcomes can be hard to realize—needed data is difficult to access, and EMR integration is a common struggle. In response to COVID-19, Amwell quickly developed and released Amwell Now, which enables patient access via a link and has received positive early feedback. Two solutions from Teladoc Health are rated in this report. The multi-year Best in KLAS winner that Teladoc acquired from InTouch Health prior to Teladoc’s recent merger with Livongo has recovered from some early COVID hiccups, including strained support and out-of-stock hardware. The solution is easy for patients and clinicians to use, and customers are particularly pleased with the telestroke capabilities. Customers report strong outcomes; for some, these offset qualms about the solution’s cost. However, most plan to supplement the InTouch solution with other products rather than incurring the high cost of going all in with Teladoc. (See next page for insights on Teladoc’s other solution.)

 High Satisfaction Prevails for Most Focused Solutions; MDLIVE and Teladoc Met Demand after Early COVID Struggles 

Note: Adoption of visit types and healthcare workflows was self-reported by interviewed organizations and may not represent a vendor’s complete capabilities. For definitions of visit types, see Expanded Insights section.
Note: Please see Expanded Insights section for preliminary insights on Updox.

Video Conferencing Platforms

Often cross-industry; offer basic healthcare workflows. Typically used primarily to enable video conferencing. Sometimes used for general business functions, though KLAS examines clinical use cases only.

EMR-Centric Virtual Care Platforms

EMR-centric telehealth tools; may be driven through a patient portal. Typically allow for scheduling, documentation, and billing, either natively or through integration with an EMR. Video capabilities may be facilitated via third-party technology.

 Patient Experience Inconsistent for Epic Customers; NextGen Healthcare Minimizes Disruption 

Overall satisfaction with the telehealth solutions from Epic and NextGen Healthcare is high (partly due to the positive clinician experience created by strong EMR integration), and all interviewed customers view the solutions as part of their long-term plans. Epic customers tend to have more complex needs, and less than half of respondents say Epic will be their sole telehealth solution; however, all respondents say Epic will be core to their telehealth strategy, with niche solutions used to fill specialized needs. Feedback about the patient experience is mixed; tech-savvy patients who have adopted MyChart are more likely to report a positive experience. However, patient mishaps can be challenging for organizations to troubleshoot since patients must enroll in MyChart and download multiple applications (for the portal and the Vidyo/Zoom video layer). The initial feedback from a few organizations that have deployed Epic’s embedded solution suggests a slightly more positive patient experience, and KLAS has validated very early use of Epic’s new link-based telehealth tool, which allows patients to circumvent MyChart. 83% of NextGen Healthcare customers—whose telehealth needs tend to revolve around straightforward scheduled visits—say they will use NextGen’s Virtual Visits solution (acquired from OTTO Health) as their sole source of telehealth technology. NextGen customers report consistently positive patient experiences—links are sent directly via email and text, allowing patients to easily launch a visit.

Overall Market Trends & Insights 

Unprecedented Adoption Rate Moves Industry from Telehealth 1.0 to Telehealth 2.0 

COVID-19 revealed telehealth to be a sleeping giant. Prior to COVID, the majority of interviewed organizations had telehealth visit volumes of less than 1%, but not surprisingly, those rates increased exponentially in the days and weeks immediately following the outbreak. In a matter of days, organizations had implemented telehealth solutions and at their peak were delivering well over half—and often all—of their visits virtually. As organizations look to the future, the majority estimate that virtual visit volumes will level off to anywhere from one-tenth to one-third of total visits (as long as current reimbursement models remain intact). Interestingly, respondents’ predictions don’t vary much between different organization types (clinics vs. hospitals vs. health systems). However, some specialties, like behavioral health and primary care, are more likely to report higher future volumes.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

Note: Some organizations may have rated more than one product.
† KLAS encourages readers to consider that feedback on MDLIVE may be weighted toward the perspective of provider organizations (as opposed to payer and employer organizations, which make up the vast majority of MDLIVE’s customer base). For this research, 11 of MDLIVE’s 24 standard evaluations and 6 of their 16 supplemental evaluations came from provider organizations. MDLIVE reports that less than 5% of their total revenue is attributable to provider organizations.
‡ These solutions are used widely by healthcare organizations for business use cases. The estimates shown in the Estimated Healthcare Customer Base column are for clinical use cases.

What Does “Limited Data” Mean? 

Some products are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

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.