Telehealth Performance 2022
What Is the State of Telehealth Post-Pandemic?

Amwell: Recently acquired Conversa Health and SilverCloud Health (August 2021). Customer experience reportedly inconsistent, though several respondents are looking forward to new Converge platform. Widely considered in the market; KLAS has validated some customers who have replaced the solution with another.

“Most people that I have talked to about telehealth love Amwell Platform. A busy parent with busy kids doesn’t want to sit in a doctor’s office if their kid has a big gash on their arm. They want to get that stitched up, and they don’t want to sit around a kid that might have the flu or something. I like the convenience of being able to use the system anywhere. If someone gets a jellyfish sting on the beach, I could call right then, hold a visit, and then go pick up whatever medication we need. Amwell Platform is a pretty streamlined and easy system; even elderly people have been able to use it. The system even tells us to test our video and audio, and it walks us through every single piece of that. In terms of technology, the application is really a very smooth system. I have never had any connectivity issues myself.” —Manager

“We are moving away from Amwell Platform because we want to consolidate the number of different software applications that we are using. We are also moving away because of the solution’s expense. Part of that decision was driven by our need to be much more closely integrated with our EMR.” —VP

Caregility: Most customers use solution in inpatient settings that require both hardware and software. Customer respondents say it is easy to add people to multiparty calls. Some are concerned about the vendor’s focus and ability to scale as their customer base grows. Often considered by organizations; KLAS has validated two replacements.

“One thing that makes Caregility a great partner for us is their willingness to bend and mold into what our system needs. It is really beneficial for us to know that Caregility will entertain any of our ideas and help us achieve our dreams. If our dreams are not realistic, Caregility helps us with workarounds and other ideas on how to achieve those dreams. Caregility is always there to listen and at least be part of trying to see things come to fruition. Caregility is able to integrate with the requests we have, and they are willing to entertain the enhancements that we request, and those two things make Caregility a phenomenal partner. We vetted a dozen or so other companies, and we landed on Caregility based on their values and beliefs. We are less of a customer and more of a partner. That is valuable. We are two entities working together toward the same goals, and that means so much to our environment and organization.” —Analyst/coordinator

“My only caution with Caregility is that they are growing and diversifying their product line so rapidly. I hope they can keep up with the demand, support the product, and provide the enhancements necessary for evolving. Caregility is rapidly developing, but the enhancements aren’t there yet. Our organization at least has made a lot of requests for enhancements.” —Director

Mend: Many customers are behavioral health facilities. Respondent outcomes include greater access to care (especially for patients in rural areas), fewer missed appointments, and stable revenue during the pandemic.

“Mend does a fairly nice job. We were looking for something that was not going to be really expensive. We really wanted a platform that also would support our clinic’s workflow, not just be a tool for the doctors to use. Mend had a full package. They had scheduling, chat, and interphysician communication functionalities. They also had the ability to add forms and have multiple people on the calls, and they were able to support all of our workloads. I consulted a couple of different online resources, and we found them. Mend is a nice little vendor.” —Director

“We have issues with Mend’s system. It is still unable to support large groups. We have to use another platform for some things. Every once in a while, we have bandwidth issues with the system, even if we have small groups. We can’t go over a certain number of participants without there being bandwidth issues. Mend’s system is not part of our long-term plans. We have been working on other options. The system cannot integrate with our EMR. Mend hasn’t followed through on providing large-group access, and that is an issue for our organization. We will choose a vendor’s system that provides access to large groups, provides the reporting system that we need, and integrates with our EMR. The biggest reason that we went to Mend was that they provided a group function, but it wasn’t ideal for our setup. There are many vendors that have hopped on the bandwagon for the functionalities we need now, so the options are starting to open up.” —Director

SOC Telemed: Customers mostly use vendor for their physician services in specialty departments; this allows organizations to offer appointments after hours or to supplement staffing gaps. Some respondents are optimistic about the offering, particularly about more EMR integration becoming available.

“One thing that we have achieved is the appropriateness of care. The SOC Telemed system is helping the admitting physicians or ED physicians to make appropriate clinical decisions. Identifying diagnoses is another outcome. We transfer out certain patients that need interventions, and the providers we consult with via the SOC Telemed system allow us to identify whether patients qualify for the transfer and determine where they need to be transferred. We receive support as an extension of our hospitalist service. We have kind of a hub-and-spoke model, and the SOC Telemed system supplements the group of hospitalists in our main center so that they don’t have to take every call or consult from across our health system. They have additional physician resources through the SOC Telemed system.” —Manager

“Telemed IQ doesn’t currently integrate with our EMR. It would be extremely helpful if providers using the system could have access to our EMR for their decision-making and evaluations. The vendor’s technology needs to keep up with where we are in our healthcare system. The vendor is working toward integration. However, that has been an ongoing process, and we haven’t seen them make any movements toward that goal.” —Director

Teladoc Health: Acquired Livongo in 2020 and announced a partnership with Microsoft Teams in 2021. Customer satisfaction has decreased slightly since InTouch was acquired in 2020. Today, however, more than half of respondents are satisfied. Solution is used in a variety of care settings and by various organization types.

“I like the way the devices and software work together and the ease of use. I also like the ability to have things like single sign-on, camera control, and specifically managed and monitored endpoints. The vendor makes sure they are on and ready to go. I like everything about the quality and development of the system. We have been with the vendor for a very long time, and they have kept the spirit of innovation. The vendor’s devices always seem to be on the cutting edge. Our physicians like to use those devices because they are very effective for complex use cases. We are really happy with everything from the utility of the product as well as the management, support, and maintenance. The ability to use the vast network to make connections and find new ways to use the vendor’s devices is good. The vendor has been an incredibly great partner for us.” —Manager

“Teladoc Health’s carts are overpriced. There is a high-dollar value associated with an emergent telestroke situation where we can really impact somebody’s quality of life, and Teladoc Health recognizes that. The system has cost us a lot over time and hasn’t given us much outside of a cart that can provide audio and video connectivity. The system is overpriced for what we get, and that is one reason we are looking elsewhere. The system sounds great, and then it comes with a price tag that was not communicated up front. Teladoc Health talks out of two sides of their mouth.” —Director

Updox: Offered communication tools like electronic faxing before moving into telehealth. Solution is used mostly by small physician practices and is easy to use. Mixed feedback around the vendor’s responsiveness and service. Customers who reported EMR integration most often used Practice Fusion.

“The product is so simple and easy to use for our providers and patients. We are very happy with the system. The process for getting a provider up and running is very lightweight. We create the login, and the provider is instantly ready to go. All they need is a browser and a login. Everything is very quick. I could set up and train a provider who has never used the system before within 45 minutes.” —Manager

“The support people are very slow to respond, and they are slow to fix anything. For example, when we called and said that the site was down, they logged in to one of our computers and said they didn’t know why it wasn’t working. That wasn’t helpful because I still couldn’t log in. The support people are also bad with communication. For example, when we open up a ticket, we might not hear from them for a week. The support people almost treat us like we are beneath them. We do what they tell us to do, and that still doesn’t fix the problem. I just don’t like Updox’s support; it is not very good. The support has been that way since the beginning.” —Analyst

VSee: Majority of respondents are small or single-physician practices. Customers report achieving financial outcomes like increasing patient volume and maintaining revenue during COVID-19. Other positive outcomes include patient satisfaction and convenient access to care. Several respondents complain that physicians become the frontline support when patients struggle to connect.

“I like that Simple Health has good connectivity to our clients no matter how bad the clients’ Wi-Fi or internet connection might be. Simple Health is way easier to use than other products we have used in the past. We can easily send an invite to a client if they are unable to find the invite on our website. With Simple Health, I can tell which of my clinicians are in an appointment or session and which aren’t, so I know who I can contact and who is busy. That is a very nice feature.” —Director

“It is definitely a struggle to get new patients onto the application. The process can be complicated and have multiple steps depending on the particular device that the patient is using. For example, if they are using an iPad, there is no trouble, but if they are using certain laptops or desktops, the process can be impossible. In some cases, I have ended up not being able to use Simple Health because the patient couldn’t get into the application. Older patients have particular trouble with downloading the application. And if they do something wrong, it can be irreversible. The only way that we can start over is if patients have a different email that we can send an invitation to, but people don’t always have a second email. I am very dissatisfied with the process for getting on to the system, and I am seriously considering using a different application. When I have a new patient, especially an older patient, I can’t count on being able to get my patient hooked up to Simple Health.” —Physician

Bluestream Health: Respondents say workflow for physicians is fairly easy to follow. Patients can easily join appointments since they don’t need to download an app. Some respondents have experienced difficulties with training and a lack of proactive service, and there are sometimes problems with connectivity. Outcomes include quick setup and ability to see patients and maintain revenue during COVID-19.

“Bluestream really just requires one click to get into a visit. Patients don’t have to download an app. From our patient population, that is a huge deal because they don’t have the bandwidth to do that. They don’t have apps or smartphones that are really advanced or the capability to even have email. Bluestream allows us to connect to those patients directly and quickly, and that experience is seamless for the patient, so the system is a big win.” —Director

“We didn’t have a lot of implementation support from Bluestream Health. Their people changed during the process. They have had growing challenges; that is the downside of going with the vendor. They have a good team, but we question whether they can scale. I am disappointed that we are in the hole for something.” —Director

Bright.md: Respondents say the asynchronous solution is easy for patients to use. Most reported outcome is improved physician efficiency. Some customers mention the vendor is distant and sometimes overly confident. Additionally, asynchronous telehealth isn’t used as often as respondents initially thought.

“The nice thing about Bright.md is that someone doesn’t even have to be our patient to use it. We have actually successfully marketed the system to areas around us because staffing is an issue everywhere now. The system has actually been really good, and I am glad we didn’t go with another system. To do anything with another system, we would have had to create a medical record number for patients and register them in the system. With Bright.md, that happens on the back end through an API, and that is really nice.” —CMIO

“Early on, the system didn’t have some functionality that we felt would make it much better for patients, and the vendor seemed like they were digging their heels in. They were too confident in their solution and their perspective of the problem they were trying to solve, and they were unwilling to listen to us. Additionally, we were paying a preposterous amount of money for the service. The vendor promised us the moon in terms of the amount of money we would make. Our experience was absolutely not what was promised; we never got to the volume that the vendor indicated we would. They seemed very confident in their understanding of what our payer mix complexity was. Bright.md’s higher-ups didn’t do a good job of building a positive relationship with us. They were pretty stubborn about how they charged us because they believed we should be making money based on their analysis of our patient data. Eventually, there was an individual who saw that the relationship was not going well. They reached out and really turned our relationship around by listening and helping the company treat us differently.” —Director

Martti by UpHealth: Offers on-demand interpretation services in addition to their telehealth platform. Respondents appreciate the access to interpreters to help patients, along with the ease of use. Some are dissatisfied with the vendor’s service and delivery of new technology. All respondents say the solution is part of their long-term plans.

“I am quite happy with Martti Telehealth. The interpreter comes relatively quickly; they come within minutes, and that is much better than our in-person experience with interpreters. The system’s contribution to our telehealth presence is translation. We don’t use them as a telemedicine platform. We have worked to integrate their product into our telehealth platform so that a clinician can click a button, select a language, and send out a call to Martti Telehealth based on the language that is selected. We also pass through all the billing and patient information. Within a minute, an appropriate interpreter pops on to the same telemedicine meeting. The system basically turns any phone into an interpreter device without extra apps.” —CMIO

“There is a huge gap between the vendor’s vision and where they are. They don’t have enough language to recognize where they are, so they set up expectations. For example, no matter who the representative is, the vendor keeps selling really high expectations and missing the bar. As a client, we calibrate lower expectations. We have been let down with a lot of things in the hospital because we haven’t been able to follow through on what was promised to us.” —Manager

swyMed: Used by paramedics and emergency care physicians, especially by those offering care in rural areas, critical access hospitals, or facilities with low staff bandwidth. Customers say the solution helps them provide care more quickly. Some report challenges with the product’s user interface. All respondents say they would buy the solution again and that it is part of their long-term plans.

“I originally became familiar with the system when the vendor went into the audiovisual side of the technology and was able to deploy their technology in low-bandwidth, rural areas. swyMed Telemedicine was the only platform that could sustain a low 3G connection at quality so that we could have telehealth cardiologist visits. Our organization is in an urban area, but we have a lot of buildings with six inches of concrete and signal-quality issues. swyMed has the platform and capability to continue to have quality over low bandwidth even with the obstructions. swyMed is doing massive amounts of telemedicine in areas where bandwidth is at a premium. swyMed actually offers a telemedicine backpack, which we use here for our first-responder program where we can take the telemedicine backpack for in-field triage.” —Manager

“The interface of the product is a little dated and more complicated than it needs to be. We have asked the vendor to remove icons that we aren’t using from the user interface because it is so massive. We probably don’t need 80% of the things because the system is not integrated with our EHR. The system is not intuitive. It is icon-driven software and is not easy to use for people who aren’t highly clinical. The kit that has to be assembled for the stethoscope is time consuming and unstable. That isn’t easy to do.” —Director

ViTel Net: Customers say vendor is highly responsive. Reported outcomes include fast clinical intervention and improved care quality, as well as patients being satisfied with the convenient access to care. All customer respondents say the solution is part of their long-term plans.

“I like ViTel Net’s responsiveness to their customers. I could text my representative and ask for anything, and they would do it quickly and responsively. I don’t have to wait to hear back for three days. Thus far, we have thrown all sorts of things at ViTel Net, and they have been able to make those things work. ViTel Net is really good at troubleshooting. They can work very professionally with outside IT teams to make things work. There is no finger-pointing.” —Director

“We have issues with the system. It was supposed to do one thing but didn’t, so the vendor fixed that issue, and we were trained on it. But ever since we implemented the function, it has never been smooth. There are often roadblocks. If something on the screen is missing, we have to call IT and repair things that we already have spent some time troubleshooting. When we go back in again, we have to do everything all over again. Most of our issues are with the actual use of the system after training and fixing it. There are frequent surprises that require a lot of time commitment on our end. The system costs us a lot of time and effort.” —Physician

Zipnosis: Offers an asynchronous video solution. Respondents report using the solution to expand a business line and improve patient satisfaction and access to care. Some mention challenges with intake questions and patient confusion around what an asynchronous visit is.

“I like the ease of use on both the provider side and the patient side of Zipnosis’ system. Providers get a notification and are basically handed over a visit that is in the queue, and providers are able to respond and take care of that within 5–10 minutes. The system is pretty convenient for providers, so it doesn’t take a list to get providers to participate. The ability to have new patients use the system is also good. One of the drawbacks of having different EMRs is that patients have to be established in the system. Zipnosis’ system can attract new patients, and that is the key reason we keep it.” —VP/other executive

“The feedback from patients is usually that they are confused about where they are supposed to go and when they are supposed to go there, especially when we launched the video piece. We had lots of patients who would log in to what was supposed to be their video visit, but the system would start an eVisit. Sometimes the links would take patients to the right place, and sometimes they wouldn’t. Patients feel like they should be able to jump right into a visit much more quickly than they can. We really tried to whittle down some of the intake questions so that patients could log in and get started. We built in some questions in some areas, and we weren’t going to change them. In other cases, there were standard questions from Zipnosis. They removed those questions upon request and recognized that some of the patient and provider feedback was that those questions weren’t adding a lot of value. Some of the patients wondered why they were being asked about their medical history when they were already a patient at our organization.” —VP/other executive

Doximity: Physicians are satisfied with the solution because it is easy to use for both physicians and patients. Solution used in a variety of settings, but mostly large and midsize clinics. Some organizations say it is fairly easy to add multiple parties to a call, even if it is last minute. Respondents experience less integration than customers of many video conferencing solutions or virtual care platforms.

“The benefit of Dialer with the patient experience is it doesn’t require patients to download an app. That makes it easier for the patient to get into the visit, and that was a stumbling block for some of our patients at the beginning of the pandemic. Clicking on the link, downloading an app, and going into that app to get everything set up just required a lot more steps. Dialer makes the process of getting into the visit more streamlined.” —Manager

“We have had such a good experience with Doximity. But when we use Dialer instead of another telehealth program that is integrated with our EMR, we don’t get our registration completed, we don’t get consent documents signed, and we don’t collect a co-payment. We don’t offer any of the things that a patient can do in our patient portal. Dialer is not a full replacement for our classic process. There are tools we would love our patients to have, so if Doximity was to add deeper integration with our EMR in terms of tasks that need to be completed before the patient connects to the doctor, that would be valuable to our health system. Those tasks may include a customized consent document, general consent for treatment, or a way for us to collect a co-pay or update the patient’s registration information. That piece hasn’t really been addressed at all with the Doximity platform. Dialer isn’t a full-spectrum telehealth platform; it is just a video and voice platform.” —Manager

Doxy.me: Used mostly in small to midsize clinics. Most respondents are satisfied, and many report a strengthened relationship with the vendor over the last year. Solution is one of the least vulnerable to replacement, according to customer respondents’ long-term plans.

“Some patients are technologically challenged, but Doxy.me gives them an easy way to do telehealth. They just click on the link to get in the visit. That is all they have to do. Then they just wait and chat with the doctor.” —Physician

“We have had issues with making the camera work. For example, providing permissions to the cameras to utilize the program can be confusing for some of our patient population. Language barriers can sometimes be an issue with some of our patients when only English, Spanish, and Portuguese are available because we have other populations that we work with. Some of our patients have bandwidth and broadband issues. Doxy.me says that we can always reach out to them. They have the ability to do standard definition and lower definition calls as well as audio-only calls.” —Director

Vidyo: Cross-industry vendor with diminishing healthcare market share, especially after Epic switched their video layer from Vidyo to Twilio. Customer respondents say solution works but that the vendor’s service is insufficient and their technology is stale. Reported outcomes include patient satisfaction, a quick setup, and the ability to scale based on telehealth volume.

“The product has performed satisfactorily, and the vendor has been very fair on their pricing. We have an annual maintenance fee, and the vendor is more than helpful. We have gotten a lot of time out of them, and they have gone above and beyond. The platform is stable and very easy for patients to use. The vendor seems to be adding new features on a regular basis.” —Manager

“I am not sure what Vidyo is planning to do with new technology, but what I have heard is not a whole lot. We are not really pleased, but we will see what is in the future. We are switching over to the new version, so it is going to be all-new training again, with things looking somewhat the same but in a whole new place. I am not happy about that. So far with the new version, I have not seen anything really different; I have just seen things that have improved here and there. The new version has the same functionality but different ways of finding it. There are little things that are going to take new training. Using the software on the iPad is not so bad, but the functionality on a PC is very different. I have also noticed that I have lost the functionality of one of our telemedicine devices. I could just dial directly on the older version, but on the new version, I still haven’t found that. I have searched everywhere and still haven’t found it, and that is not a good thing. I can’t say the newer version is going to be great.” —Analyst

Zoom: Cross-industry vendor. Organization respondents report few connectivity issues, and patients can join via app or internet browser. Customers who are considering replacing Zoom are most frequently considering their EMR vendor’s telehealth solution. Used by various organization types, mostly in outpatient scenarios.

“Zoom for Healthcare excels in multiparty scenarios. The system does well in a lot of areas. We can bring in interpreter services, and we can bring in family members from across the country. We like Zoom for Healthcare because we always know who is in the meeting. The link is password protected, so we have to actively give the link to someone. When somebody we don’t know joins the meeting, we can see them and call them out. It is tougher for people to join the meeting without permission because of the settings that we have in place. Also, we can include the right people when we are scheduling, so we don’t have to think about sending a link at the last moment. If I have an appointment with someone in two weeks, I can put it on their calendar right away. I can give them the link right away, and I am done. I can move on, and I don’t have to think about it.” —VP/other executive

“Zoom requires an extra step because patients have to download the app. That step could cause problems with connecting at the time of the visit. Our physicians’ levels of experience with Zoom have driven their patients’ ability to connect and how much time they spend troubleshooting. A lot of our providers have to help do some troubleshooting. They don’t like that though.” —Manager

Microsoft Teams: Cross-industry vendor whose solution is used internally by many healthcare organizations. Respondent feedback is mixed: some highlight user familiarity, stable multiparty calls, and robust audiovisual settings while others mention the number of steps required for patients to join calls, the low support quality, and the fact that appointment links don’t exist and can’t be shared until after appointments are scheduled.

“Teams is the only platform that we can give the highest rank to for multiparty scenarios. The vendor isn’t using WebRTC. They have their own server. The solution is good, especially in group therapy scenarios.” —Analyst

“Teams is very difficult for some patients. When there is an old population, people have to remember to go to their email and click the link. Sometimes, they don’t have Teams installed on their device if they haven’t used it before. We have to go through the installation process. There is a lot of babysitting. The physicians need the solution more than the patients do. The physicians are happy to have it, but it isn’t easy. They have to depend on wireless connectivity. When there is a problem, it throws a wrench into everything.” —CIO