Last updated: 5/3/18

By Dave Levin, MD

The American Telemedicine Association’s (ATA) annual conference just wrapped up in Chicago and there’s no question telehealth is hot and getting hotter. Here are three key observations based on my discussions with attendees and vendors.

1. Telehealth is really virtual health

I’ve never much cared for the term telehealth. Too many people equate that with television rather than telemetry. Walk around the exhibit floor or peruse the agenda at ATA18 and clearly what we are doing is creating a virtual health system. Essentially, this is about removing time and physical space as barriers to care. Telehealth may have started with the first doctor-patient telephone call, but it is now well on its way to robust multi-media and a dizzying array of devices that connect through the “internet of things.” The variety of use cases is increasing and reflect the reality that either end of the “connection” may be fixed or mobile, an individual or a group, a clinician or patient. There’s still a long way to go. But, the need is enormous and the potential obvious. As barriers like provider credentialing and reimbursement fall, the move to telehealth will accelerate further.

2. Video is transforming from hardware heavy to software

Early deployments of video for telehealth were expensive, complex and heavy on the hardware. While there are select use cases where this type of tech is needed, the trend is clearly towards leveraging the plethora of devices that have infiltrated our day-to-day lives. Hence, you see companies like Zoom moving into healthcare. They have mastered the art of providing videoconferencing on demand with your mobile device. This has enormous implications for driving down costs, expanding access and simplifying traditionally challenging activities like provisioning devices. Other than perhaps downloading some software, there’s nothing to “provision” if you already own and use the device! There’s still a place for high-def video, but it’s going to be limited to special applications like tele-dermatology.

3. Interoperability remains a fundamental barrier

All telehealth vendors claim to be interoperable with EHRs. If your definition of interoperability literally includes copy/paste or manual transcription, then I guess the claim is true. The better systems are leveraging legacy technology like HL7-based interfaces, flat-file exchanges or CCDs, but, these are expensive to set up, inconsistent, incomplete and rarely lead to a truly seamless, productive and pleasing result for providers or patients.

Most telehealth applications need robust clinical data in real-time from the EHR because it is the ultimate source of clinical truth in health IT ecosystems. It also must close the loop by putting information back into the EHR to create continuity, reduce errors and improve satisfaction. Some vendors are counting on FHIR to solve this problem, but as I noted in my recent blog, we need to be mindful of the hype and shortcomings associated with FHIR.

The winners in telehealth will be early and aggressive adopters of more robust interoperability solutions like proven APIs. I know some folks who can help with that right now

Dave Levin, MD is the Chief Medical Officer at Sansoro Health where he focuses on bringing true interoperability to healthcare. Dave is a nationally recognized speaker, author and former CMIO at the Cleveland Clinic. He has served in a variety of leadership and advisory roles for Health IT companies, health systems and investors. You can follow him @DaveLevinMD or email


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