Integrating Telehealth into an EHR using QuickBlox Q-Consultation

QuickBlox recently worked with a large healthcare provider based in the USA that operates seven long-term acute care facilities. They deal with highly complex cases, treating patients who require extended critical care, offering a multidisciplinary approach. Their in-house IT team custom-built the hospital’s robust electronic health record system (EHR), to support patient care. Their EHR satisfied many of their needs, foremost as a data center logging data from numerous medical devices to provide full patient records, and also as a health information exchange (HIE) between its seven sister hospitals. Among its features the EHR offered access to up-to-date patient vitals, nurse and physician documentation, and voice dictation for note-taking on the move.

The hospital group turned to QuickBlox to add teleconsultation functionality to its existing EHR. QuickBlox’s feature rich communication APIs and ability to install their software on the hospital’s own private cloud and local servers meant they were the obvious choice for this project.

The Requirement

Improved communication

As a provider of acute-care, the medical staff at the hospital understood the paramount importance of effective and timely communication. Life and death decisions about diagnosis and treatment planning, the ability to promptly share medical records like test results, and the need for private consultation required an efficient and secure communication solution.

Nurses and doctors at the hospital needed to communicate easily and privately with family members of patients under their care. The impact of Covid-19 which prevented family members from being able to visit the hospital intensified the need to provide a digital means for care teams to communicate with them.

Frequently, care coordination required doctors to consult with other healthcare professionals outside of acute-care. Furthermore, because staff were generally mobile and away from their offices and desktops, they needed communication channels that were available on their mobile devices.

The hospital recognized that integrating a telehealth platform within their EHR could improve their quality of medical care and ultimately patient outcomes.

HIPAA-compliance

Like all hospitals the hospital operates under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) which is a federal law that has established national standards to protect sensitive patient health information from being disclosed without the patient’s knowledge or consent.

This means that any communication with and about the patient needs to be stored and transferred within a secure and protected environment. Although it might have been convenient for family members to contact doctors with popular messenger mobile apps, like WhatsApp, the use of such third party platforms posed serious concerns around data privacy.

Regulatory requirements meant that all patient-related data including protected health information (PHI) needed to be stored on the hospital’s own private cloud. Doctors and nursing staff needed to feel confident that they could disclose sensitive information and provide personal consultations without worrying about data falling into the wrong hands.

Time and cost efficiency

The need for an effective communication solution was immediate and the outbreak of Covid-19 in 2020 only hastened this urgency. But building a communication solution from scratch would be a timely and costly venture. Whereas finding a ready solution was an attractive prospect. Also, rather than building an entirely separate communication app, management felt it would be more convenient to integrate communication functionality into their existing EHR system. Staff were already logged into their EHR which was accessible on their cell phones, tablets, and desktops. Adding chat, voice and video calling would enhance their existing system while keeping hospital resources streamlined.

The Solution

Q-Consultation

Understanding the particular needs of healthcare, QuickBlox offers a number of HIPAA-compliant solutions. Notably it has built a fully customizable virtual waiting room and teleconsultation app. The app supports medical professionals to provide quality of care in real-time by offering virtual visits. Doctors can invite other healthcare practitioners, patients or family members into a private consultation. The individual is sent a link to connect with the doctor. Once their identity is authenticated they are invited into a waiting room until the doctor is ready to meet in a private, fully secure, recordable tele-consultation session. Administrative staff are able to manage patient queues, triage patients with one-on-one chat, assign patients, share notes and patient history. The doctor can also take notes, share documents, files, and images, chat, and switch between video and voice.

Customizable & compatible

In addition to its rich and relevant features, Q-Consultation was an attractive option for the hospital because it was easy to integrate into their existing EHR system because it was built on javascript. It was also fully customizable. Collaborating with the Quickblox team, the hospital’s IT team altered the workflow of the app to suit the needs of the hospital. For example they changed the authentication set-up. They also altered the UI screen, customizing the look of the app to match the hospital’s branding.

Secure Private Cloud deployment

Perhaps one of the most compelling reasons to use QuickBlox was their flexible approach to software deployment. QuickBlox could deploy Q-Consultation directly in the hospital’s own cloud environment. This would mean that all patient data and communication would remain fully in their control.

The Outcome

The QuickBlox platform and Q-consultation has now been successfully integrated into the hospital’s EHR providing doctors the opportunity to consult privately with other medical staff and their patient’s family. The integration of telehealth in their EHR platform provides an optimal way to provide remote patient care, so critical during the Covid-19 pandemic and beyond. The availability of Q-consultation on their own tablets and mobile devices enables clinical staff and primary care physicians to offer healthcare consultation on the move.

• All communications are fully secure on the hospital’s AWS cloud.
• The app has been customized to match the hospital’s requirements.
• New functionality has been added including the ability to record consultations as video chat transcripts.
• Q-consultation has been integrated into the hospital’s intranet, allowing patient caregivers to access the app on hospital terminals where they can view a drop down menu of available medical providers and then send a message to connect for a digital consultation.

This hospital’s successful integration of innovative communication solutions into their EHR demonstrates why they are one-step ahead of their peers. They provide quality care through telehealth integration. Collaboration with QuickBlox has allowed them to develop a secure communication platform enabling doctors, nurses, and patient caregivers to communicate effectively and privately wherever and whenever they need.