Standard Features in a Telemedicine Software Platform

Below is a categorized list of features that you will typically need.

Patient Portal

A patient portal is a web application where your patients can login and securely engage with you. One of the questions that frequently comes up is should I just have a telemedicine mobile app? Do I need a web patient portal too? The reality is that a web based solution is very important if not more than a mobile app. For apps that are not used very frequently (WhatsApp would be a high frequency usage case), users typically prefer to just use the web and avoid having to download an app. Hence it is quite important that you consider adding a web patient portal to your telemedicine solution.

Depending on your actual business case, you can always consider starting with the web first and then adding in the mobile apps in a second stage, once you have sufficient patient usage and traction. Some capabilities that your patient portal should support:

• Allow patients to register and sign-up with your telemedicine service
• Provide searchable listing of your telemedicine providers, their detailed medical profiles and allow patients to book consultations with them.
• Allow patients to book and avail of the various telemedicine services you choose to offer. These services typically include video consultations, question based telemedicine consultations, remote patient monitoring programs or care plans and appointments for walk-in consultations.
• Access and update their health records. Depending on your telemedicine business requirements, this might be limited to a basic health profile or it can include a more detail patient record that covers their medical reports, medications, allergies, hospitalizations, co-morbidities and more. If you also deal with care plans, then it is important that patients have the ability to update various health trackers via the patient portal.
• Download Prescriptions, Lab Orders and Consultations: For most telemedicine businesses, the prescription, lab order or consultation note is the end point of a consultation. Hence providing patients access to their prescriptions, lab orders and consultation notes as downloadable PDFs is a critical function.
• Manage their associated family accounts.
• Support patient education initiatives.

Video Consultations

Video Consultations

Video Consultations are typically the key telemedicine service offered by most businesses. Here are some of the key features to be considered for Video Consultations:

• Appointments for Video Consultations

Many telemedicine businesses choose to follow an appointment based workflow for video consultations. Appointments typically allow patients to book telemedicine video consultations based on a combination of their chosen provider, a specific service that is offered by the provider, a specific time-slot based on the providers calendar and other factors.

• Waiting Room based Video Consultations

Some businesses prefer to use a no-appointment flow for the video consultations. The Appointment vs Waiting Room workflow is discussed in more detail later

• Video controls

Basic controls like pause the call, mute the audio, toggle the video.

• Screen share

Screen sharing is important for providers to be able to be able to share educational materials or other material with patients during the telemedicine session.

• Multi-user video calls

Multi-user telemedicine session involving patients, family members, care givers, providers, translators and other other user roles.

• Low Bandwidth Capabilities

The ability for the telemedicine software to work in low bandwidth environments and toggle between audio only mode and video enabled mode based on the bandwidth conditions.

• Call Recording

Ability to record the telemedicine call and archive it.

• Chat and File Sharing

Chatting and exchanging files during a video session.

• Notifications and Reminders which are a critical element in patient engagement and minimizing no-shows and last minute cancellations of the telemedicine session.

Text Consultations/Patient Questions

Text Consultations/Patient Questions are also a very effective form of asynchronous telemedicine consultations. Many telemedicine businesses have found Text Consultations to be a key revenue generating service and one that is surprisingly popular with patients. Some key aspects of this feature:

• File Uploads

The ability for upload medical reports and other documents during the text consultations

• Setting patient expectations

One of the key advantages of text consultations is that it is an asynchronous form of telemedicine. This however makes it imperative to set the proper expectations for patients and ensure that patients are aware about timelines regarding the consultations.

• Flexible Follow-ups

Providers need the flexibility to be able to structure the text consultation exchange as per their requirements

Patient Records

Patient Records

Patient Record are a critical element of any telemedicine consultation solution. Some telemedicine solutions might either choose exclude this completely and just choose to integrate with existing systems while others provide an inbuild patient record system. Typically patient records would comprise of the patient profile, health conditions, allergies, medications, hospitalizations, co-morbidities, surgeries, family history, social history, contraindications, vaccinations and health trackers. Health Trackers can be extensive and there are hundreds of potential trackers across various medical specialties. It is however important to have at least a few basic trackers for the vitals.

Remote Patient Monitoring and Care Plans

Remote Patient Monitoring and Care Plans

The Covid pandemic shook up the entire healthcare industry and while things have reverted back to their pre-pandemic baseline in many cases, Remote Patient Monitoring(RPM) adoption is one area that is continuing to witness significant adoption post pandemic. Combined with device integrations and remote patient monitoring, care plans present a great revenue opportunity for healthcare businesses. They allow telemedicine businesses to maximize the revenue per patient, while improving patient outcomes. Some of the basic features expected in RPM Telemedicine software are:

• Flexible Care Plans

The ability to create and manage flexible care plans bringing together care-teams, health trackers and different forms of online consultations.

• Subscription Payments

Integrated subscription payments allowing providers to create different packages that meet their care needs and financial objectives.

• Integration with trackers and health devices

Care Plans can be integrated with trackers and also consumer health devices allowing patients to send data directly to their providers from their connected health devices

• Patient Engagement

Allow patients and providers to engage in the context of their health data and individual health data readings

• Adherence Tracking and Reminders

One of the key advantages of text consultations is that it is an asynchronous form of telemedicine. This however makes it imperative to set the proper expectations for patients and ensure that patients are aware about timelines regarding the consultations.

• Care Teams

Putting together care teams comprising of different provider types and the assigning them roles and responsibilities for a particular care plan.

Family Accounts

Family accounts are a critical feature in any telemedicine software. It is quite common to have the tech savvy members in a single family manage a number of accounts or have an adult create accounts for his or her elderly parents or young children. Giving patients the ability to create these family accounts and switch between these accounts as required is standard feature in most telehealth software applications.

Prescriptions

The end point for most telemedicine consultations would be a prescription that can be shared with the patient. Most telehealth software would therefore include the ability to create prescriptions branded with the business details during each consultation which can then be available to patients via the web patient portal or the patient mobile app. Key aspects to consider:

• Downloading these prescriptions as PDF documents is a critical requirement for many telemedicine businesses or startups.
• Branding prescription documents as per the business requirements and incorporating the necessary fields required by the regulation.
• Integrating with a list or database of frequently prescribed medications, so providers can save time during each telemedicine encounter, instead of having to repeatedly type out the details of each medication during each telemedicine encounter

Patient Encounter Notes

Patient Encounter Notes

Encounter notes is obviously a basic function and most telemedicine software applications would provide an option for this, allowing providers to capture their SOAP notes detailing the patients symptoms, their observations, assessments and treatment plans. Providers should be able to easily generate prescriptions, lab orders, create new appointments, set health goals as part of the encounter.

Lab Orders

Similar to medical prescriptions, providers also need to be able to create Lab Orders during a telemedicine encounter. Key aspects include:

• Creating lab or imaging orders during a patient encounter
• Available to patients to view and download the lab orders as PDF’s
• Allowing Lab Technicians or other user roles access to the lab orders without accessing the rest of the confidential patient data

Configuring your telemedicine services

As a telemedicine startup or business, your providers will typically provide a number of services to patients. These services might differ in their duration (length of the telemedicine consultation), the pricing that you charge for this consultation. So a single specialty medical clinic might choose to create services like First Visit (30 minutes), Follow-up Visit (15 mins), while a multi-specialty hospital or multi-specialty telemedicine startup might choose to create telehealth services based on their departments like Dermatology Consultation (15 min), General Physician Consultation (15 min), Psychiatric Consultation (1 hour) etc all with different price points. Your telemedicine software solution should be able to accomodate these use cases:

• Flexibility to create and manage different telemedicine service types with different price points and taxation rules
• Link services to providers and consultations, so a patient can book an appointment slot with a provider for a specific service

Telemedicine Appointment Scheduling

There are different workflows that you can employ for a telemedicine startup. In most cases, your workflow would involve an appointment based flow. Even in cases where you don’t use appointments for your primary workflow, you might still need appointments for other use cases. An efficient and precise Telemedicine Appointment Scheduling software is therefore a must have feature for a telehealth startup or business. From a patient perspective, appointment scheduling software is key to ensuring effective and timely care. Some key capabilities for telemedicine appointment scheduling software:

• Provider Calendars

Providers should be able to define their schedules precisely down to the minute and specify the services they provide during each of the calendar slots. Providers should also be able to block off time on their calendars to prevent telemedicine appointment scheduling during those periods.

• Real time appointment scheduling

An appointment scheduling system that can allows patients and providers to book appointments taking into consideration the provider available slots, services all calculated in real time.

• Rescheduling and Cancellations

It is important that providers and administrators have the ability to reschedule appointments or cancel appointments based on the requirements of the patients or providers.

• Self-Service Online Telemedicine Appointment Bookings

The telehealth appointment software should allow patients to book and manage their own telemedicine appointments. Patients should be able to see a calendar of available slots for a their chosen provider and telemedicine service. The self-service appointment booking is offered through the web patient portal or the patient mobile application.

• Schedule Manager

A comprehensive schedule manager that allows the practice administrator or appointment coordinator to view and manage the telemedicine appointments is a basic capability. It is also important to be able to book appointments for a specified patient.

• Appropriate Roles

Telemedicine start-ups typically have workflows that differ from traditional healthcare organizations. Some of them employ website chat or call-center based workflows for their telemedicine based appointment bookings. It is important that the telemedicine software provides appropriate user roles that allow such workflows, so these appointment bookings can be done without compromising patient privacy

• Appointment Reminders and Notifications

Sending automated appointment reminders and notifications are critical to be able to reduce no-shows and last minute cancellations for telemedicine appointments

Practice Locations or Branches

If your telehealth business has physical branches or virtual branches, then you would need the telemedicine software to provide a practice location/branch feature. You should be able to assign employees and providers of your telemedicine business against each of these practice locations.

User Roles

Except for the use case of solo providers offering telemedicine services to their patients, it is expected that telemedicine software will be able to accomodate the multiple user roles that are typically found in traditional healthcare organizations like hospitals, clinics or new age virtual care services. Telemedicine software would typically need to provide roles for different user types like care providers, nurses, administrators, patient coordinators, finance team members, pharmacy team members, lab team members, appointment coordinators etc. These roles are important to ensure compliance requirements and that organizations are able to restrict access to sensitive data to just the required individuals.

Notifications and Patient Engagement

A flexible notifications system that allows patient engagement through various channels like Email, SMS and Push Notifications is very important feature of a telehealth software platform. The notification system should typically integrate with all the relevant telemedicine features, provide reminders and alerts, patient engagement pushes, besides allowing engagement with patients on a one-on-one or group basis.

Patient Education

Patient Education is a key aspect of patient engagement. While it possible to use external channels like social media and newsletter management software for this purpose, it often helps to have some form of an patient education solution directly integrated into the telemedicine software platform so it makes operations significantly easier.

Device Integrations

Adoption of consumer health devices is growing exponentially and has accelerated post pandemic. While the consumer adoption of these devices has always been robust, providers have always been reluctant to consider this data in their diagnosis. However this is fast changing. Recent studies have shown that providers are increasingly willing to take this data into account, especially since they themselves are active users of these consumer health devices. As the adoption of Consumer Health Devices increase, these devices will increasingly play a big role in telemedicine consultations. In addition to this, there are third party systems like Apple Health Kit and Google Fit, that have achieved a critical mass of users with millions of users using these services to store their data. It is important for any telemedicine software solution to have a well defined roadmap for integration with a relevant range of devices and integration with key third party health clouds and services.

Telemedicine Mobile Apps for Patients

Telemedicine Mobile Apps for Providers

Do your providers need a mobile app or will it be sufficient for them to use a web interface? In case you do decide to provide mobile apps to your providers then you will need to prioritize between the features that should be made available via the app. Patient management, Appointment Scheduling, Video Consultations, Text Consultations, Remote Patient Monitoring are some of the basic functionality that you will probably need in the provider mobile apps. In general, it would be quite reasonable to restrict the functionality on the provider mobile app to the set of provider use-cases that your business requires. Administrative functionality can be restricted to the desktop web interfaces

API’s

Depending on your business, API’s can be an important consideration in deciding a telemedicine software platform

Some telemedicine platforms will provide most of your features in a box and if this meets your requirements, then API’s might not be a high priority consideration. If you are a new telemedicine startup just launching, then it is worthwhile to find a platform that can meet your immediate and future requirements. An all-in-one approach can be really helpful in reducing you’re the overall costs of your software stack and it also eliminates any API dependent development activity. This is definitely convenient as it helps reduce your costs and it also means you do not have to deal with multiple vendors.

On the other hand if you already have an existing EMR in place, then you might find it important for your telemedicine software platform to integrate with the EMR. Other such situations might be that you have an existing appointment booking system in place or you have an existing RPM system that your team already uses.

APIs will be important to enabling any such integration requirements that you have today or in the future. You should also attempt to understand the scope of the available APIs and understand the type of integrations they can support and the future development plans for these APIs. In summary, APIs are very important from the perspective of future proofing your business. Even though you might not need them today, it would be prudent to assume that you will need APIs at some point in the future and choose a telemedicine solution that has you covered.

Payment Gateway Support

Unless you have insurance based flow, collecting payments from patients is bound to be a top priority when implementing a telemedicine software platform.

You will need to find a suitable payment gateway provider who can provision an account for your telemedicine business. Most payment gateway solutions will charge a fixed monthly fee plus a percentage of the transactions that are routed through them, so would need to look around to find the most suitable and cost-effective option. Other factors like maturity of dashboards, availability of reports, reliability, robustness and other factors need to be taken into consideration as well when making a decision.

Also keep in mind that not all payment gateways will support telemedicine businesses. In many countries patient originating healthcare transactions might be considered high risk due to various regulatory factors and payment gateways might not provide you with an account. It is always advisable to check directly with the payment gateway and ask about support in your specific country. Keep in mind that even though, a payment gateway might provision you an account in one country, they might not be able to do so in another country. This is especially relevant to telemedicine businesses that plan to operate across multiple countries.

Patient Credits/Discounts

Features like patient credits and discounts are important for user promotions and other marketing schemes. They allow you to market to patients and provide them some form of discount or reward for using your service. Common scenarios include:

• Granting credits to certain patients or to corporate patients as an incentive to use your services. These credits can be redeemed against the online services you provide. The payment module should be able to handle this transparently.
• Another common scenario for telemedicine businesses is the handling of cancellations. These might arise due to various factors including provider unavailability, poor network conditions etc. In such situations the telemedicine platform should include in an inbuilt wallet that allows you to issue credits in lieu of the cancelled consultation. These credits can then be redeemed when booking a new consultation. This approach is better than having to refund the actual payment back to the user and it ensures that you do not lose revenue. Also keep in mind that payment gateways might get concerned if you have a high level of refunds and an inbuilt credit system, allows you to deal with this without having to involve the payment gateway. Ideally your telemedicine platform should handle all of this transparently without the need for any manual intervention.
• Credits can also used to implement a loyalty program where you can grant credits to patients for their continued usage of your services. These credits can then be availed against their future usage.

Control Panel for Telemedicine Software Platform

As a telemedicine business you need a robust system that allows you to manage the entire system from an easy to use, robust interface. Here are some of the critical aspects that you need to part of the telemedicine software solution control panel:

1. Provider/User Management

Provider and user management is a critical component of any telemedicine solution. Most telemedicine businesses will need to frequently add in and remove new providers and employees, assign roles and make other changes. Being able to manage the provider profiles is another key factor. Patients typically make their decision regarding their telemedicine consultations based on the provider profiles. Provider profiles will comprise the provider designations, specializations, work experience, academic qualifications and achievements.

1. Patient Functionality

Controlling patient registrations, being able to quickly add/remove instructions for newly registering patients based on your marketing programs, managing patient groups and categories and other such features.

1. Departments

Creating and managing departments based on your organizations requirements

1. Payment Controls

Tax rate management, currency controls, payment gateway configurations

1. Patient Terms and Provider Terms

You need to be able to control the terms and conditions for your patient terms based on rules and regulations in your country and also based on the services you provide. Patients need to consent to these terms when they signup for any of the services you offer

Compliance, Privacy and Data Storage Requirements for Telemedicine Software

Depending on which country you are operating in, you will need to explore the list of healthcare regulation and data storage requirements that might apply to your telemedicine application.

1. Data Storage Regulation for Telemedicine Software

Some countries are putting in place legal requirements that mandate that the health data needs to reside within the geographic boundaries of the country. In some cases it is sufficient that a copy of the data resides within the country. There are also some countries which prohibit the data from leaving their boundaries even for temporary processing. Some of the countries which are known to have data storage regulations include UAE, and France. Many other countries like Brazil, Thailand, Nigeria have established laws that are modeled on GDPR, that permit the storage of data in other countries provided they provide adequate levels of protection. Many countries like India are in the process of rolling out their data regulation laws. Based on these requirements, you will need to determine your hosting requirements and check on the data center capabilities of your telemedicine software company.

1. Compliance Requirements for Telemedicine Software

You need to be aware of any healthcare compliance and data/privacy regulations like HIPAA and GDPR that might apply to your telemedicine business. Many countries are putting in place their own data and privacy regulations and many of them are based on them on GDPR. These typically have implications for digital healthcare as well. You need to explore these regulations to understand the implications of this in terms of feature set of the telemedicine platform and your business services.

Data Security for Telemedicine Software

Some countries are putting in place legal requirements that mandate that the health data needs to reside within the geographic boundaries of the country. In some cases it is sufficient that a copy of the data resides within the country. There are also some countries which prohibit the data from leaving their boundaries even for temporary processing. Some of the countries which are known to have data storage regulations include UAE, and France. Many other countries like Brazil, Thailand, Nigeria have established laws that are modeled on GDPR, that permit the storage of data in other countries provided they provide adequate levels of protection. Many countries like India are in the process of rolling out their data regulation laws. Based on these requirements, you will need to determine your hosting requirements and check on the data center capabilities of your telemedicine software company.

• Data Encryption

As a telemedicine software platform, you need to ensure that the data transmission is encrypted. The data needs to be encrypted at transition and at rest

• WebRTC

If your telemedicine software platform allows video calls, then you are probably going to be using the WebRTC technology for the implementation of the telemedicine video calls. You need to ensure that the connections are secure and the voice and video data streams are encrypted.

• PHI

Ensure that your telemedicine software platform deals with patient health information in ways that is inline with the data regulations in the country in which you are operating. In many cases data and privacy regulations would prohibit the transmission of patient health information over public data networks.

• Security Infrastructure and Features

Does your telemedicine software platform have the security infrastructure in place – is it protected by an enterprise grade firewalls with frequently updated security rules? Do you have digital security certificates, encrypted passwords and other necessary security features?

Usability of the Telemedicine Software

Usability will be another key factor to consider when developing/evaluating your telemedicine software solution. Telemedicine platforms would need an easy and intuitive flow. Keep in mind the nature of your patient base. One useful exercise would be to develop a set of patient personas who you expect to be using your telemedicine service. Think through various attributes like age, gender, demographic, family status, geographic location, career, technology access, problems, motivations and intentions. Once you have defined a set of personas you need to think through the user experience from their perspective. There are also other exercises that you could consider when finalizing on the user interface including user interviews,

Keep in mind user experience can have a direct impact on your revenues and one well known study showed that 88% of users will not return if they have a bad experience.

Robustness of the Telemedicine Software Platform

You need a telemedicine platform that is robust and can grow with your business. Many telemedicine businesses might start small, but can be expected to grow over time. A telemedicine software platform should also be engineered to scale up rapidly to handle unexpected surges. The first wave of Covid-19 caught the global healthcare system by surprise and telemedicine adoption shot up to unprecedented levels overnight. Such events are thankfully quite rare, but it does drive home the need to ensure that you have a robust system in place to start with. So in summary you need a system that can grow with your business, but should also be able to scale up fast if you need it tomorrow.

Scalability requirements of your telemedicine service

Some important numbers you need to think through:

1. Number of simultaneous users

The most important aspect that you will need to consider is the number of parallel or simultaneous users you expect to be using your service. You might have millions of registered users, but if only a few users are using your telemedicine software platform at a given point in time, then your scalability requirements might not be that significant.

1. Expected growth

How many users do you expect at launch and how do you expect this to grow?

It is however important to be realistic with respect to your growth expectations. The reality is that you might not be able to model the expected usage levels before you launch the telemedicine business. A realistic approach is advisable especially if you are a new telemedicine startup, because high scalability does have an associated cost implication and telemedicine startups typically need to be cash conservative.

In the cases of healthcare organizations like clinics, hospitals it should be possible to model the expected number of parallel telemedicine users and overall growth numbers by examining other data points that are already available. Some questions that will help arrive at an answer are below:

• How many healthcare providers do you have and how many appointments do these providers have per day?
• What percentage of the providers time will be set aside for telemedicine consultations? What time are these slots being allocated? Is that a traditionally busy time for the providers?
• How many visitors do you have to your existing website and other online properties on a daily basis? How many online appointments do patients currently book via your website today?
• How does your marketing team plan to promote the telemedicine services?
• What has the response to been to prior digital initiatives?

On the other hand if you are telemedicine startup without an existing patient base and you are starting from scratch, then it would be very wise to start conservatively. It would typically take time for your marketing team to find the right marketing mix to fill up all the available provider slots. Nonetheless it is useful to put in some thought and attempt to model some numbers so you have a starting point for your telemedicine software platform requirements.

Fault Tolerance, High Availability and Data Backups

When setting up your telemedicine software platform, you also want to ensure that it is fault tolerant. Nothing is perfect and hardware failures though very rare events can be expected at some point. When they do happen you want to ensure that the users of your telemedicine service do not experience any down time or data loss. This is possible by ensuring that you have redundancy built into the system, so that when one component fails, another one can take over immediately. You also want to ensure that you redundant real-time backups of your data.

Type of Services

Another factor to keep in mind is the nature of the telemedicine services you plan to offer. Although many people consider telemedicine to be synonymous with video calls, there are actually a number of different types of telemedicine services that you can offer to patients. Each of them have different scalability requirements. So for example if you are offering telemedicine video calls, then you need to be concerned about the number of parallel telemedicine video calls that the platform can support. On the other hand if you dealing with text consultations then this might not be a concern.

Platform Technical Support

Telemedicine applications typically involve video technology, mobile device integrations and external service integrations. Many of the underlying technologies might be changing rapidly themselves. Additionally applications also have to contend to rapidly changing operating system versions and mobile device versions. Your hosting provider can develop issues or network failures might occur. All of these are besides potential bugs and issues with the telemedicine software platform itself.

While technical issues might be infrequent, they are inevitable. Technical support is therefore going to be an unavoidable part of operating a telemedicine platform. When issues occur and your users encounter issues, you will need a technical support team who you can rely on to step in and address the issue.

Telemedicine Software Platform: Custom Development or SAAS Model

Irrespective of whether you are planning to custom development of a telemedicine solution or whether you are considering using an off-the-shelf SAAS telemedicine solution, it is very important to that you are clear on what the nature of your business model. and the business domain would obviously have a big bearing on your choice of a telemedicine solution