September 1, 2021

Embedded vs. Integrated Patient Engagement Solutions

When considering the level of interplay with your EHR, you’ll find patient engagement solutions that are “integrated” with your EHR and others that are “embedded” in the EHR. While many patient engagement providers claim to be integrated, this can mean many things. What is the difference and why does it matter?

Within the patient engagement landscape, not all solutions are equal. The value of the patient engagement solution is often measured by three primary attributes:

Ease of employee training; the likelihood of adoption
Interplay with the Electronic Health Record (EHR) platform
Message quality – channels, language availability, tone recognition

While all these attributes are relevant to healthcare organizations selecting a new patient engagement solution, number two (2) on this list is often the least understood. If you want to maximize your patient engagement solution, it is critical to understand how the patient engagement solution interacts with your Electronic Health Record (EHR). Before jumping into the technical differences between integrated and embedded, let’s examine why leading healthcare organizations prefer an embedded solution over integrated options.

Embedded Solutions are Frictionless

Healthcare entities benefit from embedded patient engagement solutions that provide frictionless, closed-loop workflows that write to and from the EHR which eliminates the need for manual information sharing. Here are three examples of the two-phase approach that leading patient engagement providers offer to 1) deliver patient notifications then 2) close the loop so, the staff doesn’t have to engage in manual follow-up:

Example #1 – Rescheduling

Instead of asking patients if they want to reschedule then making the patient call the office or setting up a trigger for the office to call the patient, an embedded solution allows the patient to reschedule directly within the text message – without any interaction from staff. The patient’s response is written directly back to the EHR.

Example #2 – Live Connect

Instead of notifying a patient to call the office to set up a referral/recall appointment, the embedded solution connects them in real-time to the office’s call center. This can be configured to accommodate shift hours, staff breaks, throttling counts per 15-minute intervals. Both the patient and the healthcare organization’s staff can connect when it is convenient for them.

Example #3 – Reporting

Instead of making staff log in to a separate customer application to retrieve results from notification outreaches, embedded solutions enable staff members to use their EHR’s existing reporting tools to configure and pull the notification results from the patient engagement platform. This consolidation of data ensures the EHR remains the single source of truth. Plus, you are eliminating the need to maintain duplicate databases. Now that you understand the positive impact of a patient engagement platform embedded in an EHR, here’ a quick lesson in how they technically differ.

Integrated vs. Embedded

When considering the level of interplay with your EHR, you’ll find options that are “integrated” with your EHR and others that are “embedded” in the EHR. While many patient engagement providers claim to be integrated, this can mean many things. What is the difference and why does it matter?

Integrated software combines the most commonly used functions of many software programs into one application. That software then works in parallel with other software tools, using limited application programming interface (API) to connect intermittently and when the user manually initiates the connection.For healthcare entities, integrated patient engagement solutions interface with an EHR using a staff-initiated data bridge. The most common forms of integrative technologies are file exchange, HL7, APIs; each have advantages and disadvantages. In all cases, patient engagement activities begin in the patient engagement platform and, depending on the sophistication of the software, require manual information sharing between the patient engagement platform and EHR.
Embedded software is implanted in hardware or non-PC devices or platforms. It is written specifically for the hardware or software that it runs on and has unique processing and memory attributes. Within healthcare, this is most commonly accomplished with a seamless API package that supports real-time, automated connection between the patient engagement platform and the healthcare organization’s EHR. More advanced platform solutions combine a seamless API package and additional technology, like Smart on FHIR, to create direct access to EHR data, and to allow Live Chat applications to be embedded in the EHR.

Let’s compare ways in which other common patient engagement processes are managed when integrated versus embedded with the EHR.

Difference in Tasks and Reporting

PATIENT ENGAGEMENT ACTIVITY	INTEGRATED	EMBEDDED
Appointment Reminder/ Recalls/Referrals	Using an appt data file, notifications are made to patients. Patients are asked to confirm/cancel an appointment, or to indicate if they want to schedule a visit. The responses are provided to the staff for them to then reach out to patients if scheduling is required.	Through automated outreach via SMS, the patient can self-schedule or reschedule office visits. This is accomplished by using real-time API calls with the EHR to provide open time slots. Upon selection, the appointment is automatically booked with all details written to the EHR.
Broadcast/Live Chat	Your EHR patient data allows you to select criteria for sending one-way broadcast blasts to multiple patients. You can also send messages to engage individual in live chats and 1:1 bi-directional communication. Staffers then manually capture applicable responses within the EHR.	Using Smart on FHIR we can add our broadcast/live chat portal directly to your EHR so that you never have to work in another system for delivering these types of patient notifications. All responses are automatically captured.
Reporting	Your patient engagement provider delivers performance and engagement data to you via an export file that you then manually enter in your EHR.	Your patient engagement provider writes back to your EHR, delivering results and responses from patients using pre-configured codes you have designated.

For healthcare entities, an embedded patient engagement platform is superior since it writes directly from, and back to, the EHR with zero dependency on manual information sharing to/from another application/platform/window. Intrado’s HouseCalls Pro automated patient engagement platform is a frictionless EHR embedded solution for users of Epic, NextGen and Athenahealth. Soon, HouseCalls Pro will be embedded in more EHRs. If you are considering a new patient engagement platform, let’s talk.