Telemedicine software that integrates cleanly with FHIR-based EHRs supports seven specific features. Understanding them shapes both purchasing and integration decisions.
**1. SMART on FHIR launch from EHR.** Clinician launches telemedicine session from patient chart; SMART provides patient context.
**2. Visit documentation as Encounter resource.** Video visit starts an Encounter; documented outcomes land as Observation, Condition, MedicationRequest.
3. Ambient documentation integration. Voice-recognition captures visit; structured resources extracted.
4. Pre-visit intake via SDC. Patient completes SDC Questionnaire before visit; results feed clinician review.
5. Prescription writing via MedicationRequest. e-Prescribing during or after visit; FHIR-native MedicationRequest.
6. Post-visit follow-up tasks. Task resource assigned for follow-up, lab review, referral.
7. Analytics feed via bulk export. Visit outcomes aggregated for quality reporting.
Vendor state (mid-2026)
| Vendor | SMART launch | Encounter | Ambient doc | e-Rx |
|---|---|---|---|---|
| Amwell | Yes | Full | Native | Yes |
| Teladoc | Yes | Full | Add-on | Yes |
| Doxy.me | Add-on | Basic | External | Add-on |
| Zoom for Healthcare | Add-on | Basic | External | Add-on |
| Epic MyChart Video | Native | Full | Native | Yes |
Integration considerations
1. Video-only platforms don't sync visit data. 2. External ambient tools require chart integration. 3. Manual documentation post-visit is slow. 4. Missing SMART launch requires custom integration.
Adoption metrics
1. Clinician time-to-launch (should be <10 seconds). 2. Post-visit documentation time. 3. Patient satisfaction scores. 4. Follow-up task completion. 5. Analytics availability for QC.
Common implementation mistakes
1. Buying telemedicine without EHR integration. 2. Manual visit documentation. 3. Video-only without ambient documentation. 4. No follow-up task tracking. 5. Silo'd analytics from other EHR data.
Telemedicine on FHIR is mature in 2026. The seven features above cover successful deployments.
