Tellescope

So today we’re chatting about Tellescope and how it’s used at your company. Before we jump into that, could you give a brief overview of the company and your role there?

We are a value-based tech company in the orthopedic space, founded about three years ago. We initially focused on building our tech stack and product while targeting self-funded employers; however, we realized that wasn’t the right fit for us. We now exclusively work with health plans, particularly ACOs and Medicare Advantage plans. Our role is to take on full risk in relation to their orthopedic patient population. I am the director of clinical programs and the only clinician on the team; I have been an orthopedic PA for about 22 years and lead the orthopedic team.

What business problem were you looking to solve with a tool like Tellescope?

We needed a patient-facing platform that we could make our own. So we knew we needed an EHR. However, in my experience as a clinician for 20 years and with my current company, the thing that’s lacking in almost every EHR is the client communication and care management layer. Often an EHR will have a portal for patient communication, but it doesn’t really give the essence of the minutia that’s happening with a patient, and it doesn’t allow the frictionless communication of just being able to send an SMS or a quick email without having to log into a portal. So we were really looking for an overlay for patient communication and care management, but specifically one that was incredibly easy to tailor to our own needs. There are a lot of offerings in that space offering SMS or chat, but most aren’t able to be white labeled or don’t play well with other components of our tech stack.

What were the specific requirements you had in mind when evaluating options?

We needed the platform to have SMS capability, but that specifically stayed in SMS. There were other products that would send the patient an SMS with a link that they then had to click to go into the message. We wanted it to be SMS only while remaining HIPAA compliant. We wanted the product to be white labeled and just have our branding on it. On the back end, we wanted it to be more robust and not just show the communication but also an associated chart with notes from our team about the patient, their demographics, or other information about their condition, all housed in the same dashboard.

What other vendors did you consider and how did they compare to Tellescope?

We had actually implemented Klara initially and used it for an entire year, though we had very few patients during that time so weren’t utilizing it to its full capacity. Once we did start using it more and trying to integrate it with our new EHR, we realized it wasn’t going to work. It had a lot of the problems I mentioned: patients had to click a link in the SMS to view the message, everything was Klara-branded, and the automated messages couldn’t be customized. We were sort of at the mercy of their templates.

We looked at several others, and the one we considered most seriously was Rhinogram. It had a bit more customizability. Messages did stay in SMS, and it had a fairly robust AI chat functionality that we could customize. But it didn’t play well with other components in our tech stack, and any integrations we wanted to implement would have to be done by their tech team, and we really needed to have control of the process. As a young startup, we’re iterating very quickly and needed to be able to do that development on our own. The only other one that made it past a demo was Curogram, which had a lot of the same issues as Rhinogram.

I think most products in this space and in healthcare in general are still really designed for brick and mortar facilities, where the patient portal is primarily for scheduling or for quick answers. They’re not really designed to be the primary mode of communication for a patient with their provider. I think that’s where most of them fell short for us. Pricing-wise, they’re quite similar: I think all of them ranged between $200-300 per provider per month. There was often a fee if you went above a certain number of SMS messages in a month, but it was quite a high number and it would be unlikely that anyone would hit that ceiling.

How was the sales and initial onboarding process for Tellescope?

We spent several months talking to them and found that while their product wasn’t quite where we needed it to be, they were very interested in being a development partner with us and working on getting their product up to speed. So the onboarding was very light, because their product was very light at the time. But they have a completely open API, and our development team had access to that immediately, so they could start playing around in a sandbox instance and testing integrations. It was very quick. It’s actually ongoing for us: we meet with their team—they only have three members on their team, the two co-founders and their developer— every other week to talk about bugs and enhancements and discuss their roadmap. It’s been a really iterative process, so I don’t know that we ever had an end to the implementation!

How does Tellescope fit into your workflow? What use cases do you have for it?

We use it as our primary platform for our clinicians and clinical coordinators. First, before we even transition someone to becoming a patient, we have prospective patients that we have flagged based on claims data. We have a very light CRM where our prospective patients sit, and we send email and SMS campaigns to them. When someone engages, they transition to becoming an active patient and get moved into our clinical side. We do patient registration and scheduling through Tellescope’s front end, with intake forms. They’re also one of the few in this space that has a very robust scheduling interface. Most EHRs or patient platforms don’t have the ability to schedule multiple providers in multiple states, but it’s very easy in Tellescope: when a patient inputs their zip code, it populates the schedule of every provider who is licensed in that state. It sounds so simple but it’s incredibly uncommon for a platform to do that.

Tellescope has what they call “journeys,” which are a series of steps you can set up with action items attached to them for things like automated reminders, pre-visit education, confirmations, and links to their televisits. The visit itself is also done through Tellescope, and they have an integration with Zoom. We do document the visit itself in Elation, which is our EHR. Currently, notes don’t get transferred between the two systems, that’s the next phase of development. But everything else is done in Tellescope: every time we send a patient an SMS or email, or have a phone call, or they need to send us an image of their insurance card or a medical concern they have, that’s all recorded in the chronological patient communication record. We also do surveys so we can track various metrics.

So our clinicians and care coordinators are only in Elation to document a clinical note, to send an order for imaging or lab work, or to send a referral to an outside physician. Everything else is done in Tellescope. It’s interesting about healthcare, it’s rare that you need to reference back to a clinical note! So much of healthcare is the conversations and the tasks that have been completed outside of that visit, not the note itself. But our next integration step is to have the notes populate as a PDF in Tellescope so you can see them quickly without having to toggle back and forth.

How is the UI for the product?

I actually would highlight that as a weakness of their product: the tech is fantastic, but the UI leaves a lot to be desired. We actually layered a whole different UI on top of it for the patient-facing front end, because it was functional but not very pretty, so we could have it match our branding, and to improve the user’s flow through the system. For example, if you’re filling out a form, it’s a smoother process to go screen by screen instead of scrolling down to fill it out. Things like that. The clinician-facing end still has the Tellescope UI, though.

Any other weaknesses you would call out for the product?

They’ve been fortunate that they’ve been growing really quickly, it’s great for them. But I think in doing so, they haven’t had time to develop their onboarding. Even for us as a development partner, things will get fixed or built between our biweekly calls and we won’t be aware of how to use a new functionality, or that it even exists. I think they’re playing catch-up with how to deliver information about their product to their current users.

Any strengths you’d like to call out?

The scheduling, again, is a strength. Even though it sounds fairly straightforward, it really isn’t. Over the course of our three iterations of our tech stack, we demoed about 87 platforms across patient engagement, EHR, and other products, and they’re truly the only ones that have nailed the scheduling piece. They’re very unique in that sense. The other strength they have is that they’re humble and nimble. Every time we talk about another development area or roadmap item, they’re all in, and they work quickly to get things built. They’re turning out a really good product in really short order, and they’re super receptive to customer feedback.

Have you had any reliability or stability issues?

We haven’t had any issues with downtime.

How is it integrated with the rest of your tech stack?

So my knowledge is limited in this space, but it’s all done via API. We’re integrated with Elation. Additionally, within the “journeys” that Tellescope has, they have web hooks for various items and for our reports. We use APIs to pull reporting metrics. You can do basic PDF printouts through the tool, but we really need the raw data.

The existing Elation integration is limited, but we’re continuing to iterate and build on it. We want Tellescope to show when we send a referral, and be able to directly chart form responses into the EHR. They both have completely open APIs so we can work on that on our own cadence.

Do you have any other integrations with Tellescope?

There are other integrations available, but we’re not leveraging them. Most of the integrations they have are ones they’ve built at the request of specific customers, such as with Zoho CRM. They do have an integration with Twilio for phone calls and texts, and with Zoom. But they’re really open to developing more, and are working towards having a robust library of out-of-the-box integrations.

How has the support and account management experience been?

It’s an all-in-one team! I can’t say enough about them. I think they’re incredibly talented and have really found a spot in the market that was begging for some iteration, and they’ve really come up with a product that is unique and continues to get better. They have quite a few clients now, and with that community of people providing feedback, it’s only going to improve their product. They’re super receptive. We actually suggested having the product leaders for each of their clients get together monthly to talk about the product roadmap, and they thought that was a great idea.

Have you had any patient feedback around the front-end experience?

So the new front end that we designed, we just rolled that out last week, so we don’t have feedback on that yet. But as a more general statement, patients do love and expect the feature to use SMS strictly as an SMS and not as a link to another product. They’re one of the few players in the space who did it that way.

Do you think you made the right assessment moving forward with Tellescope?

100% yes, for a lot of reasons. The fact that we can develop with them, the fact that they are really a unique product and see the space very much as we do, it was the right call.

Do you have any advice for buyers that might be out on the lookout for a similar sort of tool?

I will say it does not look as pretty in the demo as some of the other patient engagement platforms. But I would be really specific and think about, what does that patient experience look like? Are they required to log in to different items just to get to the messages you’re trying to send them? How much friction is there, really, in communications and scheduling? Really home in on precisely what a company means when they say you can customize things, because in most cases we found that wasn’t actually the case.