Choosing a telehealth platform is a different decision from choosing an EHR — some practices run telehealth natively inside their EHR/practice management system, while others use a dedicated video platform layered on top. This guide covers what actually distinguishes the options for a small practice, separate from the operational and licensure questions covered in our telehealth business guide.
Disclaimer: This content is for informational purposes only and is not legal or compliance advice. Confirm any telehealth platform’s HIPAA compliance and BAA availability before use, and verify current state licensure and reimbursement rules with your state medical board.
EHR-Native Telehealth
Most major EHR platforms (athenahealth, DrChrono, AdvancedMD, and others) now include a built-in video visit feature, which keeps documentation, billing, and the visit itself in one workflow without a separate login for staff or patients. For a small practice already happy with its EHR, native telehealth is usually the simplest option — one vendor relationship, one BAA, one bill.
Dedicated Telehealth Platforms
Standalone platforms (such as Doxy.me, SimplePractice’s telehealth feature for behavioral health, and others) can offer a more polished patient-facing video experience or specialty-specific features (like group therapy session support) that a general EHR’s bolted-on video feature may lack. The tradeoff is an additional vendor relationship, an additional BAA to execute, and potentially a separate patient login or link, which adds friction compared to a fully integrated system.
What to Actually Compare
Beyond video quality, compare: whether the platform integrates with your EHR for scheduling and documentation (or requires manual double-entry), waiting-room and multi-participant support if you ever need a caregiver or interpreter on the call, mobile app quality for patients who join from a phone rather than a computer, and — critically — confirmed HIPAA compliance with a signed BAA available, not just a claim on the marketing page.
AI Features Increasingly Bundled In
Many telehealth platforms now bundle AI transcription or ambient documentation directly into the video visit, generating a draft note from the call automatically. If this is a priority, test the actual output quality during a trial rather than assuming it matches the quality of a dedicated best-in-class scribe tool — bundled AI features vary widely in maturity between vendors.
The Bottom Line
Start by checking what your existing EHR already offers natively before adding a separate telehealth vendor — the integration benefits usually outweigh a marginally better standalone video experience, unless your specialty has a specific workflow need a general EHR’s telehealth feature doesn’t support.
See also: Telemedicine Setup for Medical Practices: Complete Guide.