Case USA51: How a Telehealth Provider Traded Video Consult Success for Enterprise Architecture Readiness
- Sunil Dutt Jha
- Jul 16
- 2 min read
Updated: Nov 3
Overview:
This case is part of a 100-diagnostic series showing how US enterprises have mistaken service-channel success for “Enterprise Architecture progress.”
In telehealth, a recurring pattern is treating high adoption of virtual consultations as proof of architectural readiness.
Video visits scaled from hundreds to thousands per day, patient satisfaction scores climbed, and marketing positioned the platform as a fully transformed care model — yet the enterprise structure connecting scheduling, clinical data exchange, care escalation, billing, and compliance was never modeled.
P1–P6 Insight Preview:
P1 (Strategy): No linkage between the virtual care growth plan and the broader health system’s service delivery goals. Telehealth KPIs existed in isolation from overall care outcomes.
P2 (Process): Intake, consultation, and follow-up processes were mapped for video visits, but escalation to in-person care and care coordination remained inconsistent.
P3 (System): Patient data moved between EHR and telehealth systems inconsistently, with different logic for different specialties.
P4 (Component): Video platform, scheduling engine, and EHR adapters functioned as separate modules without a shared governance model.
P5 (Implementation): Agile sprints delivered new virtual visit features quickly, but backlog items weren’t tied to enterprise priorities.
P6 (Operations): Business ops could deliver visits at scale, but tech ops faced constant integration rework; both struggled to manage exception cases in real time.
Role Disconnects:
CEO: “We’ve scaled telehealth massively” — but can’t prove it’s reducing total cost of care or improving clinical outcomes.
CIO: “The tech stack handles huge volumes” — yet patient data reconciliation is a daily firefight.
Sales Head (Provider Partnerships): “We attract new hospital clients easily” — but churn rises when integrations bog down.
Chief EA: “We built a high-traffic channel, not a coherent care delivery enterprise”
Head of Virtual Care Operations: “We can handle today’s consults, but one system outage can ripple across three departments instantly”
Want to read more?
Subscribe to architecturerating.com to keep reading this exclusive post.
