Digital Health Tool Sprawl: When an EHR Isn’t Enough (and What to Do Instead)

Your EHR is necessary. It just isn’t sufficient.

At Out-Of-Pocket’s Ops KnowledgeFest, Sebastian Coates (CEO and co-founder of Tellescope) summed up a problem most digital health operators run into sooner or later: teams don’t struggle because they chose the wrong EHR. They struggle because they end up building an entire digital health tech stack around the EHR, and that “everything else” becomes the thing they spend all their time managing.

If you’ve ever looked up at the end of the day and realized you’ve been living in a maze of tabs, tools, and workarounds, Sebastian’s talk probably felt a little too familiar.

Before we get into the “too many tools” spiral, it helps to name the three core components most digital health startups end up needing to run operations and patient experience at scale:

• EHR (Electronic Health Record): Your clinical system of record. It stores patient medical data and supports core clinical workflows like documentation and reporting.
• Healthcare CRM: Your relationship and engagement hub. It helps teams manage patient interactions, outreach, and operational workflows across touchpoints.
• Patient portal: The patient-facing front door. It gives patients secure, self-serve access to common tasks and information, without calling your support line.

When these three work together, the system feels clean: the EHR anchors the clinical record, the healthcare CRM helps run the relationship and operational journey, and the patient portal creates a modern, self-serve patient experience.

When they don’t work together, tool sprawl happens. Fast.

Sebastian described a journey that shows up across modern care models.

Step one: pick an EHR. It covers clinical data and core documentation.

Step two: reality hits. You still need patient engagement workflows that feel modern and easy. So you add point solutions: messaging, scheduling, intake forms, video visits, a help desk, internal coordination. It’s not unusual to end up with tools like Twilio, Calendly, Typeform, Zoom, Zendesk, and plenty of “just one more thing” additions.

Step three: you stitch everything together so it behaves like one system. You pay for integrations, you build them, or you patch them endlessly as your workflows evolve. And ultimately, everything needs to map back to the EHR.

At best, it works. At worst, it works until the next workflow change, the next state rollout, or the next insurance rule throws it off.

Either way, digital health teams experience the same daily symptom: constant context switching. Sebastian said it plainly: many teams are bouncing between a dozen tabs and Slack just to keep care moving.

Tool sprawl isn’t just a software problem. It’s an operations problem:

• Patient touchpoints get scattered. Texts in one place, emails in another, intake form responses elsewhere, call notes in another system, and video visits in yet another tool.
• Handoffs become fragile. Who owns the follow up? Who responded? Where’s the latest context? These questions turn into Slack pings and duplicated work.
• Integrations become permanent maintenance. Data sync issues, edge cases, workflow changes, new tools to connect. The “integration project” never ends.
• Building from scratch starts to look tempting. Teams consider building custom systems, but then you spend months recreating generic infrastructure instead of focusing on what makes your care model different.

Even if your patient experience looks decent on the surface, your internal operating system can become chaotic underneath.

The most important point from Sebastian’s summary was simple: Tellescope isn’t meant to replace your EHR.

It’s designed to work with your EHR.

Think of it as an operations and patient engagement layer that sits alongside the EHR. Instead of an EHR plus a patchwork of disconnected tools, you get a dynamic duo: EHR + Tellescope.

That pairing covers three critical areas in one platform:

1. Patient-facing experiences
2. Care team operations
3. EHR integrations so information flows, not just messages 

Sebastian emphasized a simple truth: patient experience is won in the basics, done well.

That means giving patients multiple ways to communicate: SMS, phone, email, chat, and video calls. Not everyone wants the same channel, and no one wants to download five apps just to manage care.

It also means building self-serve workflows that reduce friction for everyone:

• Digital intake forms 
• Scheduling links
• Patient portal experiences that are mobile-friendly and intuitive

Sebastian framed it as meeting the expectations patients bring from e-commerce and online banking. Not because healthcare is the same, but because patients now expect clarity, speed, and ease.

On the care team side, the promise isn’t “more features.” It’s fewer places to work.

Tellescope is built as a unified workspace where teams can see patient context across channels, coordinate tasks, and automate follow ups without jumping between systems.

That includes:

• A single place to manage communications across channels
• Task assignment and tracking for care coordination
• Workflow automation using a visual, drag-and-drop style
• Bulk operations and help desk style support for high-volume operations 

None of this matters if it becomes another disconnected system.

Sebastian highlighted out-of-the-box integrations with EHRs like Canvas, Elation, Athena Health, and others, with the goal that appointments, updates, form responses, and communications flow between systems without manual entry.

That’s what makes the dynamic duo work: the EHR stays the clinical backbone, while the ops layer becomes the operational command center.

If your team is spending more time managing your tech stack than improving care delivery, the answer is rarely “add one more tool.”

Sebastian’s point was cleaner: keep your EHR for what it does best, then run patient engagement and operations in a single platform built for the workflows that live around the EHR.

Not a sea of duct-taped tools. A real dynamic duo.

Ready to ditch tool sprawl and run healthcare ops in one place? See how Tellescope can be your all-in-one ops layer that works hand-in-hand with your EHR. Learn more and book a quick demo.