Teleradiology is the ability to send radiographic images (x-rays, CT, MR, PET/CT, SPECT/CT, MG, US...) from one location to another.[62] For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving-image review station. The most typical implementation are two computers connected via the Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. Sometimes the receiving computer will have a printer so that images can be printed for convenience.
As of 2015, Teladoc was the only telemedicine company to be publicly traded on the New York Stock Exchange. In December 2016, the American Hospital Association exclusively endorsed Teladoc's telehealth technology platform. Teladoc now operates its full suite of services 24 hours a day, 365 days a year, by web, phone, or mobile app in 48 of the 50 states.[7]
Telepsychiatry, another aspect of telemedicine, also utilizes videoconferencing for patients residing in underserved areas to access psychiatric services. It offers wide range of services to the patients and providers, such as consultation between the psychiatrists, educational clinical programs, diagnosis and assessment, medication therapy management, and routine follow-up meetings.[49] Most telepsychiatry is undertaken in real time (synchronous) although in recent years research at UC Davis has developed and validated the process of asynchronous telepsychiatry.[50] Recent reviews of the literature by Hilty et al. in 2013, and by Yellowlees et al. in 2015 confirmed that telepsychiatry is as effective as in-person psychiatric consultations for diagnostic assessment, is at least as good for the treatment of disorders such as depression and post traumatic stress disorder, and may be better than in-person treatment in some groups of patients, notably children, veterans and individuals with agoraphobia.
Healthcare systems that adopt telemedicine solutions can attest that it requires a lot of time and money. Implementing a new system requires training and sometimes staff members find it difficult to welcome this change. Practice managers, nurses, physicians, and more have to learn how to utilize the system so that practices can see the benefits. Although telemedicine is expensive in the beginning, healthcare systems should see a positive return on investment over time due to more patients and less staff.
Due to its digital nature it is often assumed that telehealth saves the health system money. However, the evidence to support this is varied. When conducting economic evaluations of telehealth services, the individuals evaulating them need to be aware of potential outcomes and extraclinical benefits of the telehealth service.[37] Economic viability relies on the funding model within the country being examined (public vs private), the consumers willingness-to-pay, and the expected remuneration by the clinicians or commercial entities providing the services (examples of research on these topics from teledermoscopy in Australia [38][39][40]).
Telemedicine was originally created as a way to treat patients who were located in remote places, far away from local health facilities or in areas of with shortages of medical professionals. While telemedicine is still used today to address these problems, it’s increasingly becoming a tool for convenient medical care. Today’s connected patient wants to waste less time in the waiting room at the doctor, and get immediate care for minor but urgent conditions when they need it.
Teleneuropsychology (Cullum et al., 2014) is the use of telehealth/videoconference technology for the remote administration of neuropsychological tests. Neuropsychological tests are used to evaluate the cognitive status of individuals with known or suspected brain disorders and provide a profile of cognitive strengths and weaknesses. Through a series of studies, there is growing support in the literature showing that remote videoconference-based administration of many standard neuropsychological tests results in test findings that are similar to traditional in-person evaluations, thereby establishing the basis for the reliability and validity of teleneuropsychological assessment.[30][31][32][32][33][34][35]
Telemedicine is used in many different medical fields, throughout ambulatory and hospital settings. Almost every medical field has some use for consulting a patient or another provider (usually a specialist) remotely. Because of shortages of care, limited access to specialists in some areas, and remote locations of patients (especially in rural or sparsely populated areas), telemedicine is incredibly useful to any healthcare provider trying to expand access to quality patient care.
Teladoc does not guarantee prescriptions. It is up to the doctor to recommend the best treatment. Teladoc doctors do not issue prescriptions for substances controlled by the DEA, non-therapeutic, and/or certain other drugs which may be harmful because of their potential for abuse. Also, non-therapeutic drugs such as Viagra and Cialis are not prescribed by Teladoc doctors.
Doctor on Demand is currently available for patients in 15 states, including large states like California, Florida, New Jersey, New York, Ohio, and Texas. The company has more than 1,000 doctors available for video consultants one or two days a week, according to Bloomberg Businessweek. The company trains physicians on how to use the service, and covers other logistics like patient questionnaires and malpractice insurance.
More widespread use and success of telehealth applications might spur the resolution of these reimbursement issues. CVS has been providing clinical services via telehealth since 2015. According to their study in the Journal of General Internal Medicine, 95 percent of patients “were highly satisfied with the quality of care they received, the ease with which telehealth technology was integrated into the visit, and the timeliness and convenience of their care.” If CVS’s merger with Aetna is finalized, increased competition may motivate other payers to find ways to offer telehealth services and, by extension, levels of reimbursement. 
We consider ourselves part of YOUR healthcare team. Our physicians do not take over your patients’ care but serve as a knowledgeable consultant for the attending physician. Through HD video conferencing, our team can speak with patients and assess their condition. Our services can also help your facility meet requirements for CMS and Joint Commission certifications.
Thanks to telemedicine, physicians have the wonderful opportunity to connect with clients wherever they are. Patients who once could not see a physician due to access to care issues, can now do so almost seamlessly. However, many may wonder what is telemedicine’s most valuable applications? We’ll discover a few popular ways that telemedicine is used today.
Telehealth, the use of electronic communication to remotely provide health care information and services, is gaining more and more attention as providers, patients, and payers all seek more effective and cost-efficient ways to deliver care. Physical therapy is no exception, and while those services have developed mostly in rural areas to accommodate the long distances between patients and providers, telehealth in physical therapy is being considered in other geographic and clinical settings.
Originally, health professionals developed this technology to reach remote patients living in the rural areas. But with time, medical staff and the U.S. government saw the big picture – the potential to reach urban populations with healthcare shortages, and to respond to medical emergencies by sharing medical consults and patient health records without delay. In the 1960s, heavy investments from the U.S. Government, including the Public Health Department, NASA, Department of Defense, and the Health and Human Sciences Department drove research and innovation in telemedicine. Sending cardiac rhythms during emergencies started at about this time. For instance, in Miami, the university medical center worked together with the fire rescue department by sending electro-cardiac rhythm signals over the voice radio channels from the rescue sites.
Wyoming Medicaid conducted a study measuring engagement and post-birth outcomes for patients  who used a mobile health app called, “Due Date Plus.” Use of the app, which allowed women to record pregnancy milestones, access medical services, and find symptom-related information was associated with increased compliance with prenatal care and decreased occurrence of babies born with low birth weights.

How much and which telemedicine services private payers pay for again can vary widely by state. While the trend is toward broader coverage of telemedicine services for plan enrollees, private payers are still deciding on exactly what they will cover and what they won’t. 29 states and Washington, DC have passed telemedicine parity laws, which mandate that private payers in those states pay for telemedicine services at the same rate as in-person visits.


Telehealth Reimbursement Medicare: Medicare, which finances care for patients who can most benefit from telehealth, will only pay if the originating site (service location of the patient) is either in a non-Metropolitan Statistical Area (MSA) or a Health Professional Shortage Area (HPSA). Medicare also limits the types of providers and facilities that can provide telehealth services. For more information, the Telehealth Resource Center (TRC) has furnished lists of covered providers, sites, and services.
The Satellite African eHEalth vaLidation (SAHEL) demonstration project has shown how satellite broadband technology can be used to establish telemedicine in such areas. SAHEL was started in 2010 in Kenya and Senegal, providing self-contained, solar-powered internet terminals to rural villages for use by community nurses for collaboration with distant health centres for training, diagnosis and advice on local health issues[92]
To guide these decisions, the provider should create clinical protocols which include the condition to be treated (with ICD code), scope of that condition that can be treated using telemedicine, guidelines required to diagnose (when is telephone sufficient, vs. live video), documentation needed to properly assess the patient’s condition, parameters for when the condition can be treated and cannot be treated, and guidelines for when prescription can be done. While this section provides basic, overall guidelines for practicing telemedicine, it’s best practices for the healthcare provider to create more detailed protocols for each condition they intend to treat.
There’s a lot to be optimistic about telemedicine. A survey of healthcare executives found improving the quality of patient care was their top reason for implementing telemedicine and in another study, respondents said the top benefit was ability to provide round-the-clock care. About half of patients also reported that telemedicine increases their involvement in treatment decisions, getting them engaged in managing their care. And with a potential $6 billion per yearthat US employers could save by offering telemedicine to employees, telemedicine can have a huge impact reaching past the healthcare industry.
Telemedicine reimbursement is a difficult topic, especially with the constantly changing state policies. Many states now have parity laws which require private payers to reimburse for telemedicine visits the same way as in-person visits. The best way to navigate reimbursement is to call up your top payers and ask their policies. You can also check out our guide to telemedicine reimbursement and this helpful matrix from ATA on state policy.
This service removes the need for impromptu walk-in clinic visits, lengthy waiting room stays, and long lines at the pharmacy. It also creates a safe space without judgment or the need to explain your condition to multiple strangers before you receive a prescription. Our professional and experienced team takes great care to make you feel comfortable and protected as your medical needs are met and your prescription is written, sent, and filled.

Jay McGraw and Adam Jackson, both 35, are changing the way that people interact with their doctors. Along with Dr. Phil, who is McGraw’s father, they launched Doctor On Demand in 2013. The San-Francisco-based startup offers online video consultations with 1,400 credentialed physicians around the country. One million people have downloaded the app -- and it’s raised $74 million in VC funding to date.


Telemedicine is an important and quickly growing component of healthcare delievery in the United States.  There are currently about 200 telemedicine networks, with 3,500 service sites in the US.  In 2011 alone the Veterans Health Administration delivered over 300,000 remote consultations using telemedicine. More than half of all U.S. hospitals now use some form of telemedicine.

Point-to-point connections link small remote health centers to one, large, central health facility via high speed internet. This type of telemedicine connection lets smaller or understaffed clinics outsource medical care to specialists at other locations within the same health system. Point-to-point connections are especially common for telepsychiatry, teleradiology, and urgent care services.
The study of 15 of the state’s hospitals using the platform to treat some 500,000 patients saw a 25 percent reduction in a hospital’s staffing costs, while the hospitals saw a 20 percent increase in admissions – patients who would have been transferred to UMMC for ultimately non-serious issues, depriving the local hospital of revenues and taxing UMMC’s resources.
Teladoc does not guarantee prescriptions. It is up to the doctor to recommend the best treatment. Teladoc doctors do not issue prescriptions for substances controlled by the DEA, non-therapeutic, and/or certain other drugs which may be harmful because of their potential for abuse. Also, non-therapeutic drugs such as Viagra and Cialis are not prescribed by Teladoc doctors.

Medicare pays for telemedicine services under certain circumstances. Primarily, Medicare covers live telemedicine services, or virtual visits delivered via interactive audio and video (think videochat). The goal is to cover medical services delivered virtually where an in-person visit may be difficult for the patient or provider. Store-and-forward telemedicine services are only covered in Hawaii and Alaska at this time.
As Teladoc (TDOC) completes another merger that will lead to global expansion, the market enthusiasm for the stock has grown immensely. The stock that was a bargain on a dip to $30 on the big merger last year isn't a bargain this time following the purchase of Advance Medical. At nearly $60, Teladoc trades in a completely different situation now, having rallied following the recent deal suggesting investors do the opposite as well.
Today, 95 percent of Americans own cell phones and 77 percent own smartphones. These and other mobile devices can be leveraged to promote better health outcomes and increased access to care. mHealth or mobile health refers to healthcare applications and programs patients use on their smartphones, tablets, or laptops. These applications allow patients to track health measurements, set medication and appointment reminders, and share information with clinicians. Users can access hundreds of mHealth applications including asthma and diabetes management tools as well as weight loss or smoking cessation apps. Additionally, mobile devices allow users to schedule appointments and communicate with providers via video conference and text message.
We consider ourselves part of YOUR healthcare team. Our physicians do not take over your patients’ care but serve as a knowledgeable consultant for the attending physician. Through HD video conferencing, our team can speak with patients and assess their condition. Our services can also help your facility meet requirements for CMS and Joint Commission certifications.

When you need to find care, let us bring a healthcare provider to you. From your mobile device or computer, it’s never been easier for you and your family to instantly access world class care at home or work. For nonemergency concerns, patients ages 2 and older can get a diagnosis or prescription online from a healthcare provider in about a 10-minute virtual visit. Our Express Care Online service allows you to choose between an on demand visit right away or to schedule a virtual follow-up visit for a later date.
The short-seller's online article stated that sales for Teladoc's BetterHelp mental health business would fall because of a controversy about YouTube stars receiving referral payments for promoting the BetterHelp website. BetterHelp is an important driver of Teladoc's growth, although the business makes up less than 15% of the company's total revenue.
Due to its digital nature it is often assumed that telehealth saves the health system money. However, the evidence to support this is varied. When conducting economic evaluations of telehealth services, the individuals evaulating them need to be aware of potential outcomes and extraclinical benefits of the telehealth service.[37] Economic viability relies on the funding model within the country being examined (public vs private), the consumers willingness-to-pay, and the expected remuneration by the clinicians or commercial entities providing the services (examples of research on these topics from teledermoscopy in Australia [38][39][40]).
Kaitlin Brasier has worked in primary care since 2012 and provided virtual care since 2013. She received her Doctor of Nursing Practice from the University of San Diego in 2012. In addition to providing virtual care, she works in a dermatology clinic. She has extensive experience in family practice nursing and women's health and has conducted research on childhood obesity prevention. She enjoys outdoor activities, including hiking, snowboarding and horseback riding. She also likes cooking, reading and travel.
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