This expectation for more convenient care, combined with the unavailability of many overburdened medical professionals (especially primary care providers) have led to the rise of telemedicine companies. Many offer patients 24/7 access to medical care with an on-call doctor contracted by that company. Others offer hospitals and larger health centers access to extra clinical staff and specialists, for outsourcing of special cases (common model among teleradiology companies). Still others provide a telemedicine platform for physicians to use to offer virtual visits with their own patients. Increasingly, telemedicine is becoming a way to give medical practices an edge in a competitive healthcare landscape where it’s difficult to stay independent or maintain a healthy bottom line.
Currently, smokers can seek help in the form of one on one therapy, group counselling sessions, or through medicated means, such as a patch or gum. There are also prescription medications which have shown increasing success across the United States. The most popular of these are Wellbutrin, Zyban, and Chantix. To learn more about these prescriptions and to obtain your own today,click here.
Teladoc is the oldest and largest telemedicine company in United States. It was launched in 2002 in Dallas, Texas by Dr. Byron Brooks, a former NASA flight surgeon, and serial entrepreneur Michael Gorton.[7] Teladoc launched nationally in 2005 at the Consumer Directed Health Care Conference, in Chicago, Illinois.[8] By the end of 2007, it had attracted about 1 million members, including large employers who provided it to their employees as a health benefit. Jason Gorevic was named CEO in 2009 and currently holds the role and sits on the company's board of directors.[9]

The combination of sustained growth, the advent of the internet and the increasing adoption of ICT in traditional methods of care spurred the revival or "renaissance" of telehealth.[10] The diffusion of portable devices like laptops and mobile devices in everyday life made ideas surrounding telehealth more plausible. Telehealth is no longer bound within the realms of telemedicine but has expanded itself to promotion, prevention and education.[1][8]
Increased access: Patients in rural areas can obtain specialty services, such a mental health treatment or post-surgery follow up, that they otherwise might not get without traveling a large distance for an in-person visit. Similarly, patients who live in federally designated, underserved areas have increased access to primary, dental and mental healthcare.
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.
Telemedicine is a significant and rapidly growing component of health care in the United States.  There are currently about 200 telemedicine networks, with 3,500 service sites in the US. Nearly 1 million Americans are currently using remote cardiac monitors and in 2011, the Veterans Health Administration delivered over 300,000 remote consultations using telemedicine. Over half of all U.S. hospitals now use some form of telemedicine. Around the world, millions of patients use telemedicine to monitor their vital signs, remain healthy and out of hospitals and emergency rooms. Consumers and physicians download health and wellness applications for use on their cell phones. 
Flexibility & work/life balance Very open organization with immediate access to executive leadership Transparent and communicative Promotes within organization Celebrates employee milestones and company wins Good benefits Salaries are competitive (at least to my knowledge) Open to new ideas Organization is doing very well and growing really fast Work being done has a positive influence on the current healthcare...

Today the telemedicine field is changing faster than ever before. As technology advances at exponential levels, so does the widespread affordability and accessibility to basic telemedicine tools. For example, not only do we now have the technology for live video telemedicine, but much of the U.S. population has experience using online videochat apps (like Skype or Facetime), and access to a computer or mobile device to use them.

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. 
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.
The Health Insurance Portability and Accountability Act (HIPAA), is a United States Federal Law that applies to all modes of electronic information exchange such as video-conferencing mental health services. In the United States, Skype, Gchat, Yahoo, and MSN are not permitted to conduct video-conferencing services unless these companies sign a Business Associate Agreement stating that their employees are HIPAA trained. For this reason, most companies provide their own specialized videotelephony services. Violating HIPAA in the United States can result in penalties of hundreds of thousands of dollars.[58]
With the nation’s estimated 1,400 rural hospitals looking to stay afloat in a challenging economic environment, connected care networks like Avera’s are part of a growing trend. Rural critical access hospitals – the spokes - see the virtual care platform as means of augmenting limited resources, keeping their patients in the community and reducing transfers.  Larger health systems, which serve as the hub, use the network to extend their reach, develop new business lines and reduce transfer and ED traffic that might strain their own resources.
An example of these limitations include the current American reimbursement infrastructure, where Medicare will reimburse for telehealth services only when a patient is living in an area where specialists are in shortage, or in particular rural counties. The area is defined by whether it is a medical facility as opposed to a patient's' home. The site that the practitioner is in, however, is unrestricted. Medicare will only reimburse live video (synchronous) type services, not store-and-forward, mhealth or remote patient monitoring (if it does not involve live-video). Some insurers currently will reimburse telehealth, but not all yet. So providers and patients must go to the extra effort of finding the correct insurers before continuing. Again in America, states generally tend to require that clinicians are licensed to practice in the surgery' state, therefore they can only provide their service if licensed in an area that they do not live in themselves.[1]
A major legal action prompt in telehealth thus far has been issues surrounding online prescribing and whether an appropriate clinician-patient relationship can be established online to make prescribing safe, making this an area that requires particular scrutiny.[22] It may be required that the practitioner and patient involved must meet in person at least once before online prescribing can occur, or that at least a live-video conference must occur, not just impersonal questionnaires or surveys to determine need.[43]
As technology developed and wired communication became increasingly commonplace, the ideas surrounding telehealth began emerging. The earliest telehealth encounter can be traced to Alexander Graham Bell in 1876, when he used his early telephone as a means of getting help from his assistant Mr. Watson after he spilt acid on his trousers. Another instance of early telehealth, specifically telemedicine was reported in The Lancet in 1879. An anonymous writer described a case where a doctor successfully diagnosed a child over the telephone in the middle of the night.[5] This Lancet issue, also further discussed the potential of Remote Patient Care in order to avoid unnecessary house visits, which were part of routine health care during the 1800s.[5][7] Other instances of telehealth during this period came from the American Civil War, during which telegraphs were used to deliver mortality lists and medical care to soldiers.[7]

Seek reliable information and medical advice about illnesses by body part - we have detailed information about any kind of medical condition in our database. There are also details about the kind of medication (allopathic, ayurvedic and homeopathic) that needs to be taken in certain medical conditions. You can also checkout relevant videos of specialist doctors.

The telemedicine foundation is quickly being built. But what do patients think about telemedicine? Are they ready to try it? Recent studies show that a majority of patients are interested in using telehealth services, especially once they see how it works and the potential benefits for them. NTT Data found 74% of surveyed US patients were open to using telemedicine services, and were comfortable communicating with their doctors via technology. 67% said telemedicine at least somewhat increases their satisfaction with medical care.


VSee urges organizations to try their free app so physicians can get a feel for sharing medical documents and streaming digital device images. In addition, organizations should ensure they have compatible microphones, webcams, speakers, and more. A telemedicine tech should be identified within the practice to help others get acclimated and resolve tech issues. Also, practices should be aware of their Internet connection. VSee’s video chat is robust, but how well it works comes down to the Internet connection and computer capabilities.
Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective.[16] Examples include home-based nocturnal dialysis[17] and improved joint management.[18]
Store and Forward – This is a form of telehealth consultation which uses images from the patients to come up with the medical diagnosis. The different types of Store and Forward services include dermatology, radiology and wound care. It may also include transferring of patients’ clinical data like ECG and blood test results from the patients’ site to the hospital’s site.
As technology in the medical field continues to advance, the two terms will likely become more distinguishable. With these advances, there are fortunately industry experts like VSee that keep up with the varying changes for physicians and hospitals. Healthcare organizations interested in implementing telehealth or telemedicine do not have to do so alone.
Synchronous, real-time or Clinical Video Telehealth requires the presence of both parties at the same time and a communication link between them that allows a real-time interaction to take place. Video-conferencing equipment is one of the most common forms of technologies used in synchronous telehealth. There are also peripheral devices that can be attached to computers or the video-conferencing equipment which can aid in an interactive examination.
As the population grows and ages, and medical advances are made which prolong life, demands increase on the healthcare system. Healthcare providers are also being asked to do more, with no increase in funding, or are encouraged to move to new models of funding and care such as patient-centered or outcomes based, rather than fee-for-service. Some specific health professions already have a shortage (i.e. Speech-language pathologists). When rural settings, lack of transport, lack of mobility (i.e. In the elderly or disabled), decreased funding or lack of staffing restrict access to care, telehealth can bridge the gap.[4]
“Telemedicine is not a separate medical specialty,” the organization continues. “Products and services related to telemedicine are often part of a larger investment by healthcare institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. ATA has historically considered telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth.”
Patients often look for a quick and inexpensive second opinion from a specialist, after diagnosis of a medical condition. Telemedicine has stepped up, by providing solutions in this aspect as well. Companies and traditional healthcare services such as Partners Healthcare, 2nd.MD, DoctorSpring, and Cleaveland Clinic are providing quick and efficient second opinions using telehealth.
Store-and-forward telemedicine is a great way to increase healthcare efficiency since a provider, patient, and specialist don’t need to be in the same place, at the same time. It also facilitates faster diagnosis, especially for patients located in underserved settings that may not have the necessary specialist on staff. Overall, this adds up to lower patient wait times, more accessible healthcare, better patient outcomes, and a more optimized schedule for physicians.
The rate of adoption of telehealth services in any jurisdiction is frequently influenced by factors such as the adequacy and cost of existing conventional health services in meeting patient needs; the policies of governments and/or insurers with respect to coverage and payment for telehealth services; and medical licensing requirements that may inhibit or deter the provision of telehealth second opinions or primary consultations by physicians.
But as the National Policy Telehealth Resource Center notes, “Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is more complex than simply using products that claim to be ‘HIPAA-compliant.” Not only does the telemedicine platform need to be compliant, all providers, patients, and staff using the tool need to ensure they are in compliance with HIPAA. A telemedicine software vendor, for instance, not only needs to build a secure product, but also ensure their company is operating in accordance with HIPAA.
Interactive medicine, also known as “live telemedicine”, allows patients and physicians to communicate in real-time while also maintaining HIPAA compliance. Communication methods include both phone consultations and video conferences. Physicians can assess a patient’s medical history, perform psychiatric evaluations, and more using interactive medicine.
Like most technology solutions, telemedicine platforms usually require some training and equipment purchases. How much is really dependent on the solution – a more extensive inpatient telemedicine platform that will be used between primary doctors and consulting specialist may require more training and the purchase of a telemedicine cart and various mobile health devices. A secure videochat app like eVisit, requires much less staff training and usually only requires purchase of a webcam.

In many states, current regulations require that any provider and patient doing a telemedicine visit have a pre-existing relationship. Usually this means that the provider and patient need to have had at least one in-person visit. This regulation is slowly changing as more companies like Teladoc and DoctoronDemand seek to connect patients with a random, on-call doctor for immediate care.
Telehealth is a modern form of health care delivery. Telehealth breaks away from traditional health care delivery by using modern telecommunication systems including wireless communication methods.[11][12] Traditional health is legislated through policy to ensure the safety of medical practitioners and patients. Consequently, since telehealth is a new form of health care delivery that is now gathering momentum in the health sector, many organizations have started to legislate the use of telehealth into policy.[12][13] In New Zealand, the Medical Council has a statement about telehealth on their website. This illustrates that the medical council has foreseen the importance that telehealth will have on the health system and have started to introduce telehealth legislation to practitioners along with government.[14]

ISDN Primary Rate Interface (PRI): An ISDN interface standard which operates using one 64K data channel and 23, 64K channels. When the right multiplexing equipment is used, the user can selected the IDN PRI channels for a video call. As an example, if a user would like to have his videoconference at 384K bandwidth, the multiplexer can be instructed to utilize channels 1-6 (6 x 64k= 384k). It is actually quite importance since usually the user pays charges that are based on how many 64k channels get used on a videoconference. So the fewer channels that have to be used to get a quality video signal, the lower the cost of the call will be.


The downsides of telemedicine include the cost of telecommunication and data management equipment and of technical training for medical personnel who will employ it. Virtual medical treatment also entails potentially decreased human interaction between medical professionals and patients, an increased risk of error when medical services are delivered in the absence of a registered professional, and an increased risk that protected health information may be compromised through electronic storage and transmission.[8] There is also a concern that telemedicine may actually decrease time efficiency due to the difficulties of assessing and treating patients through virtual interactions; for example, it has been estimated that a teledermatology consultation can take up to thirty minutes, whereas fifteen minutes is typical for a traditional consultation.[9] Additionally, potentially poor quality of transmitted records, such as images or patient progress reports, and decreased access to relevant clinical information are quality assurance risks that can compromise the quality and continuity of patient care for the reporting doctor.[10] Other obstacles to the implementation of telemedicine include unclear legal regulation for some telemedical practices and difficulty claiming reimbursement from insurers or government programs in some fields.[11]
Telehealth can also increase health promotion efforts. These efforts can now be more personalised to the target population and professionals can extend their help into homes or private and safe environments in which patients of individuals can practice, ask and gain health information.[8][21][24] Health promotion using telehealth has become increasingly popular in underdeveloped countries where there are very poor physical resources available. There has been a particular push toward mHealth applications as many areas, even underdeveloped ones have mobile phone coverage.[25][26]
More specific and widely reaching laws, legislations and regulations will have to evolve with the technology. They will have to be fully agreed upon, for example, will all clinicians need full licensing in every community they provide telehealth services too, or could there be a limited use telehealth licence? Would the limited use licence cover all potential telehealth interventions, or only some? Who would be responsible if an emergency was occurring and the practitioner could not provide immediate help – would someone else have to be in the room with the patient at all consult times? Which state, city or country would the law apply in when a breach or malpractice occurred? [23][42]

Noncommercial use of original content on www.aha.org is granted to AHA Institutional Members, their employees and State, Regional and Metro Hospital Associations unless otherwise indicated. AHA does not claim ownership of any content, including content incorporated by permission into AHA produced materials, created by any third party and cannot grant permission to use, distribute or otherwise reproduce such third party content. To request permission to reproduce AHA content, please click here.
Multi-point Teleconferencing – This is the process of connecting multiple users from different sites. It allows electronic communication between the users as well as transmission of video, voice and data between computers and systems. Multi-point teleconferencing requires the use of a multi-point control unit or the bridge to be able to connect the different sites for the videoconference.

Telehealth is sometimes discussed interchangeably with telemedicine. The Health Resources and Services Administration distinguishes telehealth from telemedicine in its scope. According to them, telemedicine only describes remote clinical services; such as diagnosis and monitoring, while telehealth includes preventative, promotive and curative care delivery.[1] This includes the above-mentioned non-clinical applications like administration and provider education which make telehealth the preferred modern terminology.[2]
Whether on vacation with your kids, away from your home base for business, or in between family doctors, the use of online medical care opens windows and doors to around the clock consultations and medical services. The internet has made it possible for people in rural towns to reach city doctors, for men and women on the road to access much needed prescriptions, and for busy parents to get medical help without packing the kids up and hauling them down to the nearest clinic.
Like most technology solutions, telemedicine platforms usually require some training and equipment purchases. How much is really dependent on the solution – a more extensive inpatient telemedicine platform that will be used between primary doctors and consulting specialist may require more training and the purchase of a telemedicine cart and various mobile health devices. A secure videochat app like eVisit, requires much less staff training and usually only requires purchase of a webcam.
After laying out the basics, an organization should decide what type of telemedicine solutions to offer. A telemedicine expert like VSee offers a text and video collaboration app, a Virtual waiting room, and more. The organization should be responding to their current pain points, such as overcrowded waiting rooms or difficulty reaching patients in rural areas.
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]
Monitoring center links are used for one type of telemedicine – remote patient monitoring. This type of telemedicine link creates a digital connection between a patient’s house and a remote monitoring facility, so that a patient’s medical data can be measured at home and transmitted electronically to a distant medical monitoring facility. These links usually take the form of internet, SMS, or telephone connections. They’re most commonly used for monitoring of pulmonary, cardiac, or fetal medical data.
Cheryl Graf has worked in primary care since 1996 and provided virtual care since 2014. She received her Master of Nursing from Pacific Lutheran University. She also works for a local health system and provides temporary support for emergency departments near her home. Her experience includes emergency services, family practice, pediatrics and urgent care. Additionally, she has created and developed training materials for the Sexual Assault Nurse Examiner programs in Washington State. In her spare time, she enjoys golf, gardening and family time.
×