mHealth, also known as mobile health, is a form of telemedicine using wireless devices and cell phone technologies.  It is useful to think of mHealth as a tool--a medium--through which telemedicine can be practiced. mHealth is a particularly powerful development because it delivers clinical care through consumer-grade hardware and allows for greater patient and provider mobility. ATA has an array of Special Interest Groups with one dedicated to the practice and development of mHealth.

“It really helped our emergency room with treating stroke patients and benefited patient care by avoiding transportation when minutes matter,” he explained. “We see telemedicine as a solution to expand access to care without leaving the home, as well as a solution for gaining access to a specialist who may not have the patient volumes to relocate to our market.”


Healthcare systems, policymakers, vendors, and providers alike can attest to the many gray areas within telemedicine. One particular area that requires more clarity is the legalities surrounding telemedicine. With it being an industry that is constantly growing, it has become difficult to create a concrete solution. In addition, each state follows different laws for telemedicine, which makes it increasingly difficult to keep up with it.
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]
There are currently 29 states with telemedicine parity laws, which require private payers to reimburse in the same way they would for an in-person visit. As additional states adopt parity laws, private payers may institute more guidelines and restrictions for telemedicine services. Although it’s a step in the right direction, there is still uncertainty regarding reimbursement rates, billing procedures, and more.
Ravyn Ramos has practiced medicine since 2009 and provided virtual care since 2014. She received her Doctor of Naturopathic Medicine degree from Bastyr University in 2004, and her Master of Nursing from Seattle University in 2007. In addition to her work in telemedicine, she serves as clinical faculty in Walden University's distance learning program, as well as practicing as a Family Nurse Practitioner in several local medical centers. In her spare time, she enjoys Bikram yoga, baking bread, traveling and watching the Sounders.
Facility Fees. In addition to reimbursement for the telemedicine service, Medicare will pay the originating site a facility fee. For example, if you’re a primary care provider with a patient in your office and you do a telemedicine visit to consult a physician in another location, you could bill for two separate things – the telemedicine service, and a facility fee for using your practice to “host” of the patient visit. Check HCPCS code Q3014 for a full description on facility fees.
As various parties seek more efficient ways to provide care at less cost to the patient, telemedicine's role has grown. It is often a time-saving way for a consumer to see and speak to a clinician for minor and non-urgent medical needs instead of going to a primary care physician's office or emergency department. In recent years, many states have passed laws that make telemedicine easier to practice, and federal health regulators are also exploring ways to further grant Medicare reimbursements for telemedicine services.
In many Walmart stores, retail consumers can walk up to a kiosk for a doctor consultation. The doctor is not physically present inside the store. Instead, the customer uses a touchscreen computer to type in their symptoms and enter a virtual waiting room. They are then connected by a video link to a doctor. This use-case is HIPAA-compliant because the video link is encrypted to protect patient health information.
There are a variety of payment models to fund telemedicine services. For example, some health systems offer telemedicine consultations as part of their regular care services, and payers charge patients based on insurance plans or government reimbursement schedules. In other cases, a patient's employer offers virtual care options as part of health insurance coverage premiums. Some people may opt to independently use a telemedicine vendor for a flat fee.
On July 7th, 2015, House representatives introduced the Medicare Telehealth Parity Act of 2015. If passed, the bill will expand what telemedicine services Medicare will cover and get rid of many limitations (like the requirements for what qualifies as an “originating site“). Legislation like this one could have a huge impact on coverage for remote patient monitoring and other telemedicine services delivered to the patient in their own home.

Not all state and federal agencies define telehealth in exactly the same terms, but most are fairly consistent with the federal Health Resources and Services Administration, which defines telehealth this way, “The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”
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.
Dr. Miller has practiced medicine since 1988, and provided virtual care since 2015. She completed her medical degree at the Sackler School of Medicine in Tel Aviv then returned to New York to complete her family medicine residency. She later completed her preventive medicine residency at the University of Washington, earning her MPH. Since 1992, she has worked in family medicine and public health in Washington. She continues to provide care at a local clinic and appreciates the opportunity to help her patients make effective healthcare choices. Dr. Miller received Top Docs Recognition for four years in Seattle Met Magazine. Away from work, she enjoys time with her family, traveling, gardening and being outdoors.
Policies and regulations in the telemedicine arena can be confusing for providers, vendors, and payers. Organizations interested in implementing telemedicine should be familiar with the laws in their state. For example, some states require informed consent from patients, while others do not. Some payers may not pay the same rate for telemedicine services as they do for in-person services. Practices should identify how providers will be paid, as some organizations seek grant funding.
State legislation determines the restrictions and often, the reimbursement rates for telemedicine services administered in that state. For instance, any state that has passed a telemedicine parity law has mandated that private payers in that state to reimburse telemedicine visits at the same rate as a comparable in-person visit. While a majority of states have now passed telemedicine parity laws, changing state legislation is often a time-consuming, unwieldy process and can have a huge impact on the telemedicine practices in that state.
The concept of telemedicine started with the birth of telecommunications technology, the means of sending information over a distance in the form of electromagnetic signals. Early forms of telecommunications technology included the telegraph, radio, and telephone. In the late 19th century, the radio and telephone were just starting to emerge as viable communication technologies. Alexander Graham Bell patented the telephone in 1876 and Heinrich Rudolf Hertz performed the first radio transmission in 1887.
Nursing Call Center – This is a centralized office where nurses are the ones who are working. The nurses are responsible for answering telephone calls from patients. They should also make responses to faxes, electronic mails and letters from patients. Nursing call centers may also provide the callers with the basic information regarding their health, but they should not disclose the diagnosis made by the doctors on their conditions. They should not prescribe medications as well. They may just provide basic instructions when patients are having health complaints.

Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and interpretation. While they do not meet the Medicaid definition of telemedicine they are often considered under the broad umbrella of telehealth services. Even though such technologies are not considered "telemedicine," they may nevertheless be covered and reimbursed as part of a Medicaid coverable service, such as laboratory service, x-ray service or physician services (under section 1905(a) of the Social Security Act).
The development of modern telemedicine began with the invention of the telecommunications infrastructure, including the telephone and telegraph. Early on, telemedicine technology was adopted for use in military situations during the Civil War, such as ordering medical supplies or medical consultations. Casualty and injury lists were also delivered via telegraph.
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.
Without a doubt, the emergency room is one of the most expensive, overcrowded, and stressful environments in healthcare. With telemedicine, overcrowded emergency rooms can be reduced by having patients see a remote physician using video chat first. The remote physician can determine if that individual should seek care in an emergency department, which increases ED efficiency.
Healthcare systems, physician practices, and skilled nursing facilities are using telemedicine to provide care more efficiently. Technologies that comes integrated with telemedicine software like electronic medical records, AI diagnosis and medical streaming devices, can better assist providers in diagnosis and treatment. The latter allows providers to monitor patients in real-time and adjust treatment plans when necessary. Ultimately, this leads to better patient outcomes.
We have collaborated with major hospitals like Max Hospitals, Fortis Healthcare, Global Hospitals, Medica Super Specialty (Kolkata), Pushpanjali Crosslay, Nova Specialty Hospitals, Artemis Hospital, Enhance Clinics and Delhi ENT Hospital among many others covering all parts of India. Should you need any treatment of any kind at a hospital, iClinic can facilitate this at a partner hospital and ensure that you get prompt, efficient and economical service.
^ Kontaxakis, George; Visvikis, Dimitris; Ohl, Roland; Sachpazidis, Ilias; Suarez, Juan; Selby, Peter; Cheze-Le Rest, Catherine; Santos, Andres; Ortega, Fernando; Diaz, Javier; Pan, Leyun; Strauss, Ludwig; Dimitrakopoulou-Strauss, Antonia; Sakas, Georgios; Pozo, Miguel (2006). "Integrated telemedicine applications and services for oncological positron emission tomography". Oncology Reports. doi:10.3892/or.15.4.1091.
While laws about prescriptions issued via telemedicine consultations are stringent in many states, the general trend indicates more states will allow these types of online prescriptions, the Center for Connected Health Policy reported. A sticking point is that prescriptions require the establishment of a doctor-patient relationship, and some states do not qualify virtual visits as a legitimate relationship.
In many Walmart stores, retail consumers can walk up to a kiosk for a doctor consultation. The doctor is not physically present inside the store. Instead, the customer uses a touchscreen computer to type in their symptoms and enter a virtual waiting room. They are then connected by a video link to a doctor. This use-case is HIPAA-compliant because the video link is encrypted to protect patient health information.
The doctors can treat flu symptoms, rashes, allergies, urinary tract infections, and bronchitis—and even prescribe medication—without ever physically seeing the patient. Gorevic says nurses then go back and review the charts to effectively audit the diagnoses and treatment. Teladoc refers about 1% of consultations to the E.R., and 5% to 6% to a primary care physician or urgent care center. (No, you can’t find a new doctor through Teladoc: The company prohibits its doctors from seeing their online patients in real life.) Soon, Teladoc plans to expand its specialty offerings to include dermatology and behavioral health.
While laws about prescriptions issued via telemedicine consultations are stringent in many states, the general trend indicates more states will allow these types of online prescriptions, the Center for Connected Health Policy reported. A sticking point is that prescriptions require the establishment of a doctor-patient relationship, and some states do not qualify virtual visits as a legitimate relationship.

Shannon Edmonds has practiced medicine since 2009, and provided virtual care since 2015. She started out her professional career as a teacher and eventually went back to school for her BSN, then Master's and Doctoral degrees in nursing at University of Washington. Her nursing experience ranges from being a school nurse, nursing research, and most recently, doing in-home health assessments. As a family Nurse Practitioner, she finds the gamut of diagnoses and ages interesting.
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