This is one of the most frequently asked questions at ATA. Unfortunately, it is also one of the most difficult to answer.  Estimates on the market size for telemedicine vary widely, depending on each analyst's precise definition of telemedicine. While they can't agree on a single number, one area where all research firms concur is that the telemedicine market is growing rapidly.
Even the American Telemedicine Association also considers telemedicine and telehealth to be interchangeable. “While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services, (the) ATA uses the terms in the same way one would refer to medicine or health in the common vernacular,” the organization states. 
Telemedicine/Telehealth: Basically, these two terms are used to describe the use of technology and telecommunications to exchange medical information from one place to another with an aim of improving the patient’s health status. Telemedicine is sometimes involved in direct patient clinical services which include diagnosis and treatment of patients.
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.
Patients should ask their doctor, hospital or healthcare provider about telemedicine services that are already available. In many cases, the provider may have an existing home health monitoring program or other telemedicine services.  There are also numerous private companies that sell basic telehealth services, including 24/7 access to a health professional, remote monitoring, medication adherence and online wellness apps.

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.
Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline.[3] It does not require the presence of both parties at the same time.[1] Dermatology (cf: teledermatology), radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured medical record preferably in electronic form should be a component of this transfer. A key difference between traditional in-person patient meetings and telemedicine encounters is the omission of an actual physical examination and history. The 'store-and-forward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination.
Patients and their families often want continuous monitoring and care. Traditional health insurance providers are partnering with telehealth companies, to address those concerns. Anthem is working with American Well, Cigna is working with MDLive, Bupa is working with Babylon Health and Aflac is working with MeMD to deliver benefits of telehealth to it’s existing customers. Health insurance providers such as Oscar Health is redefining health-insurance by building the whole customer experience around its own telehealth services.
Like most telemedicine tools, remote patient monitoring solutions make it easier for patients and physicians to maintain close communication. Many RPM solutions record and transmit a patient’s medical data automatically, generating a regular report for the physician. In some cases, this medical data is transmitted to a team of health monitoring professionals who are responsible for flagging any warning signs and sending them on to the physician, if needed.
Emergency room and urgent care environments are known for long wait times, overcrowding and even staffing shortages. This leads to additional stress being added to not only the patient, but the staff too. With tele-triage, patients can arrive to an emergency department and be seen by an off-site physician using video conferencing software. The off-site physician can order tests or determine a treatment plan, which moves patients through the system faster. Cases that are more severe can be moved to the next level of patient care and others can be discharged.
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]
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.
Referring to health information services, health care education, and health care services in a broad sense, the term telehealth is an all-encompassing one. In fact, telecare and telemedicine are generally covered within the broader scope of the term telehealth. Included in telehealth are health education services, remote monitoring of vital signs, ECG or blood pressure and remote doctor-patient consultations (telemedicine). Telehealth technology enables the remote diagnoses and evaluation of patients in addition to the ability to remote detection of fluctuations in the medical condition of the patient at home so that the medications or the specific therapy can be altered accordingly. It also allows for e-prescribe medications and remotely prescribed treatments.
Telemedicine also can eliminate the possible transmission of infectious diseases or parasites between patients and medical staff. This is particularly an issue where MRSA is a concern. Additionally, some patients who feel uncomfortable in a doctors office may do better remotely. For example, white coat syndrome may be avoided. Patients who are home-bound and would otherwise require an ambulance to move them to a clinic are also a consideration.
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.
“Telemedicine is the natural evolution of healthcare in the digital world,” American Telemedicine Association. Telemedicine empowers the caregivers to remotely interact with their patients, which greatly improves both the efficiency and affordability of healthcare. Today patients, doctors and caregivers have learned to accept telemedicine (often called ‘telehealth’ or ‘connected health’) as one of many ways of delivering care.

Glenda Clemens has worked in primary care since 2001 and provided virtual care since 2012. She has practiced medicine as a nurse's aide, licensed practical nurse and registered nurse before receiving her Master of Nursing from the University of Oklahoma. From running her own practice to caring for veterans, she demonstrates a commitment to providing care to underserved populations. When she is not working, she enjoys knitting, crocheting and writing poetry.

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