The population of the United States is growing, aging, and becoming more prone to chronic conditions like diabetes, congestive heart failure, and COPD. This is creating a perfect storm of demand on the healthcare system, yet there is a shortage in the pipeline of healthcare providers being educated, trained, and licensed to practice. This necessitates getting very smart about how healthcare resources are leveraged to provide high-quality care to the highest number of people possible.  Telehealth technologies increase the efficiency of the healthcare system overall by maximizing the productivity of each provider and removing geographical barriers to care.
VSee urges organizations interested in implementing telemedicine to find a telemedicine provider that offers HIPAA compliant software. This means that all data must be fully encrypted, have secure peer-to-peer network connections and have no storage of video. Telemedicine providers should also be comfortable signing a business associate agreement, which asserts that they will take responsibility in keeping patient information safe.

^ Wadsworth, Hannah E; Galusha-Glasscock, Jeanine M; Womack, Kyle B; Quiceno, Mary; Weiner, Myron F; Hynan, Linda S; Shore, Jay; Cullum, C. Munro (2016). "Remote Neuropsychological Assessment in Rural American Indians with and without Cognitive Impairment". Archives of Clinical Neuropsychology. 31 (5): 420. doi:10.1093/arclin/acw030. PMID 27246957.
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]
Real-time telemedicine (also called “synchronous telemedicine”) is probably what most people first think of when they hear “telemedicine.” Real-time telemedicine requires a live interaction between either a health professional and patient, or between health professionals, using audio and video communication. Think videochat. While most real-time telemedicine software is much more sophisticated than a simple videochat platform, the basic goal is to both see and talk to the patient from afar. This type of telemedicine is meant to offer a virtual alternative to the in-person doctor’s visit.
Founded only eight months ago, Doctor On Demand has gained rapid visibility thanks to its founders, television personality Dr. Phil and his son Jay McGraw who produces The Doctors, a health talk show where viewers can submit questions to a small stable of doctors. The McGraws flog the service on their shows to millions of mostly young women who are not necessarily aware that the McGraws are stakeholders, since disclosure appears with the credit roll. (Rival Dr. Oz who’s an investor in health and wellness platform Sharecare also uses his show to publicize that start-up).

Home Health Care And Remote Monitoring Systems: Care that is provided to patients and their families in their residences to promote, maintain or restore health; or to minimize the effects of illness and disability, including terminal illnesses. In Medicare enrollment data and claims as well a Medicare Current Beneficiary Survey, home health care is defined as home visits made by professionals, including physicians, nurses, home health aides, therapist and social workers. The use of interactive devices and remote monitoring enable a patient’s vital signs to be sent on a regular basis to health care providers without the patient having to travel.


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.

As telehealth continues to replace traditional health care, it is going to inherit some of its challenges. These include increased cost of care due to multiple vendors, complex care pathways, and government policies. However, the question that remains to be answered is will this advanced technology that we call telehealth, be able to redefine the quality, equity and affordability of healthcare throughout the world.
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.
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.
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.
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.
In the United States, the major companies offering primary care for non-acute illnesses include Teladoc, American Well, and PlushCare.[81] Companies such as Grand Rounds offer remote access to specialty care.[82] Additionally, telemedicine companies are collaborating with health insurers and other telemedicine providers to expand marketshare and patient access to telemedicine consultations. For example, In 2015, UnitedHealthcare announced that it would cover a range of video visits from Doctor On Demand, American Well's AmWell, and its own Optum's NowClinic, which is a white-labeled American Well offering.[83][84] On November 30, 2017, PlushCare launched in some U.S. states, the Pre-Exposure Prophylaxis (PrEP) therapy for prevention of HIV. In this PrEP initiative, PlushCare does not require an initial check-up and provides consistent online doctor visits, regular local laboratory testing and prescriptions filled at partner pharmacies.[85][86][87]
At TeleHealth Services, we design and deliver interactive touchpoint solutions for better outcomes across the patient care continuum. With more than 2,500 client hospitals and clinics, 430 interactive patient care solutions commissioned, and 60 years of point-of-care expertise, TeleHealth Services is the leading provider of interactive patient experience solutions to the U.S. healthcare industry. We are the only provider of end-to-end interactive patient engagement and interactive patient TV solutions to enhance the patient experience, increase patient satisfaction, improve outcomes, and support the continuum of care. Our Health AV solutions are designed for the particular needs of the healthcare industry and, with our sister division Avidex; one of the largest A/V integrator in the nation.

On the eve of its July 1 IPO, the company was billed as the first and largest telehealth platform in the United States.[22] The number of visits facilitated in 2014 was 299,000.[23] By 2016, its visit count had grown to 952,000.[24] The company had 8.1 million members in 2014 and 10.6 by the end of the first quarter of 2015.[23] By the end of the first quarter of 2015, the company has 4000 clients including 160 of the Fortune 1000 companies.[23] Two years later, the company had 7500 clients and 220 Fortune 1000 companies.[25]
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.
Bao Ng has worked in primary care since 2013 and provided virtual care since 2013. Obtaining her Doctor of Nursing Practice from the University of Washington, she began working in telemedicine shortly thereafter. Her medical interests include international health, and maternal and child health. She works at an international community health clinic near her home, and is fluent in Vietnamese and proficient in conversational Cantonese. She volunteers as a caregiver in her church nursery and is an executive board member for a local pediatric and behavioral health clinic. Outside of work, she enjoys spending time with her husband and children and exploring new cuisines.
“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.”
Additionally, Medicare will only pay for telemedicine services when the patient is located in a Health Professional Shortage Area and receives care from an eligible provider. The medical service itself also has to fall under one of thesecovered CPT/HCPCS codes. When all these conditions are met, Medicare pays for 80% of the physician fee (other 20% is paid by the patient) and will additionally pay a facility fee to the originating site.
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.
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.

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.
Telemedicine companies that are consumer-facing offer the huge benefit of on-demand care for patients. A sick patient can simply login online and request a visit with one of the company’s doctors and get treatment. But this model, similar to the retail health movement, leads to a breakdown in care continuity. A random doctor who doesn’t know the patient, doesn’t know their whole medical history. The best approach to telemedicine? Providing tools to providers to easily connect with their own patients. 
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.
Without proper medication, asthma and other respiratory related illnesses can be extremely serious. Chronic asthma affects more than 20-million citizens across the United States, and can appear in early childhood or adolescence. The symptoms vary from person to person, with most individuals experiencing shortness of breath, tightening of the chest, coughing, and wheezing.

The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services defines telehealth as the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.


Integrated Services Digital Network (ISDN): A common dial-up transmission path used for videoconferencing. ISDN services are on demand services where another IDSN based device is dialed, and per minuted charges are accumulated at a certain contracted rate. The site that places the call is then billed. The service is similar to the dialing features that come with making long distance phone calls. The person how initiates the call pays the bill. Connections of up to 128Kbps are permitted by ISDN.
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.
The company has made seven acquisitions: Consult A Doctor for $16.6 million cash in August 2013; AmeriDoc for $17.2 million in May 2014; and BetterHelp for $3.5 million in cash and a $1.0 million promissory note in January 2015.[23] The company also announced and closed the acquisition of HealthiestYou in July 2016.[23] Stat Health Services, Inc. (StatDoc) for $30.1 million, $13.3 million of cash and $16.8 million of Teladoc common stock (or 1,051,033 shares), net of cash acquired in June 2015[27] ; and HealthiestYou for $45 million in cash and 6.96 million shares of Teladoc's common stock in June 2016.[28] In 2017, the company purchased Best Doctors, Inc., a provider of medical second opinions and a "pay-to-play" medical award listing.[29] Most recently, Teladoc has acquired Advance Medical for $352 million. Advance Medical is a telemedicine company which has locations in Chile, Spain, and parts of Asia. It runs a virtual doctor service, called Global Care on Demand, which offers access to medical advice by phone or video by doctors located in eight main hubs around the world who speak more than 20 languages, and is targeted at expatriates.[30]
SSM Health telehealth programs use a variety of applications and services including two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. These modern communication pipelines offer practitioners a channel to interact with the patient and exchange information, pictures and video. Our telehealth programs:
Once the need for a Telehealth service is established, delivery can come within four distinct domains. They are live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. Live video involves a real-time two-way interaction, such as patient/caregiver-provider or provider-provider, over a digital (i.e. broadband) connection. This often is used to substitute a face to face meeting such as consults, and saves time and cost in travel. Store-and-forward is when data is collected, recorded, and then sent on to a provider.[1][2][10] For example, a patient's' digital health history file including x-rays and notes, being securely transmitted electronically to evaluate the current case. Remote patient monitoring includes patients' medical and health data being collected and transferred to a provider elsewhere who can continue to monitor the data and any changes that may occur. This may best suit cases that require ongoing care such as rehabilitation, chronic care, or elderly clients trying to stay in the community in their own homes as opposed to a care facility. Mobile health includes any health information, such as education, monitoring and care, that is present on and supported by mobile communication devices such as cell phones or tablet computers. This might include an application, or text messaging services like appointment reminders or public health warning systems.[10]
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.
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]
Two important areas of telerehabilitation research are (1) demonstrating equivalence of assessment and therapy to in-person assessment and therapy, and (2) building new data collection systems to digitize information that a therapist can use in practice. Ground-breaking research in telehaptics (the sense of touch) and virtual reality may broaden the scope of telerehabilitation practice, in the future.

Yet healthcare systems struggle to turn this form of technology into a profitable revenue stream. Consumers have been slow to adopt this model. And, according to a Rand study published in 2017, it appears to attract a new set of consumers who might not otherwise use medical services, thereby driving costs up. Findings related to utilization and spending for acute respiratory illness based on commercial claims data from more than 300,000 patients between 2011 and 2013 included:
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.”
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.
HIT is the generation and transmission of digital health data, often through an electronic health record. Generally, HIT is used for administrative functions (keeping track of patient's health history, sharing information between providers, etc.) while telemedicine is the delivery of an actual clinical service. HIT can facilitate telemedicine but it is not a requirement for delivering remote health care.

Symptoms occur due to a swelling of the breathing tubes, which makes it difficult for air to pass into the lungs. For those who smoke cigarettes, suffer from obesity, or live with allergies, these symptoms are more severe. By speaking with a U.S. doctor through your consultation, you can receive a prescription for the proper medication to treat asthma. To treat your symptoms,click herefor more information! .
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