In 1967 one of the first telemedicine clinics was founded by Kenneth Bird at Massachusetts General Hospital. The clinic addressed the fundamental problem of delivering occupational and emergency health services to employees and travellers at Boston's Logan International Airport, located three congested miles from the hospital. Over 1,000 patients are documented as having received remote treatment from doctors at MGH using the clinic's two-way audiovisual microwave circuit.[13] The timing of Bird's clinic more or less coincided with NASA's foray into telemedicine through the use of physiologic monitors for astronauts.[14] Other pioneering programs in telemedicine were designed to deliver healthcare services to people in rural settings.[citation needed] The first interactive telemedicine system, operating over standard telephone lines, designed to remotely diagnose and treat patients requiring cardiac resuscitation (defibrillation) was developed and launched by an American company, MedPhone Corporation, in 1989. A year later under the leadership of its President/CEO S Eric Wachtel, MedPhone introduced a mobile cellular version, the MDPhone. Twelve hospitals in the U.S. served as receiving and treatment centers.[15]
Telemedicine for intensive care unit (ICU) rounds: Telemedicine is also being used in some trauma ICUs to reduce the spread of infections. Rounds are usually conducted at hospitals across the country by a team of approximately ten or more people to include attending physicians, fellows, residents and other clinicians. This group usually moves from bed to bed in a unit discussing each patient. This aids in the transition of care for patients from the night shift to the morning shift, but also serves as an educational experience for new residents to the team. A new approach features the team conducting rounds from a conference room using a video-conferencing system. The trauma attending, residents, fellows, nurses, nurse practitioners, and pharmacists are able to watch a live video stream from the patient's bedside. They can see the vital signs on the monitor, view the settings on the respiratory ventilator, and/or view the patient's wounds. Video-conferencing allows the remote viewers two-way communication with clinicians at the bedside.[42]
Our panel boasts of some of the best doctors in the healthcare industry whom you can consult after booking an appointment online. You can get access from your home, office or anywhere. Quickly upload your reports and get a consultation summary. All data will be saved for future consultation. Simply enter your name, email ID and select the specialty along with a doctor. Every doctor has a set of available time slots from which you can choose according to your convenience.
Today’s competitive health care marketplace has created an environment where patients demand lower costs, higher service quality, and convenient access to services. [2] Telehealth is an innovative and valuable mechanism that provides patients with efficient access to quality services. Lowering costs and removing barriers to service access, are critical components in promoting patient wellness and population health. Convenience and cost-effectiveness are important commodities in the modern health care marketplace, as patients tend to avoid treatment that is difficult to access or too expensive. As a result, telehealth technology is emerging as a preferred choice among patients and providers. Telehealth has also attracted the attention of US legislators. They utilize this tool for improving the competitiveness of American health care services. This is especially important, seeing as health care represents 17 percent of the nation’s gross domestic product (GDP). In fact, the resource has helped to define the role that lawmakers play in ensuring that patients benefit in a competitive health care market.

As the potential -- if not the actual success, yet -- of AI grows in healthcare, telemedicine stands to benefit from it. It's not hard to imagine telemedicine chatbots being the initial party that a patient discusses symptoms with during a smartphone video call, and based on AI deductions of the situation, recommendations could follow or an actual physician could join the discussion.
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.
Telehealth Addresses Primary Care Physician Shortages/Specialist Scarcity: Telehealth is allowing patients at smaller, less-resourced hospitals to gain access to specialists based at larger regional facilities. Undeniably, lack of access and hard-to-reach populations are drivers of telehealth innovations as supported by this 2014 MUSC study on the use of telehospitalists to address physician shortages. Telehealth is being implemented to treat prison populations, as well as being deployed in rural communities and underserved urban areas to improve healthcare availability.
Chiron Health believes that the right technology is the key to ensuring both patient satisfaction and provider reimbursement. Our easy-to-use, real-time telehealth solution gives providers the piece of mind that they will be able to deliver top-quality care, while increasing revenues and remaining compliant with HIPAA and other laws and regulations. It is perfectly suited for chronic disease management and follow-up visits.
Funding Opportunities: Telehealth can be an important tool for improving access to quality health care, especially for underserved and economically or medically vulnerable populations.    Applicants who propose a telehealth component to their work plan are encouraged to reach out to one of the 12 HRSA-supported Regional Telehealth Resource Centers , which provide technical assistance to organizations and individuals who are actively providing or interested in providing telehealth services to rural and/or underserved communities.
Telemedicine in the trauma operating room: trauma surgeons are able to observe and consult on cases from a remote location using video conferencing. This capability allows the attending to view the residents in real time. The remote surgeon has the capability to control the camera (pan, tilt and zoom) to get the best angle of the procedure while at the same time providing expertise in order to provide the best possible care to the patient.[44]
Theoretically, the whole health system stands to benefit from telehealth. In a UK telehealth trial done in 2011, it was reported that the cost of health could be dramatically reduced with the use of telehealth monitoring. The usual cost of in vitro fertilisation (IVF) per cycle would be around $15,000, with telehealth it was reduced to $800 per patient.[32] In Alaska the Federal Health Care Access Network which connects 3,000 healthcare providers to communities, engaged in 160,000 telehealth consultations from 2001 and saved the state $8.5 million in travel costs for just Medicaid patients.[33] There are indications telehealth consumes fewer resources and requires fewer people to operate it with shorter training periods to implement initiatives.[10]
"Unless you plan to stay away from other people and public places during this time of year, the flu shot is your best form of protection from the flu,” Dr. Kristin Dean, associate medical director at @drondemand, tells @EliteDaily.https://www.elitedaily.com/p/are-flu-shots-really-necessary-more-people-are-opting-out-of-the-shot-survey-says-14706423 …

A native of rural Washington, Katie Gieseke has practiced medicine since 2009, and provided virtual care since 2015. She received her undergraduate degree in Nursing from the University of Portland and received her Doctorate of Nursing Practice and Family Nurse Practitioner certification from the University of Washington. Her nursing career ranges from experience in the emergency department to home health assessments. During her time in the emergency department, she became interested in improving the effectiveness, efficiency and continuity of the health care system. She has a strong interest in illness prevention and look forward to having the time to spend with patients providing education on maintaining wellness, disease prevention and motivating patients to take control of their health.

Patient Exam Cameras – These cameras are used to examine the patient’s overall condition. The different types of patient exam cameras are handheld cameras, camcorders, gooseneck cameras and those which may be placed above the set-top units. Analog and digital cameras are available and the ones that should be used depend on the connection to the set-top unit.
Several physicians and patients are finding it difficult to adapt to telemedicine, especially older adults. Physicians are very concerned about patient mismanagement. While advances in medicine have made it more efficient to use technology, there are times when system outages occur. There is also the potential for error as technology cannot always capture what the human touch can.
While many conditions not on this list can be treated via telemedicine, these conditions are an especially good fit for telemedicine: Allergies and asthma, Chronic bronchitis, Conjunctivitis, UTIs, Low back pain, Otitis media, Rashes, Upper respiratory infections, Diabetes, Hypertension, Mental illness/behavioral health, Prevention and wellness services.

Because of telemedicine, patients who previously had limited access to health care services can now see a physician without leaving their home. Seniors who would prefer to age in place can now do so with the use of medical streaming devices. The spread of disease is reduced as individuals with contagious diseases don’t have to expose it to others in crowded waiting rooms.
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.
Online doctor consultation are rapidly gaining popularity these days as more health insurers offer telemedicine services to help cut costs. Studies have shown that virtual care may effectively used to treat common problems such as flu, acne, deer tick bites, sinus and urinary tract infections. Video doctor consultations can save patients a lot in time and convenience. 
WiFi :  Wifi was originally licensed bu the Wi-Fi alliance and it is used to describe the technology of wireless local area networks, abbreviated as WLAN. This technology was primarily developed for mobile computing devices like laptops in Local Area Networks, but with technological advancements, it is now used for an array of services which include VoIP phone access, gaming as well as basic connection of electronics such as smartphones, DVD players, Home theaters and Televisions.
Soon after Alexander Graham Bell patented the telephone in 1876, ideas of using a telephone to communicate with physicians started appearing in the medical literature. However, telemedicine was truly born in the 1950s, when radiologic images were successfully transferred by telephone between West Chester and Philadelphia, Pennsylvania. In the late 1960s and 1970s, telemedicine developed with support from National Aeronautics and Space Administration (NASA), U.S. Public Health Service, Department of Defense and other federal agencies.
^ Arora, Sanjeev; Thornton, Karla; Murata, Glen; Deming, Paulina; Kalishman, Summers; Dion, Denise; Parish, Brooke; Burke, Thomas; Pak, Wesley; Dunkelberg, Jeffrey; Kistin, Martin; Brown, John; Jenkusky, Steven; Komaromy, Miriam; Qualls, Clifford (2011). "Outcomes of Treatment for Hepatitis C Virus Infection by Primary Care Providers". New England Journal of Medicine. 364 (23): 2199–207. doi:10.1056/NEJMoa1009370. PMC 3820419. PMID 21631316.
Store-and-forward telemedicine works best for interprofessional medical services – where a provider needs to outsource diagnosis to a specialist. For instance, teleradiology relies heavily on store-and-forward technology to allow technicians and healthcare professionals at smaller hospitals to share patient x-rays for diagnosis by a specialist at another location. Asynchronous telemedicine is also commonly used for teledermatology and teleophthalmology.
It has not only expanded and improved access to healthcare services, but also increased patient engagement and enabled more efficient care models. The Department of Veterans Affairs (VA) is one of the largest providers of telehealth services. Last year, more than 700,000 veterans accessed VA telehealth services, which include everything from mental healthcare to surgical specialist consultations. But it’s not just veterans who are benefiting.

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In-person patient-doctor visits are clearly valuable and necessary in many circumstances. Telemedicine is best used to supplement these visits – to do simple check-ins with patients and make sure everything is going well. For minor acute conditions (like infections), an in-person visit with an established patient is often not needed. In those cases, telemedicine can save the patient, the doctor, and the healthcare system time and money.
However, for a while, adopting and investing in telehealth services had been too high, and the distribution of telehealth resolutions and hospital-based networks proved to be too costly. But now, due to technological improvement, improved broadband services are now powerful and easily affordable which makes the level of return on investment in telehealth higher than ever before. Across almost all medical specialties, telehealth services can be applied in connecting providers with different patients in different locations via real-time audio and video. In other cases, service centers can use telemedicine to collect remotely as well as send data to a central monitoring system for interpretation.
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.
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.

Doctor On Demand offers fast, easy and cost-effective video consultations with board-certified physicians, psychiatrists, and licensed psychologists via smartphone or computer. The service is available for anyone to use 24 hours a day, 7 days a week. To access Doctor On Demand, download the app (iTunes or Google Play) or create an account on the website. Once registered, patients can enter code HARVEY2017 to redeem their visit with a medical physician.


For purposes of Medicaid, telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.
“Although many definitions are similar, there are nuanced differences that reflect each organization's legislative intent and the population they serve,” the study concluded. “These definitions affect how telemedicine has been or is being applied across the healthcare landscape, reflecting the U.S. government's widespread and influential role in healthcare access and service delivery. The evidence base suggests that a common nomenclature for defining telemedicine may benefit efforts to advance the use of this technology to address the changing nature of healthcare and new demands for services expected as a result of health reform.”
However, coverage, payment and other policy issues prevent full use of telehealth, remote patient monitoring and similar technologies. Medicare policy is particularly challenging, as it limits the geographic and practice settings where beneficiaries may receive services, as well as the types of services that may be provided via telehealth and the types of technology that may be used. Access to broadband services and state-level policy issues, such as licensure, also limit the ability to use telehealth.
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.
There are the typical discussions about balance between expanding vs. deepening what we currently do. Fair arguments on both sides of the discussion. The company tends to be conservative. Unclear decision making can lead to confusion across the company. Some decisions are made by corporate leaders who don't understand the day to day realties. Needs of the company have outgrown some functional leaders. These issues are...
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. 
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.

"Being able to tie [telehealth] to a larger strategic goal is critical to success," said Mr. Heller. UnityPoint Health aimed to provide the same quality of care for lower acuity visits at a reduced cost. The company looked at more than 1,000 visits from its self-insured health plan, assessing the additional value it generated from its employees using telehealth rather than taking off of work for medical care.
Chiron Health believes that the right technology is the key to ensuring both patient satisfaction and provider reimbursement. Our easy-to-use, real-time telehealth solution gives providers the piece of mind that they will be able to deliver top-quality care, while increasing revenues and remaining compliant with HIPAA and other laws and regulations. It is perfectly suited for chronic disease management and follow-up visits.
Today, there are telemedicine solutions that allow patients to seek a second opinion from the comforts of their home. Sending another physician copies of your medical images and more can easily be done by uploading the content to their secure website. This is very convenient for those who need a specialist but do not have the resources to drive thousands of miles away or wait a long time.
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]
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]

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 defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Traditional use of telehealth services has been for specialist treatment. However, there has been a paradigm shift and telehealth is no longer considered a specialist service.[15] This development has ensured that many access barriers are eliminated, as medical professionals are able to use wireless communication technologies to deliver health care.[16] This is evident in rural communities. For individuals living in rural communities, specialist care can be some distance away, particularly in the next major city. Telehealth eliminates this barrier, as health professionals are able to conduct a medical consultation through the use of wireless communication technologies. However, this process is dependent on both parties having Internet access.[16][17][18]
There are innumerable articles submitted by patients having slightly rare diseases like Rheumatoid Arthritis, Eczema, TIA, TKR, Sarcoidiosis, Cancer, Parkinson’s etc. along with articles from doctors. You can read these articles online and learn from patient experiences. Get lifestyle dos and don’ts, ask questions to any patient, form an online patient group / forum and interact and seek advice from your counterparts.
Today's high-speed broadband based Internet enables the use of new technologies for teleradiology: the image reviewer can now have access to distant servers in order to view an exam. Therefore, they do not need particular workstations to view the images; a standard personal computer (PC) and digital subscriber line (DSL) connection is enough to reach keosys central server. No particular software is necessary on the PC and the images can be reached from wherever in the world.

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]
While this definition sounds a lot like telemedicine, there is one distinct difference. Unlike telemedicine, telehealth also covers non-clinical events like administrative meetings, continuing medical education (CME), and physician training. Telehealth is not a specific service, but a collection of methods to improve patient care and education delivery.
Dr. Bernstein has practiced medicine since 1990 and provided virtual care with our team since 2006. He received his medical degree from the University of North Carolina and completed a residency at Providence Family Practice in Seattle. He also holds a Master's Degree in Public Health from the University of Washington. Dr. Bernstein is dedicated to quality preventive medicine, public health promotion, and research. As Director of Clinical Quality, he manages the development and maintenance of the clinical standards of patient care, working with the development team to create new systems for measuring clinical delivery effectiveness. In his spare time, he is an avid cyclist and a soccer fan.
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