The future of telemedicine is wide open, with room for drastic improvement and more technology based medical care. As the world of tech continues to evolve, so too can the world of telehealth. Already, patients can sit down for a one on one appointment anywhere and anytime with the use of nothing more than a mobile phone. Imagine what new technology will bring in terms of holographic imaging, long distance x-ray, and more work in the field of ultrasounds.
Applications of telehealth in physical therapy already have roots that expand throughout patient/client care and consultation, as it allows PTs to better communicate with patients/clients and provide more flexible care. Telehealth will not replace traditional clinical care. However, it will give PTs and PTAs the flexibility to provide services in a greater capacity. Examples:

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.

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.


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.
Although this is more difficult to prove, big payers like Blue Cross Blue Shield and Aetna are benefiting from telemedicine too. Patients with substance abuse disorders who are treated using various telemedicine strategies provide cost-savings for payers. The cost per treatment is cheaper overall and offers cost savings across the board. As technology continues to improve, the cost savings will become more visible.

With approximately 30-million cases of thyroid conditions across the U.S., including some 15-million which are undiagnosed, the need for fast and efficient prescriptions in this area is high. Women have a higher chance of contracting disorders of the thyroid, but they can affect men as well. Symptoms include anxiety, chronic fatigue syndrome, numbed senses of smell and taste, lowered sex drive, dry skin, stomach pain, digestive issues, high blood pressure, pain in the joints and muscles, heart palpitations, weight gain, hair loss, and uncontrollable body temperature.
Disease Management: A coordinated and continuous health process for the purposes of managing and improving the health status of a specifically defined population of patients over the complete course of the disease (e.g., DM, CHF). The targeted patient populations are high-cost, high-risk patients that have chronic conditions that require appropriate care in order to be maintained properly.
Through live video visits, our hand-picked, US-trained doctors take patient history, perform an exam, and recommend a treatment plan. Prescriptions, if needed, go directly to the pharmacy of choice. While insurance isn’t required, tens of millions of Americans enjoy covered medical and mental health visits through employer and health plan partnerships. To learn more about the hundreds of medical issues we treat, visit us at DoctorOnDemand.com.
Informed consent is another issue – should the patient give informed consent to receive online care before it starts? Or will it be implied if it is care that can only practically be given over distance? When telehealth includes the possibility for technical problems such as transmission errors or security breaches or storage which impact on ability to communicate, it may be wise to obtain informed consent in person first, as well as having backup options for when technical issues occur. In person, a patient can see who is involved in their care (namely themselves and their clinician in a consult), but online there will be other involved such as the technology providers, therefore consent may need to involve disclosure of anyone involved in the transmission of the information and the security that will keep their information private, and any legal malpractice cases may need to involve all of those involved as opposed to what would usually just be the practitioner.[22][42][43]
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 telehealth allowing physicians to expand their coverage area, there have been questions regarding interstate medical licensing. Interstate medical licensing permits more physicians to serve individuals in underserved and rural areas, but currently, only a few states offer this. The Interstate Medical Licensure Compact helps streamline the licensing process for physicians that are interested in practising in participating states.
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.
Through live video visits, our hand-picked, US-trained doctors take patient history, perform an exam, and recommend a treatment plan. Prescriptions, if needed, go directly to the pharmacy of choice. While insurance isn’t required, tens of millions of Americans enjoy covered medical and mental health visits through employer and health plan partnerships. To learn more about the hundreds of medical issues we treat, visit us at DoctorOnDemand.com.
The Health Resources Services Administration defines telehealth as 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. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
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.
With telemedicine, patients can connect with their dermatologist using a smartphone, tablet, or computer. Using high definition images and video, dermatologists can examine a patient suffering from psoriasis, eczema, bedsores, and more. This is extremely convenient for those patients that are housebound. Using telemedicine solutions, dermatologists can diagnose and treat skin care conditions effectively and efficiently. In addition, it not only saves a patient from travelling to a clinic but it also helps them maintain their dignity.
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.

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. 


Telehealth has emerged as a critical tool in providing health care services. [1] The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.
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.
“For the most part, an interaction — whether in person, via telemedicine or on the phone — between a patient and a physician can be beneficial,” Downey wrote in a 2015 blog. “The sticking point is the issuance of a prescription medication to a previously unknown person who the doctor has never examined and for which the doctor has no access to the medical record. And here's where telemedicine differs from telehealth. During a telemedicine visit, the patient is seen by the provider. A patient presenter is with the patient in most cases, and follows the directions of the remote provider in placing a stethoscope or exam camera on the patient's body, providing both sounds and images. The remote provider also has the benefit of an array of other medical devices to gather patient information not available to a D2C telehealth physician.”

“Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status,” the ATA writes. “Telemedicine includes a growing variety of applications and services using two-way video, e-mail, smart phones, wireless tools and other forms of telecommunications technology.”
Telehealth’s existence can be dated from the 1960’s with one of the earliest applications being the monitoring of the physiological parameters of astronauts. Over the years, thanks to technological advancement, there has been a number of technological and communications tools that have been implemented to enable the transfer of patient’s information for recommendations and consultations across almost every medical environment and specialty. Telehealth services have also been able to provide remote monitoring of the patient, consumer health communication and information and medical education for providers. Typically, delivery techniques include: networked programs that link tertiary medical centers to outlying centers and clinics in rural areas, home phone-video connections, point-to-point connection to hospitals and clinics, web-based e-health service pages and home monitoring links.

While the industry is still a long way from a standard set of established guidelines for telemedicine, the American Telemedicine Association has put together guidelines for a range of specialties based on a survey hundreds of research study. What are the clinical, technical, and administrative guidelines a medical practice needs to put in place when they’re adopting telemedicine? Beyond the minimal legal requirements of that state, what are telemedicine best practices?
Most telerehabilitation is highly visual. As of 2014, the most commonly used mediums are webcams, videoconferencing, phone lines, videophones and webpages containing rich Internet applications. The visual nature of telerehabilitation technology limits the types of rehabilitation services that can be provided. It is most widely used for neuropsychological rehabilitation; fitting of rehabilitation equipment such as wheelchairs, braces or artificial limbs; and in speech-language pathology. Rich internet applications for neuropsychological rehabilitation (aka cognitive rehabilitation) of cognitive impairment (from many etiologies) were first introduced in 2001. This endeavor has expanded as a teletherapy application for cognitive skills enhancement programs for school children. Tele-audiology (hearing assessments) is a growing application. Currently, telerehabilitation in the practice of occupational therapy and physical therapy is limited, perhaps because these two disciplines are more "hands on".
Telemedicine has come a long way and there’s still so much room for growth. Currently, telemedicine is used to conference specialists on important appointments when patients have no other access, to provide diagnosis and prescriptions to remote areas where access to a physician isn’t always possible, and even to assist in invasive surgeries when a high caliber surgeon can’t reach a patient in time.
Physicians and patients can share information in real time from one computer screen to another. And they can even see and capture readings from medical devices at a faraway location. Using telemedicine software, patients can see a doctor for diagnosis and treatment without having to wait for an appointment. Patients can consult a physician at the comfort of their home.
^ Cartwright M, Hirani SP, Rixon L, Beynon M, Doll H, Bower P, et al. (February 2013). "Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial". BMJ (Clinical Research Ed.). 346: f653. doi:10.1136/bmj.f653. PMC 3582704. PMID 23444424.
The term ‘telehealth’ is gaining popularity among medical professionals, compared to the original term, ‘telemedicine.’ [4] Some medical professionals use the names interchangeably. However, telemedicine is a term that may apply to the application of any technology in the clinical setting, while telehealth more distinctly describes the delivery of services to patients. Telemedicine is a familiar term, but telehealth more appropriately describes the latest trends in using technology to deliver treatments to patients. Depending on the organization, service providers may use a different definitions of telehealth. Although the basic premise remains similar, the context may change according to factors such as organizational objectives, and the needs of the patient population being served. Medical experts do agree on one point; telehealth is an innovative way of engaging patients, and it is highly beneficial for both providers and patients.

A radiologist specializes in using medical imaging techniques to both diagnose and treat disease. Their day-to-day responsibilities include working with other healthcare professionals, which can be extremely time-consuming. With telemedicine, radiologists can receive high-quality images and provide feedback on where ever they are. They no longer have to be in the same area as the provider sending over the images, which allows for a more streamlined process.
With telemedicine, patients can connect with their dermatologist using a smartphone, tablet, or computer. Using high definition images and video, dermatologists can examine a patient suffering from psoriasis, eczema, bedsores, and more. This is extremely convenient for those patients that are housebound. Using telemedicine solutions, dermatologists can diagnose and treat skin care conditions effectively and efficiently. In addition, it not only saves a patient from travelling to a clinic but it also helps them maintain their dignity.
Although there were distant precursors to telemedicine, it is essentially a product of 20th century telecommunication and information technologies. These technologies permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging and health informatics data from one site to another.
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.
Telehealth has emerged as a critical tool in providing health care services. [1] The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.
If a practitioner serves several states, obtaining this license in each state could be an expensive and time-consuming proposition. Even if the practitioner never practices medicine face-to-face with a patient in another state, he/she still must meet a variety of other individual state requirements, including paying substantial licensure fees, passing additional oral and written examinations, and traveling for interviews.

The definition of telemedicine is somewhat controversial. Some definitions (such as the definition given by the World Health Organization[2]) include all aspects of healthcare including preventive care. The American Telemedicine Association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments.[3]


Type of telehealth. Medicare primarily only reimburses for live telemedicine, where the physician and patient are interacting in real-time through secure, videochat. This type of telemedicine visit is meant to substitute a face-to-face in-person visit. The only exception is in Hawaii and Alaska, where Medicare reimburses for store-and-forward telemedicine as well.
Telerehabilitation (or e-rehabilitation[36][37]) is the delivery of rehabilitation services over telecommunication networks and the Internet. Most types of services fall into two categories: clinical assessment (the patient's functional abilities in his or her environment), and clinical therapy. Some fields of rehabilitation practice that have explored telerehabilitation are: neuropsychology, speech-language pathology, audiology, occupational therapy, and physical therapy. Telerehabilitation can deliver therapy to people who cannot travel to a clinic because the patient has a disability or because of travel time. Telerehabilitation also allows experts in rehabilitation to engage in a clinical consultation at a distance.

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Telehealth and Patient Engagement: With telehealth technologies, patients are taking more control of their well-being. Educational videos, health management apps for mobile devices, and online health learning and support communities empower patients to manage chronic conditions, lose weight, increase physical activity levels, and gain emotional support. Diabetes patients are benefiting from carbohydrate tracking apps and are using glucose monitoring devices to document and report their blood sugar measurements. Other patients are interacting with their providers and scheduling appointments through secure online communication portals. Additionally, they are accessing health education content via smartphones and computers to add to their self-care toolboxes. They are also using wearables and monitoring systems to gain knowledge about their sleep patterns, vital signs, and activity levels.
The U.S. spends over $2.9 trillion on healthcare every year, more than any other developed nation. On top of that, an estimated $200 billion of those costs are avoidable, unnecessary spending. Telemedicine has the power to cut our healthcare spending by reducing problems like medication non-adherence and unnecessary ER visits, and making typical doctor visits more efficient.

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]


It has been around for decades, but in recent years private insurers, employers, and government programs have expanded their coverage. By 2016 at least half of U.S. healthcare institutions and hospitals were using some form of telehealth. And last September the Senate passed a bill that will expand Medicare coverage for telehealth services, if it’s signed into law.
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