Telenursing is achieving significant growth rates in many countries due to several factors: the preoccupation in reducing the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.[22]
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]
Teleradiology is the ability to send radiographic images (x-rays, CT, MR, PET/CT, SPECT/CT, MG, US...) from one location to another.[62] For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving-image review station. The most typical implementation are two computers connected via the Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. Sometimes the receiving computer will have a printer so that images can be printed for convenience.
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.
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.
This isn't to say that you should jump right in and begin providing services via telehealth. You'll first need to consider federal and state legislation and regulations that govern your practice, risk management implications, billing and coding issues, and hardware/software requirements. The resources below aren't meant to give you detailed instructions on developing and using telehealth in your practice, but they identify areas most important for you to investigate and consider.
The telemedicine foundation is quickly being built. But what do patients think about telemedicine? Are they ready to try it? Recent studies show that a majority of patients are interested in using telehealth services, especially once they see how it works and the potential benefits for them. NTT Data found 74% of surveyed US patients were open to using telemedicine services, and were comfortable communicating with their doctors via technology. 67% said telemedicine at least somewhat increases their satisfaction with medical care.
Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective.[16] Examples include home-based nocturnal dialysis[17] and improved joint management.[18]
Whether on vacation with your kids, away from your home base for business, or in between family doctors, the use of online medical care opens windows and doors to around the clock consultations and medical services. The internet has made it possible for people in rural towns to reach city doctors, for men and women on the road to access much needed prescriptions, and for busy parents to get medical help without packing the kids up and hauling them down to the nearest clinic.
Likely one of the most popular specialities for telemedicine, mental health practices can increase revenue, streamline patient flow, and provide counselling sessions from anywhere. With telemedicine, patients in rural areas can now access mobile and web apps to speak with their therapist. In addition, cancellations and no-shows are less likely to occur. Mental health practices that implement telemedicine can also see more patients and still provide a high level of patient care. This leads to increased profitability and effective time management.
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]
Many doctors who choose to offer virtual visits to their patients will do so as part of a direct-pay or concierge practice model. Instead of having their doctor bill through an insurance carrier, these patients might have a high-deductible insurance plan for emergencies and then pay a yearly fee to essentially have their doctor on retainer. The patients might pay an additional convenience fee for each virtual visit, or just have access to virtual visits with their doctor as part of their subscription fee for the practice.
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.
Today, 95 percent of Americans own cell phones and 77 percent own smartphones. These and other mobile devices can be leveraged to promote better health outcomes and increased access to care. mHealth or mobile health refers to healthcare applications and programs patients use on their smartphones, tablets, or laptops. These applications allow patients to track health measurements, set medication and appointment reminders, and share information with clinicians. Users can access hundreds of mHealth applications including asthma and diabetes management tools as well as weight loss or smoking cessation apps. Additionally, mobile devices allow users to schedule appointments and communicate with providers via video conference and text message.

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?
The first radiologic images were sent via telephone between two medical staff at two different health centers in Pennsylvania by 1948. The health centers were 24 miles apart from one another! Then in 1959, physicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television. Five years later, a closed-circuit television link was built that allowed physicians to provide psychiatric consultations 112 miles away at Norfolk State Hospital.
In many states, current regulations require that any provider and patient doing a telemedicine visit have a pre-existing relationship. Usually this means that the provider and patient need to have had at least one in-person visit. This regulation is slowly changing as more companies like Teladoc and DoctoronDemand seek to connect patients with a random, on-call doctor for immediate care.
Healthcare systems that are thinking about implementing telemedicine solutions should consult with experts in the industry. VSee, a leading telemedicine organization, suggests that practices do not rush into telemedicine without having the right equipment. They offer a variety of practical solutions for practices wanting to add telemedicine to their clinic and can make the integration more seamless.
A company’s culture is defined by the behavior that is allowed. The Board, CEO and the management team need to set the example—allowing toxic, demoralizing, untrustworthy actions to persist is implicitly endorsing that behavior. Look to the past for what’s likely to come—every leader in the company has brought former colleagues to work alongside them at DOD except for one. Red flag. This leader burns bridges. Act before...

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.
One of the biggest advantages of telehealth services is easy access to on-demand care. During a telemedicine consultation, a physician can inquire about symptoms, discuss treatment and determine whether a prescription is necessary. More importantly, for patients who don’t have a reliable means of transportation or who struggle with mobility challenges or disabilities that make traveling difficult, remote access can be a huge quality of life improvement. This is especially true for those living with chronic conditions for which frequent checkups are necessary. Telehealth services are also helping to fill healthcare gaps faced by rural communities across the United States — in areas where patients may have to drive for hours to get to the nearest hospital or specialist.
This system enabled wireless transmission of ECG from the moving ICU van or the patients home to the central station in ICU of the department of Medicine. Transmission using wireless was done using frequency modulation which eliminated noise. Transmission was also done through telephone lines. The ECG output was connected to the telephone input using a modulator which converted ECG into high frequency sound. At the other end a demodulator reconverted the sound into ECG with a good gain accuracy. The ECG was converted to sound waves with a frequency varying from 500 Hz to 2500 Hz with 1500 Hz at baseline.
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.

Another reason you might find yourself in need of Express Med Refills is during your own vacation, business trip, or weekend getaway. There’s nothing worse than waking up to realize you’ve left your medication at home on the kitchen counter. For patients who require medicine everyday this is a nightmare, and one that should be rectified as soon as possible. Through our quick and secure services, you can speak to a doctor and receive the help you need within 20 minutes to 2-hours.
“If there are areas of clinical need across the healthcare network, telemedicine may allow for better leveraging and expanding access to sub-specialists,” Sokolovich said. “Another opportunity could include better triaging patients through telemedicine-enabled provider-to-provider or provider-to-patient evaluations, which bring together experts who can quickly assess the best care path and eliminate unnecessary hospital admissions or emergency department visits.”
Originally, health professionals developed this technology to reach remote patients living in the rural areas. But with time, medical staff and the U.S. government saw the big picture – the potential to reach urban populations with healthcare shortages, and to respond to medical emergencies by sharing medical consults and patient health records without delay. In the 1960s, heavy investments from the U.S. Government, including the Public Health Department, NASA, Department of Defense, and the Health and Human Sciences Department drove research and innovation in telemedicine. Sending cardiac rhythms during emergencies started at about this time. For instance, in Miami, the university medical center worked together with the fire rescue department by sending electro-cardiac rhythm signals over the voice radio channels from the rescue sites.
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.
Kaitlin Brasier has worked in primary care since 2012 and provided virtual care since 2013. She received her Doctor of Nursing Practice from the University of San Diego in 2012. In addition to providing virtual care, she works in a dermatology clinic. She has extensive experience in family practice nursing and women's health and has conducted research on childhood obesity prevention. She enjoys outdoor activities, including hiking, snowboarding and horseback riding. She also likes cooking, reading and travel.
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