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.

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.

The first example of an electronic medical record transfer occurred in 1948 in Pennsylvania, when radiology images were sent 24 miles between two townships via telephone line. A few years later, Canadian radiologists built on that early application of telemedicine technology and created a teleradiology system for use in and around Montreal. In 1959, clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television.


Reimbursement for Medicaid covered services, including those with telemedicine applications, must satisfy federal requirements of efficiency, economy and quality of care. States are encouraged to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology. For example, states may reimburse the physician or other licensed practitioner at the distant site and reimburse a facility fee to the originating site. States can also reimburse any additional costs such as technical support, transmission charges, and equipment. These add-on costs can be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state. If they are separately billed and reimbursed, the costs must be linked to a covered Medicaid service.
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.
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.
Telemedicine solutions that fall into the remote patient monitoring (RPM) allow healthcare providers to track a patient’s vital signs and other health data from a distance. This makes it easy to watch for warning signs and quickly intervene in patients who are at health-risk or are recovering from a recent surgery, for example. This type of telemedicine is sometimes also called telemonitoring or home telehealth.

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).

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]


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.
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]
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.
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.
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 different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.”
ISDN Primary Rate Interface (PRI): An ISDN interface standard which operates using one 64K data channel and 23, 64K channels. When the right multiplexing equipment is used, the user can selected the IDN PRI channels for a video call. As an example, if a user would like to have his videoconference at 384K bandwidth, the multiplexer can be instructed to utilize channels 1-6 (6 x 64k= 384k). It is actually quite importance since usually the user pays charges that are based on how many 64k channels get used on a videoconference. So the fewer channels that have to be used to get a quality video signal, the lower the cost of the call will be.
Telemedicine for trauma triage: using telemedicine, trauma specialists can interact with personnel on the scene of a mass casualty or disaster situation, via the internet using mobile devices, to determine the severity of injuries. They can provide clinical assessments and determine whether those injured must be evacuated for necessary care. Remote trauma specialists can provide the same quality of clinical assessment and plan of care as a trauma specialist located physically with the patient.[41]
Florida Health Care Plans welcomes you to our online Member Portal. To begin taking advantage of this offering, you must login using your Member Portal account, or if you do not have an account, create one by clicking the above link labeled “New Member Registration.” If you require assistance with logging into the Member Portal, please contact technical support at 1-877-814-9909.
Clinicians are conquering distance and providing access to patients who are not able to travel by providing appointments utilizing real-time video communication platforms. Video conferencing technology has been utilized to provide care for inmates, military personnel, and patients located in rural locations for some time. Also, suppliers of both care and financing such as Kaiser Permanente, the Defense Department, and the Department of Veterans Affairs have been exploiting telehealth modalities to increase access to healthcare services and promote better care quality. In another example, S.C. Department of Corrections and the Medical University of South Carolina are using video scopes and high-resolution cameras to diagnose and treat inmates remotely. They are also conducting virtual appointments using video/audio communication applications to reduce prisoner transportation costs and increase safety by keeping inmates in and providers out of correctional facilities.
Medicaid guidelines require all providers to practice within the scope of their State Practice Act. Some states have enacted legislation that requires providers using telemedicine technology across state lines to have a valid state license in the state where the patient is located. Any such requirements or restrictions placed by the state are binding under current Medicaid rules.
But getting doctors to jump on board is easier said than done, and takes time. Many are afraid of liability, as it's possible to miss something during a remote visit. And for years, it wasn't clear whether they would get paid as much as an in-person visit. Reimbursement questions are still getting resolved across different states, but most of the commercial and government plans are on board with the idea of telemedicine -- at least in specific circumstances.
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.
But investors had other worries that weren't related to the broader market. Teladoc Health CFO and COO Mark Hirschhorn sold more than $700,000 of his stock right after the company's third-quarter earnings update. A short-seller posted an online article predicting that sales for one of Teladoc's fastest-growing businesses would soon fall. These two stories hit on the same day. As you might imagine, Teladoc stock tanked in response.

Although telemedicine itself permits physicians to treat patients nationwide, there are restrictions on who can provide services across state lines. States with large rural areas with limited access to care could greatly benefit from this, but varying state regulations make the process challenging. Physicians who do want to practice medicine across states may have to obtain a full medical license in all states. Not only is the process time consuming, but it is also expensive for physicians to do.

Distance Learning: The use of audio and video technologies allows students to attend training sessions classes that are conducted from a remote location. Usually distance learning systems are interactive. They are a useful tool for delivering education and training to students that are widely dispersed, or in some cases where an instructor is unable to travel to the site where the students are located.

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.
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.
In 2009, the South Carolina Department of Mental Health established a partnership with the University of South Carolina School of Medicine and the South Carolina Hospital Association to form a statewide telepsychiatry program that provides access to psychiatrists 16 hours a day, 7 days a week, to treat patients with mental health issues who present at rural emergency departments in the network.[51]
With many rural areas facing a shortage of specialists, telemedicine enables individual doctors to reach more patients. And the cost to patients for telehealth consultations is often lower than an in-office visit. By serving more patients in a shorter amount of time, healthcare organizations can cost-effectively grow their membership while increasing care quality and patient satisfaction.
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.
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.

These emerging models produce virtual communities of learning and practice that embrace all members of the healthcare team. They are the latest point on the telemedicine continuum that began with the point-to-point connection achieved by Einthoven's pioneering electrocardiogram. Building out the connection established under telemedicine into an ever-expanding knowledge-sharing network can create new potential to improve health and save lives.
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.
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.
To keep up with the rate that technology is progressing, the telemedicine will of course need to overcome other administrative barriers, such as restrictions placed on telemedicine practice by state legislation, state-specific licensing requirements by medical boards, and the reimbursement policies that affect whether doctors are reimbursed by payers and patients are not out-of-pocket. But with the projection that telemedicine will be a $36.3 billion industry by 2020, over 50 telehealth-related bills in the 113th Congress, and 75% of surveyed patients reporting interest in telemedicine, telemedicine’s future is bright and demand is likely to overcome these barriers.
There are many new medical tech terms being used today that the average patient may not be familiar with. For example, a common misunderstanding is that the terms telemedicine, telecare, and telehealth are interchangeable. The truth is that each of these terms refers to a different way of administering health care via existing technologies or a different area of medical technology. To clarify the subtle differences between these three terms, we have provided a detailed definition of each.
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:
Asynchronous or "Store and Forward": Transfer of data from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site for consultation. Asynchronous or "store and forward" applications would not be considered telemedicine but may be utilized to deliver services.
Thanks to telemedicine programs, hospitals, clinics and all other health facilities can ensure that patients receive the best care possible when that care is in their hometown or even hundred of miles away. So what is telehealth’s role in this? It can play a major role in addressing some of the upcoming challenges for healthcare in the United States. For instance, the population growth from 2008-2030 is set at 20%, that is 363 million people, which is predicted to bring about a shortage of healthcare professionals and the lack of specialists and medical facilities in rural areas. Additionally, there is an expected increase in chronic diseases such as diabetes, congestive heart failure, and obstructive pulmonary disease. Statistics indicates that almost 5 million patients are admitted to the intensive care unit that accounts for 20% of the hospital’s operating budgets. Telemedicine can reduce the impact of such challenges by connecting the right people with the correct resources and expertise in real-time.
The future appears to be bright for virtual healthcare services. Patients like using the services because of the convenience. Payers like virtual healthcare because it lowers their costs. As overall healthcare costs increase with more older individuals across the world, telehealth should experience even more growth as a way to control costs without angering patients. 

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.


Doctor On Demand is one of the best-funded Bay Area digital health companies. The region's top digital health startups pulled in $1.5 billion in 2016. As health care continues finding customers outside hospital walls, the industry has seen even brick-and-mortar providers investing in the tech. Fifty million Americans are now willing to switch doctors if given a video visit option, according to a recent trends report.
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.
“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.”
“I woke up Sunday morning with a dry cough and terrible headache,” Ben said. “Realizing I didn’t feel up to going to a clinic, I logged on to Medical City and selected the virtual option. Using the interface was straightforward. I answered several easy questions about my current condition and minutes later I received an email that my info was being examined. I was instructed to set up an account. A second email contained my prescription and expected recovery time. I sent the prescription to the pharmacy next to my house and good to go. In no time, I had the medication and was on my way to feeling better.”
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