“It is less about the technology as it is about delivering medicine via a new medium,” Clement explained. “Luckily, the C-suite is accustomed now to teleconferencing, so they have a feel for the benefits, as well as some of the communication struggles that come with being audio-visual from remote locations. Much like teleconferencing, there are situations where telemedicine will fit and others where it will not: It can’t be looked upon as a silver bullet.”
There are several areas where telehealth medicine could make a significant impact. It could be used as a tool to remotely monitor patients who have recently been discharged. It may also help treat individuals with behavioral health issues who might normally avoid treatment due to its high cost, or to avoid any perceived public stigma. [5] The largest area where technology could advance medicine is in treating the chronically ill. These patients usually require many visits with several specialists who may practice at different and distant originating sites. To move telehealth forward, organizational leaders must present evidence to peers and patients that the technology offers value. In addition, care providers must work to transition patients from using telehealth services only for minor conditions (for headaches, colds, etc.), to accepting the technology as a viable replacement for costly physician office visits. Advocates for telehealth medicine must also develop quality controls, so that this potentially transformational tool can maximize its problem solving capabilities and its service effectiveness. To harness the benefits of telehealth technology, America’s brightest medical professionals (both experienced and up-and-coming) must make a concerted effort to incorporate the tool into their practices and make it a regular service offering. Today’s medical students — as they enter a world where telehealth is becoming more pervasive — can take part in what might be a monumental change in the way health professionals think about medical treatment.
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.

Flu is a common virus that affects all ages. Early diagnosis is best. With McLeod Telehealth you’ll receive quality healthcare online by a physician at anytime, from anywhere – on your laptop, phone, or tablet – without ever leaving home. See a doctor in minutes. No appointment necessary. Visits are private and secure. Sign Up is free. Find answers to our most Frequently Asked Questions (FAQ). Watch our video below for a demonstration of Telehealth.
Online doctors are becoming a real thing across America, not just for those who are tech savvy, but for anyone. Although telemedicine was introduced in the United States in the 1960s, it didn’t become popular for the everyday man or women until this last decade. In the past, missing a prescription refill with your family doctor right before the weekend would mean going until Monday before you could even try to schedule an appointment. And even then, it might be days or weeks before you could get in to see the physician.

While telemedicine has shown to be a game changer in the field of medicine, there are still a number of barriers to overcome. Physicians face challenges regarding how they’ll be paid and where they can practice, while patients voice security concerns. Once these barriers are removed, we can anticipate greater access to care and improved patient outcomes.
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.
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?
Due to its digital nature it is often assumed that telehealth saves the health system money. However, the evidence to support this is varied. When conducting economic evaluations of telehealth services, the individuals evaulating them need to be aware of potential outcomes and extraclinical benefits of the telehealth service.[37] Economic viability relies on the funding model within the country being examined (public vs private), the consumers willingness-to-pay, and the expected remuneration by the clinicians or commercial entities providing the services (examples of research on these topics from teledermoscopy in Australia [38][39][40]).
The popularity of real-time telemedicine solutions has increased rapidly in the past few years, as companies like Teladoc and DoctoronDemand have offered an affordable, easy way for patients to connect with a doctor from anywhere and get immediate treatment. Doctors are also starting to adopt real-time telemedicine solutions to give their patients the added convenience of virtual doctor visits, improve their care outcomes, boost work-life balance, and reap the many other benefits. With simply a compatible device, internet connection, microphone, and webcam – a patient can now get medical treatment. That’s the beauty of real-time telemedicine.   
Through its agreements with insurers, Doctor On Demand stipulates what kinds of conditions its video consultations can cover, and which ailments and maladies require immediate medical attention. Increasingly, customers are taking advantage of the company’s mental health services — an area that’s grown 240 percent since it was introduced, according to Ferguson.

Before setting up a telemedicine practice, an organizations administration and providers should know how laws differ when using telemedicine solutions. They should also consult with an expert to determine what equipment they need, and have a basic understanding of why they want to offer this in the first place. In addition, if it’s an existing practice, they should get buy-in as some physicians are not ready to make the transition.
Telecare is the term that relates to technology that enables patients to maintain their independence and safety while remaining in their own homes. This technology includes mobile monitoring devices, medical alert systems, and telecommunications technology like computers and telephones. Continuous remote monitoring of patients enables telecare to track lifestyle changes over time as well as receiving alerts relating to real-time emergencies.
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.
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.
But as the National Policy Telehealth Resource Center notes, “Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is more complex than simply using products that claim to be ‘HIPAA-compliant.” Not only does the telemedicine platform need to be compliant, all providers, patients, and staff using the tool need to ensure they are in compliance with HIPAA. A telemedicine software vendor, for instance, not only needs to build a secure product, but also ensure their company is operating in accordance with HIPAA.

To guide these decisions, the provider should create clinical protocols which include the condition to be treated (with ICD code), scope of that condition that can be treated using telemedicine, guidelines required to diagnose (when is telephone sufficient, vs. live video), documentation needed to properly assess the patient’s condition, parameters for when the condition can be treated and cannot be treated, and guidelines for when prescription can be done. While this section provides basic, overall guidelines for practicing telemedicine, it’s best practices for the healthcare provider to create more detailed protocols for each condition they intend to treat.
Those in the healthcare industry recognize that medication management is a big deal, especially among seniors. Older adults are more likely to forget to take their medications, which is where telemedicine comes in. Providers and other healthcare professionals can use telemedicine technology to monitor when and if their patients took their medicine. As a result, this leads to fewer hospital readmissions and enhances medication compliance.
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.
1. Request a visit with a doctor 24 hours a day, 365 days a year. Requests can be made by web, phone, or mobile app. Want to see the doctor with whom you’re speaking? Choose “video” as the method for your visit. Feeling camera shy? Choose “phone.” Got a busy schedule? Select a time that’s best for you by choosing “schedule” instead of “as soon as possible.”

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.
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. 
Like all technology in the healthcare space, telemedicine solutions need to be HIPAA compliant to protect patient privacy. While an app like Skype might offer a doctor an easy way to consult a patient remotely, using it in that way is not in compliance with HIPAA. Technology used for telemedicine services needs to ensure high-level security and prevent any breaches of patient personal health data.  
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.
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.
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