The growth in telemedicine solutions means that telemedicine options are now more diverse, with many more affordable solutions. However, most telemedicine programs do require the purchase, set-up and staff training of new technology and equipment – some of which may be outside the budget of providers in smaller independent practices. Many providers are already stretched thin on new technology budgets and staff training for EHR systems, imposed by the Meaningful Use program. Also, for patients who may not have access to a smartphone or a computer with internet, real-time telemedicine may be out of reach.
Without a doubt, the emergency room is one of the most expensive, overcrowded, and stressful environments in healthcare. With telemedicine, overcrowded emergency rooms can be reduced by having patients see a remote physician using video chat first. The remote physician can determine if that individual should seek care in an emergency department, which increases ED efficiency.
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]
Synchronous, real-time or Clinical Video Telehealth requires the presence of both parties at the same time and a communication link between them that allows a real-time interaction to take place. Video-conferencing equipment is one of the most common forms of technologies used in synchronous telehealth. There are also peripheral devices that can be attached to computers or the video-conferencing equipment which can aid in an interactive examination.
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...

In addition to medical assistance, there are psychologists and psychiatrists you can schedule appointments with for online therapy. They treat depression, additions, social anxiety, trauma and workplace stress as well as social issues. Like the doctors, psychiatrists can prescribe medication. Doctor on Demand provides an online assessment to help you determine if you could benefit from telepsychology.
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.
Telemedicine/Telehealth: Basically, these two terms are used to describe the use of technology and telecommunications to exchange medical information from one place to another with an aim of improving the patient’s health status. Telemedicine is sometimes involved in direct patient clinical services which include diagnosis and treatment of patients.
In the NICU/ICU, telemedicine can be used in a variety of ways. One approach is by using HD webcams to see the baby from different angles. High-risk infants can be seen by a specialist at another hospital by simply sharing the video within seconds. This decreases the need for infants to be transferred to another hospital, which is costly and time consuming.

Healthcare providers currently earn their medical licenses for a specific state. This lets them practice medicine legally in that state, and only that state. This presents a problem for telemedicine, as the entire goal is to break down geographical barriers between a patient and provider. According to medical licensing regulations, a specialist based in Colorado would not be legally allowed to treat a patient in New Mexico.
With telemedicine, a medical practice or hospital system can immediately expand access to niche medical specialists. This makes it easy for primary care doctors to consult medical specialists on a patient case, and for patients to see a needed specialist on a rare form of cancer, no matter their location. As another example, small hospitals without adequate radiology specialist on-staff can outsource evaluation of x-rays via telemedicine.
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.
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.

ISDN Basic Rate Interface (BRI): A type of ISDN interface that provides 128K of bandwith tht is used for videoconferencing as well as simultaneous data and voice services. A multiplexer can be used to link together multiple BRI lines in order for higher bandwidth levels to be achieved. For example, one popular option among telehealth networks is combining 3 BRI lines in order for video-conferencing to be provided with 384K of bandwidth. BRI services are unavailable in some rural areas. Before videoconferencing equipment is order for using this kind of service, one needs to check with their telecommunications provider to see if BRI services are available.

Cheryl Graf has worked in primary care since 1996 and provided virtual care since 2014. She received her Master of Nursing from Pacific Lutheran University. She also works for a local health system and provides temporary support for emergency departments near her home. Her experience includes emergency services, family practice, pediatrics and urgent care. Additionally, she has created and developed training materials for the Sexual Assault Nurse Examiner programs in Washington State. In her spare time, she enjoys golf, gardening and family time.


According to a May 2017 article by Alignment Chief Medical Officer Ken Kim, the organization’s efforts paid off. “Because of the program, Alignment’s seniors are seeing reduced 30-day readmission rates … compared to the national Medicare average readmission rate of about 18%. In 2016, Alignment members enrolled in remote [monitoring] across all markets saw hospital readmission rates of 7.2%.”

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.
On July 7th, 2015, House representatives introduced the Medicare Telehealth Parity Act of 2015. If passed, the bill will expand what telemedicine services Medicare will cover and get rid of many limitations (like the requirements for what qualifies as an “originating site“). Legislation like this one could have a huge impact on coverage for remote patient monitoring and other telemedicine services delivered to the patient in their own home.
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.
Where telemedicine refers specifically to the practice of medicine via remote means, telehealth is a blanket term that covers all components and activities of healthcare and the healthcare system that are conducted through telecommunications technology. Healthcare education, wearable devices that record and transmit vital signs, and provider-to-provider remote communication are examples of telehealth activities and applications that extend beyond remote clinical care.
A pathologist, Ronald S. Weinstein, M.D., coined the term "telepathology" in 1986. In an editorial in a medical journal, Weinstein outlined the actions that would be needed to create remote pathology diagnostic services.[65] He, and his collaborators, published the first scientific paper on robotic telepathology.[66] Weinstein was also granted the first U.S. patents for robotic telepathology systems and telepathology diagnostic networks.[67] Weinstein is known to many as the "father of telepathology".[68] In Norway, Eide and Nordrum implemented the first sustainable clinical telepathology service in 1989.[69] This is still in operation, decades later. A number of clinical telepathology services have benefited many thousands of patients in North America, Europe, and Asia.
A pathologist, Ronald S. Weinstein, M.D., coined the term "telepathology" in 1986. In an editorial in a medical journal, Weinstein outlined the actions that would be needed to create remote pathology diagnostic services.[65] He, and his collaborators, published the first scientific paper on robotic telepathology.[66] Weinstein was also granted the first U.S. patents for robotic telepathology systems and telepathology diagnostic networks.[67] Weinstein is known to many as the "father of telepathology".[68] In Norway, Eide and Nordrum implemented the first sustainable clinical telepathology service in 1989.[69] This is still in operation, decades later. A number of clinical telepathology services have benefited many thousands of patients in North America, Europe, and Asia.

In Pakistan three pilot projects in telemedicine was initiated by the Ministry of IT & Telecom, Government of Pakistan (MoIT) through the Electronic Government Directorate in collaboration with Oratier Technologies (a pioneer company within Pakistan dealing with healthcare and HMIS) and PakDataCom (a bandwidth provider). Three hub stations through were linked via the Pak Sat-I communications satellite, and four districts were linked with another hub. A 312 Kb link was also established with remote sites and 1 Mbit/s bandwidth was provided at each hub. Three hubs were established: the Mayo Hospital (the largest hospital in Asia), JPMC Karachi and Holy Family Rawalpindi. These 12 remote sites were connected and on average of 1,500 patients being treated per month per hub. The project was still running smoothly after two years.[48]
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. 
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.
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]

State medical licensing boards have sometimes opposed telemedicine; for example, in 2012 electronic consultations were illegal in Idaho, and an Idaho-licensed general practitioner was punished by the board for prescribing an antibiotic, triggering reviews of her licensure and board certifications across the country.[79] Subsequently, in 2015 the state legislature legalized electronic consultations.[79]
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.
As technology in the medical field continues to advance, the two terms will likely become more distinguishable. With these advances, there are fortunately industry experts like VSee that keep up with the varying changes for physicians and hospitals. Healthcare organizations interested in implementing telehealth or telemedicine do not have to do so alone.
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.

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.


In the 2010s, integration of smart home telehealth technologies (wellness and health devices and software, Internet of Things) appears to be a growing phenomenon in the industry. Beyond that, healthcare organizations are increasingly adopting the use of self-tracking technologies, cloud-based technologies, and innovative data analytic approaches to accelerate the transformation of the healthcare system.
According to an SEC filing relating to its recent fundraising round, Teladoc brings in between $25 million and $100 million in sales. The company is also experimenting with taking a cut of the cost savings it delivers to health plans, which could boost revenue further. Revenue grew 75% in 2012, 100% in 2013 and is expected to grow another 100% this year, Gorevic says.
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.

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.
Blue Sky Telehealth is committed to making specialty healthcare services more accessible to patients nationwide. We partner with hospitals to create a customized telehealth system that integrates with the facility’s existing processes and technology. Through our service, medical facilities can contact highly experienced medical specialists 24/7 to assist with patient care, diagnosis, and treatment. This saves hospitals the cost of keeping a medical specialist on-call full time and ensures that a qualified medical professional will always be available to tend to a patient with special care needs.
Several decades later, in the 1950’s, a few hospital systems and university-based medical centers experimenting with how to put concept of telemedicine into practice. Medical staff at two different health centers in Pennsylvania about 24 miles apart transmitted radiologic images via telephone. In 1950’s, a Canadian doctor built upon this technology into a Teleradiology system that was used in and around Montreal. Then, in 1959, Doctors at the University of Nebraska were able to transmit neurological examinations to medical students across campus via a two-way interactive television. By 1964, they had built a telemedicine link that allowed them to provide health services at Norfolk State Hospital, 112 miles away from campus.
Remote patient monitoring, which is sometimes called self-monitoring or self-testing, is a means of monitoring patient health and clinical information at a distance. It helps to simplify patient compliance with testing and it lowers the cost of frequent monitoring. It is frequently used in the treatment and management of chronic illnesses like asthma, cardiovascular disease, and diabetes.
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.
Medicare: Yes... in certain circumstances.  Many “telehealth” services, such as remote radiology, pathology and some cardiology, are covered simply as "physician services."  For traditional fee-for-service beneficiaries living in rural areas, Medicare covers physician services using videoconferencing and remote patient monitoring. The ~14 million beneficiaries in Medicare Advantage (managed care) plans, have complete flexibility in using telehealth, as long as their provider offers the service.  ATA is pushing the Centers for Medicare and Medicaid, and Congress to removing the arbitrary restrictions that limit telehealth coverage, so that all beneficiaries can get this great benefit.  The ATA Wiki has details explaining coverage details in Medicare. 
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.
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.
The amount providers are reimbursed for telemedicine will vary depending on a state’s legislation. Some states specifically mandate that private payers reimburse the same amount for telemedicine as if the service was provided in-person. However, most states with reimbursement mandates leave this determination up to the payers. We have found the majority of private payers still reimburse at levels equivalent to in-person visits.
We are currently partnered with over 145 facilities across 25 states and have over 12,000 patient encounters annually. Average response time for calls is three minutes, and we use redundant staffing procedures to ensure a medical specialist will always be available to assist your patients. By working together, we can drastically improve patient outcomes and your community’s access to specialty medical services.
We make any additions or deletions to the services defined as Medicare telehealth services effective on a January 1st basis. The annual physician fee schedule proposed rule published in the summer and the final rule (published by November 1) is used as the vehicle to make these changes. The public has the opportunity to submit requests to add or delete services on an ongoing basis.
In the NICU/ICU, telemedicine can be used in a variety of ways. One approach is by using HD webcams to see the baby from different angles. High-risk infants can be seen by a specialist at another hospital by simply sharing the video within seconds. This decreases the need for infants to be transferred to another hospital, which is costly and time consuming.
Patients who are planning to visit India for medical treatment can make the most of our Medical Tourism service. We are associated with the best hospitals and through our secure virtual platform we can assist you 8/7 between 11 AM to 7 PM and connect you with the best doctors online to resolve your medical concern. Get everything you need to know about various treatments before planning your travel. Receive pre and post travel assistance, plan the right treatment procedure, compare cost options and stay connected with your doctor online after returning to your home country.

Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Today, applications of teleophthalmology encompass access to eye specialists for patients in remote areas, ophthalmic disease screening, diagnosis and monitoring; as well as distant learning. Teleophthalmology may help reduce disparities by providing remote, low-cost screening tests such as diabetic retinopathy screening to low-income and uninsured patients.[75][76] In Mizoram, India, a hilly area with poor roads, between 2011 till 2015, Tele-ophthalmology has provided care to over 10000 patients. These patients were examined by ophthalmic assistants locally but surgery was done on appointment after viewing the patient images online by Eye Surgeons in the hospital 6–12 hours away. Instead of an average 5 trips for say, a cataract procedure, only one was required for surgery alone as even post op care like stitch removal and glasses was done locally. There were huge cost savings in travel etc.[77]


As telehealth continues to replace traditional health care, it is going to inherit some of its challenges. These include increased cost of care due to multiple vendors, complex care pathways, and government policies. However, the question that remains to be answered is will this advanced technology that we call telehealth, be able to redefine the quality, equity and affordability of healthcare throughout the world.
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.

The complex US health care system is under a tremendous amount of pressure. Many traditional health care business models are designed to allow high-volume, low-cost procedures to offset the costs of low- volume, high-cost procedures. An upward shift in the aging population is projected to result in a large increase in demand for health care, and new legislation such as the Affordable Care Act has added uncertainty to the future of health care business models and payment. Telehealth is projected to grow worldwide to 1.8 million users by 2017, according to the World Market of Telehealth.


Doctor on Demand is currently available for patients in 15 states, including large states like California, Florida, New Jersey, New York, Ohio, and Texas. The company has more than 1,000 doctors available for video consultants one or two days a week, according to Bloomberg Businessweek. The company trains physicians on how to use the service, and covers other logistics like patient questionnaires and malpractice insurance.
Telehealth Reimbursement Medicaid: According to Chiron Health, Medicaid systems in 48 states will reimburse for telehealth provided via live video systems while 19 state Medicaid programs will pay for RPM. 12 state programs will finance store and forward telehealth and seven states allow payment for all three telehealth categories. But even though Medicaid is more accommodating of telehealth than Medicare, rules governing payment through state Medicaid programs vary considerably. For instance, some states require patients to be in a medical facility and not at home while receiving telehealth care, and others require a licensed provider to be co-located with patients while they are receiving telehealth services.
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.
Sometimes the answer to the question “What is telemedicine?” is simply mobile medicine. It doesn’t require a heavy desktop computer or a lot of equipment. Activities that used to happen only in person are now easy to do on a smartphone. Modern consumers are accustomed to downloading apps and using their smartphones for simple transactions. The same is true for doctor visits. For example, with MDLIVE the patient simply opens the app and clicks to choose a doctor, with whom they can speak either by phone, instant message, or video.    

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.
In August 2017, hospitals across the country were penalized with Medicare reimbursement cuts due to high 30-day readmission rates. The potential to reduce these rates and avoid penalties has made telehealth a financial priority. Healthcare provider TripleCare was the subject of a study conducted by the TRECS Institute, which found that virtual physician services had both increased care quality and averted 91 unnecessary admissions. The result was $1.3 million in Medicare savings. Telehealth services can also provide patients and healthcare facilities in rural areas with additional benefits. NTCA — The Rural Broadband Association released a report in March 2017 that estimated the average annual cost savings per facility could add up to:

Without a doubt, the emergency room is one of the most expensive, overcrowded, and stressful environments in healthcare. With telemedicine, overcrowded emergency rooms can be reduced by having patients see a remote physician using video chat first. The remote physician can determine if that individual should seek care in an emergency department, which increases ED efficiency.

Telehealth technology will play a critical role in meeting the healthcare needs of the US long into the future. It increases access, reduces costs, and provides a more convenient delivery channel for patients and providers alike. Practices that embrace the technology now will protect themselves from increasing competition, develop closer relationships with patients, increase profitability, and help their patients stay healthier. We’re proud to be helping make all of that happen for our customers.


In the early days of telemedicine, health professionals used the burgeoning technology as a way to reach patients living in rural areas. However, the technology quickly expanded into urban areas, especially those that suffered from healthcare shortages. In 1967, physicians at the University of Miami School of Medicine and Miami's Fire Department transmitted electrocardiographic rhythms over existing voice radio channels from fire-rescue units to the city's Jackson Memorial Hospital.

Telehealth is defined as the delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies. Live video conferencing, mobile health apps, “store and forward” electronic transmission, and remote patient monitoring (RPM) are examples of technologies used in telehealth.
Devices are also being used to track blood glucose levels and report high or low levels to patients and providers. In partnership with Stanford, Apple is testing whether its Apple Watch can be used to detect irregular heart patterns, and AliveCor’s KardiaBand allows Apple Watch wearers to perform electrocardiograms in 30 seconds that can easily be transmitted to physicians. Patients often go months without seeing their providers. RPM can allow for earlier detection of complications and identify patients who need to seek medical attention prior to in-person appointments. Moreover, chronic conditions can be more readily and efficiently managed resulting in higher quality care and outcomes as well as reduced costs.
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.
As technology developed and wired communication became increasingly commonplace, the ideas surrounding telehealth began emerging. The earliest telehealth encounter can be traced to Alexander Graham Bell in 1876, when he used his early telephone as a means of getting help from his assistant Mr. Watson after he spilt acid on his trousers. Another instance of early telehealth, specifically telemedicine was reported in The Lancet in 1879. An anonymous writer described a case where a doctor successfully diagnosed a child over the telephone in the middle of the night.[5] This Lancet issue, also further discussed the potential of Remote Patient Care in order to avoid unnecessary house visits, which were part of routine health care during the 1800s.[5][7] Other instances of telehealth during this period came from the American Civil War, during which telegraphs were used to deliver mortality lists and medical care to soldiers.[7]
Significantly, at the end of 2016 Congress unanimously approved legislation focused on emerging technology-enabled collaborative learning models. The new law directs HHS to assess these models and their ability to improve patient care and provider education, and to report its findings to Congress, along with recommendations for supporting their spread.
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.
Medical City Virtual Care allows patients to see and talk to licensed, board-certified physicians, nurse practitioners or physician assistants from their mobile device or computer through a secure internet video connection. These healthcare professionals can diagnose, treat and prescribe non-narcotic medication for a wide variety of adult and pediatric non-emergency medical conditions, including:
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