Without proper medication, asthma and other respiratory related illnesses can be extremely serious. Chronic asthma affects more than 20-million citizens across the United States, and can appear in early childhood or adolescence. The symptoms vary from person to person, with most individuals experiencing shortness of breath, tightening of the chest, coughing, and wheezing.
The company employs its own doctors and staffs its video consultation service 24 hours a day, seven days a week, Ferguson says. Despite the workload — which sees the company’s virtual doctors consult with four patients each hour on average — the company’s 14-day readmission rate (a standard measure of effective diagnoses) is on par with brick and mortar services, Ferguson says.
Telehealth requires a strong, reliable broadband connection. The broadband signal transmission infrastructure includes wires, cables, microwaves and optic fibre, which must be maintained for the provision of telehealth services. The better the connection (bandwidth quality), the more data can be sent and received. Historically this has priced providers or patients out of the service, but as the infrastructure improves and becomes more accessible, telehealth usage can grow.[1][2]
Although, traditional medicine relies on in-person care, the need and want for remote care has existed from the Roman and pre-Hippocratic periods in antiquity. The elderly and infirm who could not visit temples for medical care sent representatives to convey information on symptoms and bring home a diagnosis as well as treatment.[5] In Africa, villagers would use smoke signals to warn neighbouring villages of disease outbreak.[6] The beginnings of telehealth have existed through primitive forms of communication and technology.[5]
Ms. Officer described a study of Nemours' specialist telehealth services. The pediatric health system saved about $24 per orthopedic patient using telemedicine. On average, patients and their families traveled 85 miles round-trip for in-person services; with telemedicine, they received care without leaving their homes. "It's cost-saving, and time-saving, for patients and families," said Ms. Officer. "Telemedicine is here to stay."
Telehealth - powered by Teladoc - is a convenient, affordable new way to access quality care for general medical, behavioral health, and dermatology2 services by web, phone3, or mobile app. Connect with a board-certified doctor, therapist, or dermatologist from the comfort of home, during your lunch break, or while traveling throughout the country. 
The field of telemedicine has changed drastically from its inception. It was only about fifty years ago that a few hospitals started experimenting with telemedicine to reach patients in remote locations. But with the rapid changes in technology over the last few decades, telemedicine has transformed into a complex integrated service used in hospitals, homes, private physician offices, and other healthcare facilities.
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.

There’s a lot to be optimistic about telemedicine. A survey of healthcare executives found improving the quality of patient care was their top reason for implementing telemedicine and in another study, respondents said the top benefit was ability to provide round-the-clock care. About half of patients also reported that telemedicine increases their involvement in treatment decisions, getting them engaged in managing their care. And with a potential $6 billion per yearthat US employers could save by offering telemedicine to employees, telemedicine can have a huge impact reaching past the healthcare industry.
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]

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.
Teladoc is the oldest and largest telemedicine company in United States. It was launched in 2002 in Dallas, Texas by Dr. Byron Brooks, a former NASA flight surgeon, and serial entrepreneur Michael Gorton.[7] Teladoc launched nationally in 2005 at the Consumer Directed Health Care Conference, in Chicago, Illinois.[8] By the end of 2007, it had attracted about 1 million members, including large employers who provided it to their employees as a health benefit. Jason Gorevic was named CEO in 2009 and currently holds the role and sits on the company's board of directors.[9]
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.

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.

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]
When a healthcare service decides to provide telehealth to its patients, there are steps to consider, besides just whether the above resources are available. A needs assessment is the best way to start, which includes assessing the access the community currently has to the proposed specialists and care, whether the organisation currently has underutilized equipment which will make them useful to the area they are trying to service, and the hardships they are trying to improve by providing the access to their intended community (i.e. Travel time, costs, time off work).[1][2] A service then needs to consider potential collaborators. Other services may exist in the area with similar goals who could be joined to provide a more holistic service, and/or they may already have telehealth resources available. The more services involved, the easier to spread the cost of IT, training, workflow changes and improve buy-in from clients. Services need to have the patience to wait for the accrued benefits of providing their telehealth service and cannot necessarily expect community-wide changes reflected straight away.[1]
Store-and-forward telemedicine is a great way to increase healthcare efficiency since a provider, patient, and specialist don’t need to be in the same place, at the same time. It also facilitates faster diagnosis, especially for patients located in underserved settings that may not have the necessary specialist on staff. Overall, this adds up to lower patient wait times, more accessible healthcare, better patient outcomes, and a more optimized schedule for physicians.
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.
At the Consumer Electronics Show (CES), TV celebrity Dr. Phil McGraw discussed the Doctor On Demand app, which connects any patient with a Board Certified physician or pediatrician via video chat in just two minutes. To use Doctor On Demand, patients download the app, give some background on their medical history, enter information on what’s wrong, and the app connects them to a health care provider from there. The service is currently available in 47 US states (excluding Arkansas, Louisiana, and Alaska) and can be accessed through the iPhone, iPad, Android, and on the web. Doctor on Demand’s hours of operation are 7 am to 11 pm local time (we're hoping it will one day become available 24 hours a day). A 15-minute session costs $40, which is a bit higher than the average co-pay many patients have for in-office visits, and the program currently does not accept health insurance. From the app demo at CES and from Kelly’s experience (more on that below), the Doctor On Demand app is quite sleek and the video chat is as easy to use as Facetime or Skype. Patients can find pharmacists and manage their prescriptions right from their smartphone – no more hard-to-read prescriptions or the potential to lose the prescription slip. Dr. Phil characterized the service as a “game-changer” and proposed that it could address 17 of the top 20 reasons people see a doctor (the flu, skin conditions, etc.) – these day-to-day conditions seem to be a key focus of Docotor on Demand, as opposed to more chronic conditions like full-time diabetes management. To learn more about Doctor on Demand’s policies and most frequently asked questions, please see this page.
The potential benefits of telehealth services may be limited by other factors, such as the ability to pay for them. Insurance reimbursement for telehealth still varies by state and type of insurance. Also, some people who would benefit most from improved access to care may be limited because of regional internet availability or the cost of mobile devices.
Telehealth is part of APTA's Frontiers in Research, Science, and Technology (FiRST) Council. FiRST grew out of identification of high priority areas to advance science and innovation that our profession needs to understand and incorporate into our practice, education, and research. FiRST is intended to serve as a community for interested stakeholders. Ideas generated by the council may be implemented by participants' stakeholder groups (sections, academies, external groups, APTA, etc) at the discretion of each entity's governing body.

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]

As the virtual health provider highlights, the global health insurance market is worth in the trillions and expected to double in the next decade. This market growth will play out over time, but the really easy addressable market is in the US multinational employment outside the US. The new company can now provide a more complete virtual health solution for corporations with over 14 million employees outside the US on top of the 28 million in the US.


Telepathology has been successfully used for many applications including the rendering histopathology tissue diagnoses, at a distance, for education, and for research. Although digital pathology imaging, including virtual microscopy, is the mode of choice for telepathology services in developed countries, analog telepathology imaging is still used for patient services in some developing countries.
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.
The concept of telemedicine started with the birth of telecommunications technology, the means of sending information over a distance in the form of electromagnetic signals. Early forms of telecommunications technology included the telegraph, radio, and telephone. In the late 19th century, the radio and telephone were just starting to emerge as viable communication technologies. Alexander Graham Bell patented the telephone in 1876 and Heinrich Rudolf Hertz performed the first radio transmission in 1887.
Sharla Peterson has worked in primary care since 2007 and provided virtual care since 2011. She received her Master of Nursing from Washington State University. In addition to her career in telemedicine, she works part-time in a plastic surgery office and volunteers at a free clinic near her home. She serves as Medical Director for local Camporee events with the Boy Scouts of America and works with youth in her church. When she is not working, she enjoys cooking, family time and outdoor adventures of all kinds.
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