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]
It is common for outlying healthcare facilities to transfer unnecessarily or forced to refer patients to complex cases that are beyond the knowledge-base of the local providers. Patients are therefore frequently transported over long distances to get direct care or for specialist’s consultation. These referrals and transfers can be quite costly for the patient since they present clinical, operational and financial challenges to all the parties that are involved. Telemedicine can curb such issues, reduce the frequency of travel and deliver considerable efficiencies and returns for all parties involved.
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.
With the nation’s estimated 1,400 rural hospitals looking to stay afloat in a challenging economic environment, connected care networks like Avera’s are part of a growing trend. Rural critical access hospitals – the spokes - see the virtual care platform as means of augmenting limited resources, keeping their patients in the community and reducing transfers.  Larger health systems, which serve as the hub, use the network to extend their reach, develop new business lines and reduce transfer and ED traffic that might strain their own resources.
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.
The term telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole. 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. According to the World Health Organization, telehealth includes, “Surveillance, health promotion and public health functions.”

WiFi :  Wifi was originally licensed bu the Wi-Fi alliance and it is used to describe the technology of wireless local area networks, abbreviated as WLAN. This technology was primarily developed for mobile computing devices like laptops in Local Area Networks, but with technological advancements, it is now used for an array of services which include VoIP phone access, gaming as well as basic connection of electronics such as smartphones, DVD players, Home theaters and Televisions.


Store and forward telehealth refers to the capture, storage, and transmittal of patient health information for asynchronous healthcare delivery using data storage and transmission technology. CAT Scans, MRIs, X-rays, photos, videos, and text-based patient data are gathered and sent to specialists and other members of a care team to evaluate patients and assist in their treatment. Technologies used for store and forward telehealth include secure servers and routers that temporarily house incoming packets of information and then route them to the appropriate end users. Secure email platforms are also used for store and forward telehealth.
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.
^ Kontaxakis, George; Visvikis, Dimitris; Ohl, Roland; Sachpazidis, Ilias; Suarez, Juan; Selby, Peter; Cheze-Le Rest, Catherine; Santos, Andres; Ortega, Fernando; Diaz, Javier; Pan, Leyun; Strauss, Ludwig; Dimitrakopoulou-Strauss, Antonia; Sakas, Georgios; Pozo, Miguel (2006). "Integrated telemedicine applications and services for oncological positron emission tomography". Oncology Reports. doi:10.3892/or.15.4.1091.

This type of telemedicine allows providers to share patient information with a practitioner in another location. For example, a primary care physician can now share patient records and medical data with a specialist without being in the same room. Systems can transmit information across vast distances and different systems (sometimes) so one physician can know what another has already done. This leads to less duplicate testing and fewer instances of poor medication management.
As Teladoc (TDOC) completes another merger that will lead to global expansion, the market enthusiasm for the stock has grown immensely. The stock that was a bargain on a dip to $30 on the big merger last year isn't a bargain this time following the purchase of Advance Medical. At nearly $60, Teladoc trades in a completely different situation now, having rallied following the recent deal suggesting investors do the opposite as well.
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.

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.
Telehealth can also increase health promotion efforts. These efforts can now be more personalised to the target population and professionals can extend their help into homes or private and safe environments in which patients of individuals can practice, ask and gain health information.[8][21][24] Health promotion using telehealth has become increasingly popular in underdeveloped countries where there are very poor physical resources available. There has been a particular push toward mHealth applications as many areas, even underdeveloped ones have mobile phone coverage.[25][26]
Patients and their families often want continuous monitoring and care. Traditional health insurance providers are partnering with telehealth companies, to address those concerns. Anthem is working with American Well, Cigna is working with MDLive, Bupa is working with Babylon Health and Aflac is working with MeMD to deliver benefits of telehealth to it’s existing customers. Health insurance providers such as Oscar Health is redefining health-insurance by building the whole customer experience around its own telehealth services.

While Doctor on Demand’s chief executive Adam Jackson says the start-up targets mainly retail customers who pay $40 for 10 minutes or so with a physician, it signed up Comcast , its first major corporate customer which will subsidize its employees video visits. Doctor on Demand has a network of more than 1,400 general practitioners, internists and pediatricians in 47 states. They diagnose simple ailments, such as pink eye, sore throat and allergies. Insurance doesn’t reimburse video consultations, but customers can use pre-tax dollars from their health savings account to pay.


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.
Their distinguishing feature is that they expand the point-to-point connection that is the foundation of telemedicine. Instead of connecting one person to one person for a single interaction, they connect many to many, on an ongoing basis. To address system challenges like access, quality and dissemination of best practices, we need these more powerful linkages.
Router – This is a device which provides connection to at least two networks on an organization. It provides network connection on multiple locations and it is responsible in finding the best route between two sites. It tells the videoconferencing devices where the destination devices can be found and it will find the best way to gather the information from that specific destination.
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.
These devices can be packed into a kit and sent out into the field. In this way, telemedicine has proved extremely useful in rural and developing countries like Gabon, Iraqi Kurdistan, and Nigeria, where there is very little access to high-quality medical care. Telemedicine eliminates the barrier of distance and improves access to medical services that would otherwise not be available in distant rural communities.   
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.
Video chatting has become ubiquitous with technology advances such as 4G internet speeds, low-cost smartphones and standardized phone operating systems. The advent of additional technology standards such as interoperable electronic health records (EHR), secure cloud storage (HIPAA), and wearable health trackers that can communicate with the smartphone has further incentivized consumers to jump on to the telehealth bandwagon. Perhaps the ultimate goal of telehealth is to bring continuous care to consumers while they are working or at home, years before they end up in a clinic.

As a caregiver for a loved one, you have enough to worry about. That’s why Teladoc® gives you a convenient and affordable way to provide care, letting you arrange a 2- or 3-way video or phone visit with a licensed doctor 24/7 for just $45/visit. Add the individual you care for to your Teladoc® account, even if they’re not covered by your health plan.
Point-to-point connections link small remote health centers to one, large, central health facility via high speed internet. This type of telemedicine connection lets smaller or understaffed clinics outsource medical care to specialists at other locations within the same health system. Point-to-point connections are especially common for telepsychiatry, teleradiology, and urgent care services.
“Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status,” the ATA writes. “Telemedicine includes a growing variety of applications and services using two-way video, e-mail, smart phones, wireless tools and other forms of telecommunications technology.”
BayCareAnywhere allows you and your children two years and older instant access to a board-certified doctor from any place at any time, day or night. You can video chat with a doctor from the comfort of your own home for just $45 per visit. If the doctor determines that you need to be seen in-person at an urgent care center, you can print your patient summary and present it at any BayCare Urgent Care to receive a $45 discount off your visit. 
With the recent news that Amazon’s Jeff Bezos, Berkshire Hathaway’s Warren Buffet, and J.P. Morgan Chase’s Jamie Dimon have teamed up to disrupt healthcare, it’s easy to speculate that telehealth technology will be a key strategy in efforts to bring down costs. Other employers are seeking to bring down prices as well with the help of telehealth. According to the Society for Human Resource Management (SHRM), not only are employers encouraging the use of telehealth services, their employees, many of whom are digital natives, are quite comfortable using these services. Because of remote healthcare’s lower costs and increased worker productivity and satisfaction, organizations will likely seek telehealth solutions. Moreover, payers, like employers, may be lured by decreased medical expenditures and consumers may be motivated by the convenience and promptness of care that it offers.
Monitoring center links are used for one type of telemedicine – remote patient monitoring. This type of telemedicine link creates a digital connection between a patient’s house and a remote monitoring facility, so that a patient’s medical data can be measured at home and transmitted electronically to a distant medical monitoring facility. These links usually take the form of internet, SMS, or telephone connections. They’re most commonly used for monitoring of pulmonary, cardiac, or fetal medical data.

Fundamentally, we tend to think of telemedicine as a way to overcome a serious distance barrier between a patient and a healthcare provider. This point-to-point connection supports a critical function. There are cases when a patient requires the care of a particular doctor at a particular time, and technology is the best way to facilitate that interaction.
More accessible, convenient healthcare for patients is the driving force behind the telemedicine field. Telemedicine was originally developed in the U.S. as a way to address care shortages, especially in remote rural areas. Now telemedicine is used around the world, whether it’s to provide basic healthcare in third-world countries or allow an elderly patient with mobility issues to see the doctor from home. Telemedicine has the power not only to break down typical geographical barriers to care access, but to make the entire healthcare delivery model more convenient to patients.
As with many other aspects of modern life, new technologies have had profound impacts on the healthcare delivery system in the US. Modern healthcare customers think nothing of booking an appointment, requesting a prescription refill, or looking at test results online. Many of us count our steps, keep track of what we eat, and monitor our heart rate from a smart device. These days, healthcare and technology go hand in hand.
There are a variety of payment models to fund telemedicine services. For example, some health systems offer telemedicine consultations as part of their regular care services, and payers charge patients based on insurance plans or government reimbursement schedules. In other cases, a patient's employer offers virtual care options as part of health insurance coverage premiums. Some people may opt to independently use a telemedicine vendor for a flat fee.
In an increasingly crowded field, the start-up is undercutting the competition with its $40 fee. American Well, which provides its technology to WellPoint , charges $49 for online visits, so does MDLive. Better offers access to a personal health assistant for $49 a month, and HealthTap recently announced it will facilitate medical consultations for $99 a month. Jackson also says that his company charges corporations $40 when the service is used, as opposed to the industry practice of charging per employee per month.
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.
Shannon Edmonds has practiced medicine since 2009, and provided virtual care since 2015. She started out her professional career as a teacher and eventually went back to school for her BSN, then Master's and Doctoral degrees in nursing at University of Washington. Her nursing experience ranges from being a school nurse, nursing research, and most recently, doing in-home health assessments. As a family Nurse Practitioner, she finds the gamut of diagnoses and ages interesting.
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