On the eve of its July 1 IPO, the company was billed as the first and largest telehealth platform in the United States.[22] The number of visits facilitated in 2014 was 299,000.[23] By 2016, its visit count had grown to 952,000.[24] The company had 8.1 million members in 2014 and 10.6 by the end of the first quarter of 2015.[23] By the end of the first quarter of 2015, the company has 4000 clients including 160 of the Fortune 1000 companies.[23] Two years later, the company had 7500 clients and 220 Fortune 1000 companies.[25]
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.
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]
Facility Fees. In addition to reimbursement for the telemedicine service, Medicare will pay the originating site a facility fee. For example, if you’re a primary care provider with a patient in your office and you do a telemedicine visit to consult a physician in another location, you could bill for two separate things – the telemedicine service, and a facility fee for using your practice to “host” of the patient visit. Check HCPCS code Q3014 for a full description on facility fees.
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.
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.
After laying out the basics, an organization should decide what type of telemedicine solutions to offer. A telemedicine expert like VSee offers a text and video collaboration app, a Virtual waiting room, and more. The organization should be responding to their current pain points, such as overcrowded waiting rooms or difficulty reaching patients in rural areas.
Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective.[16] Examples include home-based nocturnal dialysis[17] and improved joint management.[18]
Internet Protocol (IP): The protocol for sending data from one computer over the Internet to another. Every computer that is on the Internet has one address at least that identifies it uniquely from all of the other computers that are on the Internet. Internet Protocol is a connectionless form of protocol, meaning there isn’t a connection that is established between the two points that are communicating with one another. A videoconferencing system’s IP address is its telephone number.
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]).
Home Health Care And Remote Monitoring Systems: Care that is provided to patients and their families in their residences to promote, maintain or restore health; or to minimize the effects of illness and disability, including terminal illnesses. In Medicare enrollment data and claims as well a Medicare Current Beneficiary Survey, home health care is defined as home visits made by professionals, including physicians, nurses, home health aides, therapist and social workers. The use of interactive devices and remote monitoring enable a patient’s vital signs to be sent on a regular basis to health care providers without the patient having to travel.

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.


Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective.[16] Examples include home-based nocturnal dialysis[17] and improved joint management.[18]
Project ECHO, a knowledge-sharing enterprise that works both across the U.S. and globally, offers a good example of how technology-enabled collaborative learning models work. Launched initially in New Mexico to help patients with hepatitis C gain access to specialty treatment, Project ECHO connects a team of specialists at a university medical center "hub" with teams of primary-care clinicians at community health centers—or "spokes"—across a state or region. This connection is recurring: Typically, it takes place every week or every other week, during telementoring clinics that operate like virtual grand rounds.
A company’s culture is defined by the behavior that is allowed. The Board, CEO and the management team need to set the example—allowing toxic, demoralizing, untrustworthy actions to persist is implicitly endorsing that behavior. Look to the past for what’s likely to come—every leader in the company has brought former colleagues to work alongside them at DOD except for one. Red flag. This leader burns bridges. Act before...
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.
Lab work and scheduling will be handled virtually on Doctor On Demand’s mobile app. Between Quest and LabCorp, patients should be able to visit a lab in-person and continue care via the app with their assigned doctor. It’s a move that will allow the tele-provider to move beyond urgent care into preventative care and encourage more regular virtual visits.
Initially, Medicare only reimbursed providers for very specific health services provided via telemedicine, often with strict requirements. In the past few years with the rapid growth in the telemedicine industry, Medicare has expanded the list of reimbursable telemedicine services  but still imposes many restrictions on how the service is provided.
Teleneuropsychology (Cullum et al., 2014) is the use of telehealth/videoconference technology for the remote administration of neuropsychological tests. Neuropsychological tests are used to evaluate the cognitive status of individuals with known or suspected brain disorders and provide a profile of cognitive strengths and weaknesses. Through a series of studies, there is growing support in the literature showing that remote videoconference-based administration of many standard neuropsychological tests results in test findings that are similar to traditional in-person evaluations, thereby establishing the basis for the reliability and validity of teleneuropsychological assessment.[30][31][32][32][33][34][35]
Interoperability: This refers to two systems ((software, networks, communication devices, computers and other types of information technology components))or more being able to interact with each other and exchange information so that predictable results can be achieved. There are three different kinds of interoperability: technical; clinical and human/operational.
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.
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.
When a patient is in the hospital and he is placed under general observation after a surgery or other medical procedure, the hospital is usually losing a valuable bed and the patient would rather not be there as well. Home health allows the remote observation and care of a patient. Home health equipment consists of vital signs capture, video conferencing capabilities, and patient stats can be reviewed and alarms can be set from the hospital nurse’s station, depending on the specific home health device.
In-person patient-doctor visits are clearly valuable and necessary in many circumstances. Telemedicine is best used to supplement these visits – to do simple check-ins with patients and make sure everything is going well. For minor acute conditions (like infections), an in-person visit with an established patient is often not needed. In those cases, telemedicine can save the patient, the doctor, and the healthcare system time and money.

Mobile Telehealth Clinic – This involves using vehicles like van, trailer or any mobile unit to provide health care services for patients. The services are given by health care professionals. This is helpful to those who are living on areas far from the hospital. Some mobile units are equipped with medical technologies that are found in the hospital like mobile CT, MRI and TeleDentistry.

RPM telemedicine is quickly rising in popularity as more health professionals realize its potential effects on chronic care management. For instance, a patient with diabetes who has a glucose tracker in their home can measure their glucose levels at regular intervals and transmit them to their doctor. If all is well, those results are simply recorded. If something looks off, the physician may flag it and call in the patient for a consult.


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.

Dr. Parker has practiced medicine since 1994 and provided virtual care since 2013. He received his medical degree from the Medical College of Wisconsin and went on to complete a family practice residency at St. Joseph's Hospital and St. Mary's Family Practice. In addition to his work in telemedicine, he is an Assistant Clinical Professor at the St. Louis University School of Medicine. Dr. Parker and his family have a strong commitment to organic, sustainable, and humane food preparation, raising and growing much of their own food. In his spare time, he is a trail runner, half-marathoner and amateur photographer.
×