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.

Store-and-forward is the oldest form of telehealth technology. It refers to the transmission of images or information from one provider to another. For example, if your doctor sends digital images of an x-ray to a radiologist for analysis, they are leveraging store-and-forward telehealth technology. This is one of the most common uses, but images and information of any type can be transmitted in this matter. One thing we should point out, however, is that store-and-forward telehealth is not always covered by state telemedicine reimbursement laws, even in states that require parity for real-time communication.
In December 2018, it was revealed that Teladoc's chief financial officer, Mark Hirschhorn, 54, had an extra-marital affair with a lower-level employee, 30. He is also alleged to have passed tips to her about when to sell Teladoc company stock. Hirschhorn sold over $20,000,000 in company stock during and after the alleged affair.[19] Several law firms launched investigations of potential securities law violations.[20] Company stock fell roughly 20% in the days following the report.[21]
Only some states have actually regulations requiring healthcare providers to get patients’ informed consent to use telemedicine. However, this is always good practice, whether or not your state requires it. Before the first telemedicine visit, providers should explain to patients how telemedicine works (when service is available, scheduling, privacy etc), any limits on confidentiality, possibility for technical failure, protocols for contact between virtual visits, prescribing policies, and coordinating care with other health professionals. Everything should be explained in simple, clear language.
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.
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.  
Equipping nursing homes and hospital rooms this way would enable a variety of practitioners to provide bedside care more conveniently—for the patient and the provider. Patients wouldn't have to be transported, and practitioners could see more patients without disruption. In addition, the primary care provider, family, and friends located elsewhere could link into the video consultations, enhancing communication between all parties involved in the patient's care.
We have collaborated with major hospitals like Max Hospitals, Fortis Healthcare, Global Hospitals, Medica Super Specialty (Kolkata), Pushpanjali Crosslay, Nova Specialty Hospitals, Artemis Hospital, Enhance Clinics and Delhi ENT Hospital among many others covering all parts of India. Should you need any treatment of any kind at a hospital, iClinic can facilitate this at a partner hospital and ensure that you get prompt, efficient and economical service.
However, whether or not the standard of health care quality is increasing is quite debatable, with literature refuting such claims.[23][34][35] Research is increasingly reporting that clinicians find the process difficult and complex to deal with.[34][36] Furthermore, there are concerns around informed consent, legality issues as well as legislative issues. Although health care may become affordable with the help of technology, whether or not this care will be "good" is the issue.[23]
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]
The rise of the internet age brought with it profound changes for the practice of telemedicine. The proliferation of smart devices, capable of high-quality video transmission, opened up the possibility of delivering remote healthcare to patients in their homes, workplaces or assisted living facilities as an alternative to in-person visits for both primary and specialty care.
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.

Reimbursement for telemedicine services is often not as straightforward for traditional medical services. State telemedicine policy landscape is continuously shifting, affecting rules around reimbursement through state Medicaid programs and through private payers. Medicare does now reimburses for real-time telemedicine services, but places restrictions on the eligible healthcare providers, the location of the patient, the medical procedures that can be done, etc. The good news is, there is a shift towards more widespread reimbursement for telemedicine through all third-party payers, with less restrictions.  


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.
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.
In December 2018, it was revealed that Teladoc's chief financial officer, Mark Hirschhorn, 54, had an extra-marital affair with a lower-level employee, 30. He is also alleged to have passed tips to her about when to sell Teladoc company stock. Hirschhorn sold over $20,000,000 in company stock during and after the alleged affair.[19] Several law firms launched investigations of potential securities law violations.[20] Company stock fell roughly 20% in the days following the report.[21]

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:
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.
With the interrelated fields of mobile health, digital health, health IT, telemedicine all constantly changing with new developments, it’s sometimes difficult to pin down a definition for these terms. In much of the healthcare industry, the terms “telehealth” and “telemedicine” are often used interchangeably. In fact, even the ATA considers them to be interchangeable terms. This isn’t surprising since the telehealth and telemedicine definitions encompass very similar services, including: medical education, e-health patient monitoring, patient consultation via video conferencing, health wireless applications, transmission of image medical reports, and many more.
NewYork-Presbyterian is making investments in all of these because it believes telemedicine and virtual medicine in general will make delivery of care more efficient and higher-quality in the long run, he explained. Each telemedicine modality has its own associated cost and reimbursement, and the organization is making decisions on where to put its efforts not based on net revenue but on the impact that each will have for patients, he added.
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.”
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]
The benefits posed by telehealth challenge the normative means of healthcare delivery set in both legislation and practice. Therefore, the growing prominence of telehealth is starting to underscore the need for updated regulations, guidelines and legislation which reflect the current and future trends of healthcare practices.[2][23] Telehealth enables timely and flexible care to patients wherever they may be; although this is a benefit, it also poses threats to privacy, safety, medical licensing and reimbursement. When a clinician and patient are in different locations, it is difficult to determine which laws apply to the context.[41] Once healthcare crosses borders different state bodies are involved in order to regulate and maintain the level of care that is warranted to the patient or telehealth consumer. As it stands, telehealth is complex with many grey areas when put into practice especially as it crosses borders. This effectively limits the potential benefits of telehealth.[2][23]
Doctor On Demand operates subject to state laws. As of August 2017, Doctor On Demand offers behavioral healthcare in all states where Mental Health services are available to Doctor On Demand’s patient population at large, and Medical care in all 50 states and the District of Columbia. Doctor On Demand is not intended to replace an annual, in-person visit with a primary care physician.** Doctor On Demand physicians do not prescribe Controlled Substances, and may elect not to treat or prescribe other medications based on what is clinically appropriate.
Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care (e.g., face-to-face consultations or examinations between provider and patient). As such, states have the option/flexibility to determine whether (or not) to cover telemedicine; what types of telemedicine to cover; where in the state it can be covered; how it is provided/covered; what types of telemedicine practitioners/providers may be covered/reimbursed, as long as such practitioners/providers are "recognized" and qualified according to Medicaid statute/regulation; and how much to reimburse for telemedicine services, as long as such payments do not exceed Federal Upper Limits.

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.

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]
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. 

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.
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...
Did you know that there are different types of telemedicine? That’s right, there are a few different ways that healthcare systems can use telemedicine to assist patients. As discussed in previous articles, telemedicine is the method of using telecommunications to connect patients and providers over a distance. Today, there are three different types of telemedicine used and it includes the following:
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]
In the future, experts say, internet-­connected sensors—such as blood pressure monitors—could be paired with e-visits to help people manage chronic conditions from home. So far, such devices aren't widely used. But the list of conditions that patients and doctors can manage remotely is “ever expanding,” says Eric Topol, M.D., director of the Scripps Translational Science Institute.
×