Teladoc is a fantastic product offered by AgileHealthInsurance and a great way to take control of your health care. But what is it? It’s simple. Teladoc is the nation's leading telehealth service. Whenever you feel unwell or have a health question, you can receive convenient, quality care from a variety of licensed healthcare professionals. Teladoc doctors are available anytime, day or night.
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.
Obamacare—or the Affordable Care Act, as it is officially called—has been a catalyst for Teladoc’s recent growth surge. The law puts pressure on doctor’s offices, who are seeing more patients, as well as employers, who are looking to cut healthcare costs. As a result, telemedicine is becoming increasingly popular as a cheaper alternative to going to the emergency room. Insurance companies including Aetna (AET), Blue Shield of California and Oscar—which offers Obamacare plans on New York’s health exchange—have recently signed on with Teladoc, as have Home Depot (HD), T-Mobile (TMUS), pension giant CalPERS, and others.
Based on over 600 studies, the AMA has put together a comprehensive set of guidelines for professionals using telemedicine in primary and urgent care – a field that is quickly adopting telemedicine to expand basic healthcare access. Here are some of the basic protocols and rules a primary care or urgent care facility should put into place when starting their telemedicine program.
An example of these limitations include the current American reimbursement infrastructure, where Medicare will reimburse for telehealth services only when a patient is living in an area where specialists are in shortage, or in particular rural counties. The area is defined by whether it is a medical facility as opposed to a patient's' home. The site that the practitioner is in, however, is unrestricted. Medicare will only reimburse live video (synchronous) type services, not store-and-forward, mhealth or remote patient monitoring (if it does not involve live-video). Some insurers currently will reimburse telehealth, but not all yet. So providers and patients must go to the extra effort of finding the correct insurers before continuing. Again in America, states generally tend to require that clinicians are licensed to practice in the surgery' state, therefore they can only provide their service if licensed in an area that they do not live in themselves.
The future of telemedicine is wide open, with room for drastic improvement and more technology based medical care. As the world of tech continues to evolve, so too can the world of telehealth. Already, patients can sit down for a one on one appointment anywhere and anytime with the use of nothing more than a mobile phone. Imagine what new technology will bring in terms of holographic imaging, long distance x-ray, and more work in the field of ultrasounds.
Type of telehealth. Medicare primarily only reimburses for live telemedicine, where the physician and patient are interacting in real-time through secure, videochat. This type of telemedicine visit is meant to substitute a face-to-face in-person visit. The only exception is in Hawaii and Alaska, where Medicare reimburses for store-and-forward telemedicine as well.
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.
Limitations of Online Doctor/Medical Consultations and Online Prescriptions, QuickRxRefills Cannot and Will NOT Prescribe, Dispense, or Resell any and all medications Narcotics/Controlled Substances (this policy is fully enforced by theDrug Enforcement Administration (DEA)) for Anti-depressants, Pain, Anxiety, Weightloss, Sleep, ADHD/ADD, Anabolic Steroids, Testosterone Replacement Therapy and any and all Medications that contain GabaPentin or Pseudroephedrine including non-controlled substances or any medications that are considered controversial, Off Labeled (Growth Hormone aka HGH) or recalled in nature such (i.e. Retin-A, Accutane). Furthermore, QuickRxRefills is not a substitute for an office based physician in your location nor is it a substitute for Emergency Medical Care or 911. If you do experience a "true" medical emergency your are encouraged to pick up the phone and dial 911 as soon as possible.
“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.”
Each online video chat appointment with a doctor costs patients $40; doctors get $30 of that, with the company taking a $10 cut. Doctors can diagnose illnesses and prescribe medication, but the app and website are not recommended for any patient experiencing a potentially life-threatening emergency medical condition. Doctors also cannot use it to prescribe medications like sedatives and narcotics.
“Telemedicine is not a separate medical specialty,” the organization continues. “Products and services related to telemedicine are often part of a larger investment by healthcare institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. ATA has historically considered telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth.”
In many Walmart stores, retail consumers can walk up to a kiosk for a doctor consultation. The doctor is not physically present inside the store. Instead, the customer uses a touchscreen computer to type in their symptoms and enter a virtual waiting room. They are then connected by a video link to a doctor. This use-case is HIPAA-compliant because the video link is encrypted to protect patient health information.
“It is less about the technology as it is about delivering medicine via a new medium,” Clement explained. “Luckily, the C-suite is accustomed now to teleconferencing, so they have a feel for the benefits, as well as some of the communication struggles that come with being audio-visual from remote locations. Much like teleconferencing, there are situations where telemedicine will fit and others where it will not: It can’t be looked upon as a silver bullet.”
ECGs, or electrocardiographs, can be transmitted using telephone and wireless. Willem Einthoven, the inventor of the ECG, actually did tests with transmission of ECG via telephone lines. This was because the hospital did not allow him to move patients outside the hospital to his laboratory for testing of his new device. In 1906 Einthoven came up with a way to transmit the data from the hospital directly to his lab. See above reference-General health care delivery. Remotely treating ventricular fibrillation Medphone Corporation, 1989
Telemedicine services can range widely by specialty. A surgeon might use telemedicine to do post-operation check-ins with patients, to make sure their wound is not infected. A gynecologist might use a live telemedicine solution to provide birth control counseling. An endocrinologist may do live videochats with patients to discuss recent lab results and answer questions.
Effective September 1, 2018, the AlaskaCare Employee Health Plan has partnered with Teladoc® to provide you with a convenient and affordable way to receive quality medical care. Teladoc® lets you talk with experienced doctors by phone or video anytime, anywhere. All Teladoc® doctors are board-certified, state-licensed and can treat many health issues, including:
In its mHealth Roadmap, the Health Information and Management Systems Society (HIMSS) muddies the waters a bit. It uses the Health and Human Services Definition for telehealth — “the use of electronic information and telecommunications technologies to support remote clinical healthcare, patient and professional health-related education, public health and health administration” — then goes on to say that “telemedicine usage ranges from synchronous video chat between a patient and a doctor, to conferencing between doctors, to conferencing between doctors and allied health professionals (e.g., nutritionists, physical therapists), to providing live or recorded presentations to groups of patients who are geographically separated.”
All the guidelines and restrictions we’ve listed above are for billing telemedicine through traditional Medicare. Medicare Advantage plans under a commercial payer have complete flexibility to cover telemedicine however they want! This means, Advantage plans may cover telemedicine for your patient and not have any of those restrictions on what qualifies as an eligible originating site. Call the payer and ask what they’ll cover and what their telemedicine guidelines are.
Because of telemedicine, physicians can access patient medical records without being onsite. Some telemedicine providers offer the ability to do data entry using a point-and-click method or video/handwriting recognition. This can cut down on the amount of time that physicians dedicate to administrative tasks. As a result, physicians can see more patients or spend more time with those cases that are more complex.
While telemedicine has shown to be a game changer in the field of medicine, there are still a number of barriers to overcome. Physicians face challenges regarding how they’ll be paid and where they can practice, while patients voice security concerns. Once these barriers are removed, we can anticipate greater access to care and improved patient outcomes.
Healthcare systems, policymakers, vendors, and providers alike can attest to the many gray areas within telemedicine. One particular area that requires more clarity is the legalities surrounding telemedicine. With it being an industry that is constantly growing, it has become difficult to create a concrete solution. In addition, each state follows different laws for telemedicine, which makes it increasingly difficult to keep up with it.
One especially successful telemedicine project funded by the government was called the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC), and was a partnership between NASA and the Indian Health Services. The program funded remote medical services to Native Americans living on the Papago Reservation in Arizona and astronauts in space! Projects like STARPAHC drove research in medical engineering, and helped expand advancements in telemedicine. The next few decades saw continued innovations in telemedicine and wider research at universities, medical centers and research companies.
In April 2012, a Manchester-based Video CBT pilot project was launched to provide live video therapy sessions for those with depression, anxiety, and stress related conditions called InstantCBT The site supported at launch a variety of video platforms (including Skype, GChat, Yahoo, MSN as well as bespoke) and was aimed at lowering the waiting times for mental health patients. This is a Commercial, For-Profit business.
Dr. Bernstein has practiced medicine since 1990 and provided virtual care with our team since 2006. He received his medical degree from the University of North Carolina and completed a residency at Providence Family Practice in Seattle. He also holds a Master's Degree in Public Health from the University of Washington. Dr. Bernstein is dedicated to quality preventive medicine, public health promotion, and research. As Director of Clinical Quality, he manages the development and maintenance of the clinical standards of patient care, working with the development team to create new systems for measuring clinical delivery effectiveness. In his spare time, he is an avid cyclist and a soccer fan.