Telemedicine also can eliminate the possible transmission of infectious diseases or parasites between patients and medical staff. This is particularly an issue where MRSA is a concern. Additionally, some patients who feel uncomfortable in a doctors office may do better remotely. For example, white coat syndrome may be avoided. Patients who are home-bound and would otherwise require an ambulance to move them to a clinic are also a consideration.

Tim Panek has worked in primary care since 1999 and provided virtual care since 2011. He received his Master of Nursing from the University of Washington and has worked in many primary and urgent care settings in Washington State. He is an adjunct clinical faculty member at the University of Washington School of Nursing. He is also a high school soccer coach and enjoys golf, fly-fishing, skiing and hiking with his family.
Applications of telehealth in physical therapy already have roots that expand throughout patient/client care and consultation, as it allows PTs to better communicate with patients/clients and provide more flexible care. Telehealth will not replace traditional clinical care. However, it will give PTs and PTAs the flexibility to provide services in a greater capacity. Examples:
Today’s competitive health care marketplace has created an environment where patients demand lower costs, higher service quality, and convenient access to services. [2] Telehealth is an innovative and valuable mechanism that provides patients with efficient access to quality services. Lowering costs and removing barriers to service access, are critical components in promoting patient wellness and population health. Convenience and cost-effectiveness are important commodities in the modern health care marketplace, as patients tend to avoid treatment that is difficult to access or too expensive. As a result, telehealth technology is emerging as a preferred choice among patients and providers. Telehealth has also attracted the attention of US legislators. They utilize this tool for improving the competitiveness of American health care services. This is especially important, seeing as health care represents 17 percent of the nation’s gross domestic product (GDP). In fact, the resource has helped to define the role that lawmakers play in ensuring that patients benefit in a competitive health care market.
Bao Ng has worked in primary care since 2013 and provided virtual care since 2013. Obtaining her Doctor of Nursing Practice from the University of Washington, she began working in telemedicine shortly thereafter. Her medical interests include international health, and maternal and child health. She works at an international community health clinic near her home, and is fluent in Vietnamese and proficient in conversational Cantonese. She volunteers as a caregiver in her church nursery and is an executive board member for a local pediatric and behavioral health clinic. Outside of work, she enjoys spending time with her husband and children and exploring new cuisines.

Originally, health professionals developed this technology to reach remote patients living in the rural areas. But with time, medical staff and the U.S. government saw the big picture – the potential to reach urban populations with healthcare shortages, and to respond to medical emergencies by sharing medical consults and patient health records without delay. In the 1960s, heavy investments from the U.S. Government, including the Public Health Department, NASA, Department of Defense, and the Health and Human Sciences Department drove research and innovation in telemedicine. Sending cardiac rhythms during emergencies started at about this time. For instance, in Miami, the university medical center worked together with the fire rescue department by sending electro-cardiac rhythm signals over the voice radio channels from the rescue sites.

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The development of modern telemedicine began with the invention of the telecommunications infrastructure, including the telephone and telegraph. Early on, telemedicine technology was adopted for use in military situations during the Civil War, such as ordering medical supplies or medical consultations. Casualty and injury lists were also delivered via telegraph.

Visit Teladoc and set up an account using the information provided on your GuideStone/Highmark BCBS ID card. You'll also complete a medical history so that it's easy for the Teladoc physician to access when providing treatment. Or you can set up your account and provide your medical history by calling 1-800-TELADOC (1-800-835-2362). If they ask for your employer's name, be sure to tell them your coverage is provided through GuideStone/Highmark BCBS and provide the identification information from your ID card. Learn more about How to Register.


There are the typical discussions about balance between expanding vs. deepening what we currently do. Fair arguments on both sides of the discussion. The company tends to be conservative. Unclear decision making can lead to confusion across the company. Some decisions are made by corporate leaders who don't understand the day to day realties. Needs of the company have outgrown some functional leaders. These issues are...

Reimbursement for Medicaid covered services, including those with telemedicine applications, must satisfy federal requirements of efficiency, economy and quality of care. States are encouraged to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology. For example, states may reimburse the physician or other licensed practitioner at the distant site and reimburse a facility fee to the originating site. States can also reimburse any additional costs such as technical support, transmission charges, and equipment. These add-on costs can be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state. If they are separately billed and reimbursed, the costs must be linked to a covered Medicaid service.
Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline.[3] It does not require the presence of both parties at the same time.[1] Dermatology (cf: teledermatology), radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured medical record preferably in electronic form should be a component of this transfer. A key difference between traditional in-person patient meetings and telemedicine encounters is the omission of an actual physical examination and history. The 'store-and-forward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination.
“If there are areas of clinical need across the healthcare network, telemedicine may allow for better leveraging and expanding access to sub-specialists,” Sokolovich said. “Another opportunity could include better triaging patients through telemedicine-enabled provider-to-provider or provider-to-patient evaluations, which bring together experts who can quickly assess the best care path and eliminate unnecessary hospital admissions or emergency department visits.”
Store and forward, a type of telemedicine that allows providers to share information over a distance, has been a game changer. Today, primary care physicians can connect with specialists who are in another location than them. Healthcare information like diagnostic images, blood analysis, and more can be shared for appropriate patient assessment in real time.
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]
Patients often look for a quick and inexpensive second opinion from a specialist, after diagnosis of a medical condition. Telemedicine has stepped up, by providing solutions in this aspect as well. Companies and traditional healthcare services such as Partners Healthcare, 2nd.MD, DoctorSpring, and Cleaveland Clinic are providing quick and efficient second opinions using telehealth.
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.
Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and interpretation. While they do not meet the Medicaid definition of telemedicine they are often considered under the broad umbrella of telehealth services. Even though such technologies are not considered "telemedicine," they may nevertheless be covered and reimbursed as part of a Medicaid coverable service, such as laboratory service, x-ray service or physician services (under section 1905(a) of the Social Security Act).
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.
* Physicians on Silver Cross Hospital’s Medical Staff have expertise in their areas of practice to meet the needs of patients seeking their care.  These physicians are independent practitioners on the Medical Staff and are not the agents or employees of Silver Cross Hospital. They treat patients based upon their independent medical judgment and they bill patients separately for their services. 

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.
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.
However, coverage, payment and other policy issues prevent full use of telehealth, remote patient monitoring and similar technologies. Medicare policy is particularly challenging, as it limits the geographic and practice settings where beneficiaries may receive services, as well as the types of services that may be provided via telehealth and the types of technology that may be used. Access to broadband services and state-level policy issues, such as licensure, also limit the ability to use telehealth.
The short-seller's online article stated that sales for Teladoc's BetterHelp mental health business would fall because of a controversy about YouTube stars receiving referral payments for promoting the BetterHelp website. BetterHelp is an important driver of Teladoc's growth, although the business makes up less than 15% of the company's total revenue.
The first example of an electronic medical record transfer occurred in 1948 in Pennsylvania, when radiology images were sent 24 miles between two townships via telephone line. A few years later, Canadian radiologists built on that early application of telemedicine technology and created a teleradiology system for use in and around Montreal. In 1959, clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television.
The development of modern telemedicine began with the invention of the telecommunications infrastructure, including the telephone and telegraph. Early on, telemedicine technology was adopted for use in military situations during the Civil War, such as ordering medical supplies or medical consultations. Casualty and injury lists were also delivered via telegraph.
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.

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.
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.
Telehealth allows multiple, different disciplines to merge and deliver a much more uniform level of care using the efficiency and accessibility of everyday technology. As telehealth proliferates mainstream healthcare and challenges notions of traditional healthcare delivery, different populations are starting to experience better quality, access and personalised care in their lives.[22][23]
The United States has 14 Telehealth Resource Centers, all funded by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) Office for the Advancement of Telehealth. These resource centers serve as a local hub of information and research about telehealth, usually with a focus on increasing healthcare access for underserved communities. Plus, the services they provide are generally free!
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.
1. The doctor writes you a prescription. In-person, this can mean a handwritten prescription or a digital prescription sent directly to a pharmacy. Prescriptions can be sent to a retail pharmacy, mail-order pharmacy, or pharmacy inside your doctor’s office. Online doctors only have the digital option and will likely send the prescription to a retail pharmacy in your area.
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