“Creating a viable telemedicine program is both a short-term and a long-term proposition,” said Daniel Barchi, CIO at New York-Presbyterian. “It is possible, with a small team and early investment of resources, to create telemedicine capability in a specific vertical. It could be post-surgical follow-up visits for patients and surgeons, medication reconciliation video visits with a pharmacist, or urgent care emergency department video calls.”
While this definition sounds a lot like telemedicine, there is one distinct difference. Unlike telemedicine, telehealth also covers non-clinical events like administrative meetings, continuing medical education (CME), and physician training. Telehealth is not a specific service, but a collection of methods to improve patient care and education delivery.
Telehealth - powered by Teladoc - is a convenient, affordable new way to access quality care for general medical, behavioral health, and dermatology2 services by web, phone3, or mobile app. Connect with a board-certified doctor, therapist, or dermatologist from the comfort of home, during your lunch break, or while traveling throughout the country. 
But getting doctors to jump on board is easier said than done, and takes time. Many are afraid of liability, as it's possible to miss something during a remote visit. And for years, it wasn't clear whether they would get paid as much as an in-person visit. Reimbursement questions are still getting resolved across different states, but most of the commercial and government plans are on board with the idea of telemedicine -- at least in specific circumstances.
This isn't to say that you should jump right in and begin providing services via telehealth. You'll first need to consider federal and state legislation and regulations that govern your practice, risk management implications, billing and coding issues, and hardware/software requirements. The resources below aren't meant to give you detailed instructions on developing and using telehealth in your practice, but they identify areas most important for you to investigate and consider.
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.
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.
Teledermatology – Teledermatology solutions are usually store-and-forward technologies that allow a general healthcare provider to send a patient photo of a rash, a mole, or another skin anomaly, for remote diagnosis. As frontline providers of care, primary care practitioners are often the first medical professionals to spot a potential problem. Teledermatology solutions lets PCPs continue to coordinate a patient’s care, and offer a quick answer on whether further examination is needed from a dermatologist.
Projections for the growth of the telehealth market are optimistic, and much of this optimism is predicated upon the increasing demand for remote medical care. According to a recent survey, nearly three-quarters of U.S. consumers say they would use telehealth.[44] At present, several major companies along with a bevvy of startups are working to develop a leading presence in the field.

Where telemedicine refers specifically to the practice of medicine via remote means, telehealth is a blanket term that covers all components and activities of healthcare and the healthcare system that are conducted through telecommunications technology. Healthcare education, wearable devices that record and transmit vital signs, and provider-to-provider remote communication are examples of telehealth activities and applications that extend beyond remote clinical care.
Today, 95 percent of Americans own cell phones and 77 percent own smartphones. These and other mobile devices can be leveraged to promote better health outcomes and increased access to care. mHealth or mobile health refers to healthcare applications and programs patients use on their smartphones, tablets, or laptops. These applications allow patients to track health measurements, set medication and appointment reminders, and share information with clinicians. Users can access hundreds of mHealth applications including asthma and diabetes management tools as well as weight loss or smoking cessation apps. Additionally, mobile devices allow users to schedule appointments and communicate with providers via video conference and text message.
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.
As the potential -- if not the actual success, yet -- of AI grows in healthcare, telemedicine stands to benefit from it. It's not hard to imagine telemedicine chatbots being the initial party that a patient discusses symptoms with during a smartphone video call, and based on AI deductions of the situation, recommendations could follow or an actual physician could join the discussion.
In the early days, telemedicine was used mostly to connect doctors working with a patient in one location to specialists somewhere else. This was of great benefit to rural or hard to reach populations where specialists aren’t readily available. Throughout the next several decades, the equipment necessary to conduct remote visits remained expensive and complex, so the use of the approach, while growing, was limited.
As the virtual health provider highlights, the global health insurance market is worth in the trillions and expected to double in the next decade. This market growth will play out over time, but the really easy addressable market is in the US multinational employment outside the US. The new company can now provide a more complete virtual health solution for corporations with over 14 million employees outside the US on top of the 28 million in the US.
To date, there are 33 states plus the District of Columbia, that have parity laws that require private payer reimbursement for telemedicine services. All states with parity laws require private payers to pay for video-conferencing. To date, only a few states require reimbursement for store and forward telemedicine. Organizations should also understand that payment for telemedicine services may not equal that of onsite services.
Today, most people have access to basic telemedicine devices like mobile phones and computers. With improved accessibility, individuals in rural areas and busy urban areas can connect with a provider with ease. Home-use medical devices make it possible for caregivers to monitor everything from vitals to glucose levels. Physicians can gather essential medical information and make a diagnosis without patients stepping foot in a doctors office.
Symptoms occur due to a swelling of the breathing tubes, which makes it difficult for air to pass into the lungs. For those who smoke cigarettes, suffer from obesity, or live with allergies, these symptoms are more severe. By speaking with a U.S. doctor through your consultation, you can receive a prescription for the proper medication to treat asthma. To treat your symptoms,click herefor more information! .
Dr. Mercado has practiced medicine since 2000, and provided virtual care since 2015. She earned her medical degree at the University of the Philippines in Manila. She completed her Family Medicine Residency at Akron General Medical Center in Ohio, where she was the chief resident during her final year of residency. She has spent the last six working in a primary care setting where she saw patients of all ages. Dr. Mercado believes communication is an integral part of a physician-patient interaction. During her free time, she enjoys reading, traveling, watching movies, volunteering, and spending time with her family.
While many branches of medicine have wanted to fully embrace telehealth for a long time, there are certain risks and barriers which bar the full amalgamation of telehealth into best practice. For a start, it is dubious as to whether a practitioner can fully leave the "hands-on" experience behind.[23] Although it is predicted that telehealth will replace many consultations and other health interactions, it cannot yet fully replace a physical examination, this is particularly so in diagnostics, rehabilitation or mental health.[23]

Informed consent is another issue – should the patient give informed consent to receive online care before it starts? Or will it be implied if it is care that can only practically be given over distance? When telehealth includes the possibility for technical problems such as transmission errors or security breaches or storage which impact on ability to communicate, it may be wise to obtain informed consent in person first, as well as having backup options for when technical issues occur. In person, a patient can see who is involved in their care (namely themselves and their clinician in a consult), but online there will be other involved such as the technology providers, therefore consent may need to involve disclosure of anyone involved in the transmission of the information and the security that will keep their information private, and any legal malpractice cases may need to involve all of those involved as opposed to what would usually just be the practitioner.[22][42][43]


Today, most people have access to basic telemedicine devices like mobile phones and computers. With improved accessibility, individuals in rural areas and busy urban areas can connect with a provider with ease. Home-use medical devices make it possible for caregivers to monitor everything from vitals to glucose levels. Physicians can gather essential medical information and make a diagnosis without patients stepping foot in a doctors office.
Emergency room and urgent care environments are known for long wait times, overcrowding and even staffing shortages. This leads to additional stress being added to not only the patient, but the staff too. With tele-triage, patients can arrive to an emergency department and be seen by an off-site physician using video conferencing software. The off-site physician can order tests or determine a treatment plan, which moves patients through the system faster. Cases that are more severe can be moved to the next level of patient care and others can be discharged.

Like most technology solutions, telemedicine platforms usually require some training and equipment purchases. How much is really dependent on the solution – a more extensive inpatient telemedicine platform that will be used between primary doctors and consulting specialist may require more training and the purchase of a telemedicine cart and various mobile health devices. A secure videochat app like eVisit, requires much less staff training and usually only requires purchase of a webcam.

Telemedicine was originally created as a way to treat patients who were located in remote places, far away from local health facilities or in areas of with shortages of medical professionals. While telemedicine is still used today to address these problems, it’s increasingly becoming a tool for convenient medical care. Today’s connected patient wants to waste less time in the waiting room at the doctor, and get immediate care for minor but urgent conditions when they need it.
With many rural areas facing a shortage of specialists, telemedicine enables individual doctors to reach more patients. And the cost to patients for telehealth consultations is often lower than an in-office visit. By serving more patients in a shorter amount of time, healthcare organizations can cost-effectively grow their membership while increasing care quality and patient satisfaction.
While the loss of an in-person human interaction is often cited by skeptics of telemedicine, 76% of patients said they care more about access to healthcare than having an in-person interaction with their doctors. Also, only 16% if surveyed patients would rather go to the ER for minor conditions if they could instead use telemedicine for treatment. With the ongoing shortage of patient slots open with overburdened primary care doctors, these stat says a lot about patients’ willingness to try out telemedicine.
Sometimes the answer to the question “What is telemedicine?” is simply mobile medicine. It doesn’t require a heavy desktop computer or a lot of equipment. Activities that used to happen only in person are now easy to do on a smartphone. Modern consumers are accustomed to downloading apps and using their smartphones for simple transactions. The same is true for doctor visits. For example, with MDLIVE the patient simply opens the app and clicks to choose a doctor, with whom they can speak either by phone, instant message, or video.    

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.

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