In Defense of Asynchronous Telemedicine

It seems that one of the dirty little secrets of medicine exposed during the COVID-19 pandemic is that it’s not always necessary for a doctor to physically examine a patient to deliver high quality care. An explosion of new telemedicine users have now realized that their care is essentially par for the course without physically having to go to their doctor's office.

Want to know another dirty little secret? Providers don’t necessarily need to talk to you either. If you’re coming in to clinic because it burns when you urinate and there’s a urinalysis and urine culture that shows an infection, there’s not much talking we need to do that couldn’t be adequately addressed with a simple questionnaire before giving you a course of antibiotics.

Need to schedule your yearly diabetic eye exam? The VA administration has been conducting screening teleretinal exams asynchronously for years that an article in JAMA Ophthalmology describes as "an effective method to screen patients for sight-threatening conditions." 

Telemedicine that is provided without a live, real-time component is described as "asynchronous" telemedicine or a "store and forward" form of telehealth.

From the VA Telehealth Services Fact Sheet:

"Store and Forward Telehealth (SFT) is generally defined as the use of technologies to asynchronously acquire and store clinical information (e.g. data, image, sound and video) that is then forwarded to or retrieved by a provider at another location for clinical evaluation. VA’s national Store-and-Forward Telehealth programs operationalize this definition to cover services that provide this care using a clinical consult pathway and a defined information technology platform to communicate the event/encounter between providers, as well as enabling documentation of the event/encounter and the associated clinical evaluation within the patient record."

Synchronous telemedicine is generally defined as a real-time interaction between provider in patient. 

An example of a asynchronous telemedicine company that has had huge success would be forHims. According to Vox, they may have reached a $1 billion dollar valuation in 2019 by asynchronously providing telemedicine care for erectile dysfunction, hair loss, and skin care through the use of questionnaires and the ability of providers to look at pictures.

In the academic world, a study of Stanford University's teledermatology clinic has revealed that Dermatologists were able to asynchronously diagnose a patient accurately in 36 out of 38 cases.

For providers looking for an asynchronous telemedicine job they can take comfort in knowing that store and forward telehealth has been repeatedly shown to be both cost-effective and safe.

Do you work for an asynchronous telemedicine company or work on an asynchronous telemedicine platform and want to share your experience? Reach out at support@whitecoatremote.com and share your experience!