Quick guide to store and forward telehealth

Learn more about what store and forward telehealth is, its benefits, drawbacks, some examples of use in the different medical fields and frequently asked questions.

Author: Jennifer Highland, Content Manager of Miiskin | Reviewed by: Jon Friis, Founder, and CEO of Miiskin

Covered in this article:
What is telemedicine? | Synchronous telemedicine | Asynchronous telemedicine | How does it work? | Benefits | Applications | Disadvantages | FAQ

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What is the definition of telemedicine?

Telemedicine can be defined as the use of digital communication methods to deliver healthcare services remotely. This encompasses transmitting medical information like images, videos, documents, and patient data to healthcare professionals for assessment, diagnosis, and treatment planning, without requiring the physical presence of the patient and the provider at the same time.

Types of telemedicine

Telemedicine can be broadly categorized into two main types, each with its unique applications and benefits in the healthcare landscape:

• Synchronous telehealth
• Asynchronous telemedicine

What is synchronous telemedicine?

Synchronous Telemedicine, also referred to as real-time telemedicine facilitates live interactions between patients and healthcare providers through video conferencing or phone calls. This method is suitable for consultations, follow-up visits, and certain types of therapy sessions, providing an immediate exchange of information and feedback.

What is asynchronous telemedicine? 

Store and forward telehealth, also known as asynchronous telehealth, is a digital communication method where medical information—such as images, videos, documents, and patient data—is collected and then transmitted to a physician for assessment at a later time. This approach does not necessitate the simultaneous presence of both the patient and the healthcare professional, offering flexibility in how and when care is provided. It’s particularly useful in fields such as dermatology, radiology, and pathology where detailed evaluations of patient data can be conducted without direct interaction, facilitating efficient diagnosis and treatment planning from a distance.

How does asynchronous telehealth work?

In asynchronous telehealth, patients compile relevant medical data at their convenience, which might include photographic evidence of a condition, recorded symptoms, or other health metrics. This information is then securely sent to a physician, who reviews it at a time that fits their schedule. This process allows for a detailed examination of the patient’s condition without the need for live interaction or an in-person appointment. For healthcare providers, it means being able to manage their workload more flexibly while still offering comprehensive care. It enables the delivery of healthcare services to wider populations, especially those in remote locations or with constraints that make traditional, synchronous consultations challenging.

What are the implications of store and forward for healthcare providers?

The implications for healthcare providers are profound and multifaceted. These advancements can significantly enhance the quality and scope of services offered, enabling providers to offer more accurate diagnoses, broader treatment options, and improved patient monitoring capabilities. However, this also means that they need to invest in new technologies and training, ensure compatibility with existing systems, and navigate the complexities of cybersecurity to protect patient data. As technology evolves, healthcare providers must adapt to stay at the forefront of healthcare delivery, leveraging these advancements to improve patient care while also managing the challenges they present.

Benefits of store and forward telemedicine

Increased patient access

Store and forward is a type of telemedicine that makes healthcare services more accessible, especially to patients in remote or underserved areas, by eliminating the need for physical travel to see a specialist or booking a virtual appointment in real time.

Efficiency and convenience

Asynchronous telemedicine allows healthcare providers to review patient information and make diagnoses at their convenience, optimizing their schedules and reducing patient wait times for feedback.

Cost-effectiveness

By minimizing the need for in-person consultations, telemedicine can lead to significant savings in healthcare costs for both patients and providers, including reduced travel expenses and time off work.

Enhanced quality of care

This method of telemedicine facilitates remote healthcare and remote patient monitoring, easy consultation with specialists, ensuring that patients receive the best possible care based on a comprehensive review of their medical data by experts, possibly leading to better health outcomes.

Improved documentation and record keeping

The digital nature of store and forward telemedicine ensures that all patient data is stored electronically, enhancing the accuracy and accessibility of medical records for ongoing patient management.

Store and forward telemedicine applications

Primary care physicians

Store and forward is a form of telemedicine that is highly beneficial for primary care. It improves access to specialists, in many cases it enables patient triage, and it ensures timely diagnosis and treatment. It also supports the treatment of skin conditions and chronic disease management. This approach complements traditional care, providing a comprehensive and accessible healthcare solution.

Specialist referrals

Asynchronous telemedicine offers an effective platform for specialist referrals. Primary care physicians can securely transfer patient information and images to specialists remotely, enabling them to provide remote diagnostics and determine whether a consultation is necessary. This seamless process enhances collaboration between healthcare providers and ensures timely access to specialized care for patients.

Dermatology

Teledermatology plays a pivotal role in scenarios where visual assessment is key. Patients can easily capture and share images of skin conditions, rashes, or lesions with dermatologists, who then review these visuals to diagnose, suggest treatments, or prioritize cases by urgency.

The advantage of store and forward telehealth in dermatology is evident, benefiting both patients and physicians. Studies indicate that the use of high-quality images during virtual consultations results in substantial patient satisfaction.

Ophthalmology

Teleophthalmology enhances access to eye care specialists, especially in remote or underserved areas. Here are some key applications: diabetic retinopathy screening, glaucoma monitoring, age-related macular degeneration (AMD) management, acute eye infections.

Clinical research

Asynchronous telehealth offers multiple benefits for clinical trials. It enhances remote data collection, enables real-time monitoring, and improves patient recruitment and retention. By reducing participant burden, ensuring data accuracy, and streamlining collaboration, it contributes to cost and time savings. Additionally, it promotes diversity in participant representation and facilitates remote adverse event reporting, making it adaptable for global trials.

Wound care management

Store and forward telemedicine is also suitable for the remote care of wounds. Patients can capture images of their wounds using a digital camera or a smartphone and upload them to a secure online platform or electronic health record system. These images provide healthcare providers with visual information about the wound’s healing trajectory, allowing them to assess the progress remotely. Patients can provide updates on their wound’s progress, share photographs of the wound, and describe any changes or concerns they may have.

Remote health care

Asynchronous telemedicine facilitates remote patient monitoring by enabling healthcare providers to assess patient data collected and transmitted at different times, thus ensuring continuous care without the need for real-time interaction.

What are the disadvantages of store and forward telemedicine?

Store and forward telemedicine, while offering numerous advantages for healthcare delivery, also comes with its own set of challenges and disadvantages.

Limited clinical information

Relying solely on patient-submitted information or images may sometimes result in incomplete clinical data, which can potentially lead to misdiagnosis or an underestimation of the severity of a patient’s condition.

Lack of real-time interaction

The absence of real-time communication between the patient and healthcare provider can limit the ability to ask follow-up questions or clarify information on the spot, which may be critical for certain diagnoses.

Reimbursement issues

Reimbursement policies for store and forward telemedicine are still evolving in many regions. This uncertainty can make it challenging for healthcare providers to integrate these services into their practices and for patients to access them.

So, what is connected health then?

Connected health refers to a comprehensive, technology-driven approach to healthcare that uses various forms of digital communication and information technologies to provide and manage healthcare services remotely. It encompasses telehealth, telemedicine, remote patient monitoring (RPM), mobile health (mHealth), wearable devices, and other digital health tools to facilitate the exchange of data between patients and healthcare providers, as well as among healthcare professionals.

The goal of connected health is to improve patients’ access to healthcare services, enhance the quality of care, increase the efficiency of healthcare delivery, and personalize the healthcare experience. By leveraging the internet, smartphones, wearables, and other technologies, connected health enables continuous monitoring of patients’ health, early intervention in case of adverse trends, and better chronic disease management. It also supports preventive care initiatives and empowers patients by giving them more control over their health and wellness.

Are patients satisfied with remote health care?

A McKinsey survey revealed that up to 98% percent of patients reported satisfaction with virtual care. In another, 72% of physicians reported similar or better experiences with remote engagement compared with in-person visits. Research findings also indicate that store and forward telehealth is comparable to high-quality live video conferencing in terms of diagnostic accuracy and effectiveness. In other words, the two methods demonstrate similar diagnostic capabilities, highlighting the potential of store and forward telehealth as a reliable and viable option for remote healthcare consultations. 
Moreover, store and forward telehealth has minimal technical requirements, making it highly convenient for both patients and providers with busy schedules. Unlike synchronous methods, it does not require simultaneous availability, allowing for flexible interactions and efficient healthcare delivery at the convenience of all parties involved.

Frequently asked questions about telehealth

What are the options for telehealth?

Depending on the delivery model you want to use, telehealth care allows you to exchange images and information with your physician at different points in time or talk to your health care provider using video. This happen with the help of your smartphone, computer or a tablet.

What is the difference between asynchronous and synchronous telehealth?

Asynchronous telehealth allows patients to send clinical information and images to their physician at any time, which they can then review at their convenience. On the other hand, synchronous telehealth involves real-time communication between the patient and provider through video conferencing or phone calls, facilitating instant feedback and discussion.

Which situation is the best choice for using telehealth?

An ideal scenario for utilizing telehealth can be the case where the medical condition can be diagnosed through digital images without the need for immediate, live interaction. For example, with asynchronous teledermatology, physicians can evaluate skin lesions, rashes, or other visible skin conditions that do not require an in-person physical examination for an initial diagnosis. Asynchronous telehealth is particularly effective for follow-up consultations, monitoring the progression of chronic skin conditions, or determining the response to treatment over time. It is also a valuable tool for initial screenings, where the dermatologist can triage cases based on urgency and decide which patients need to be seen in person versus those who can be managed remotely. This approach maximizes convenience for both patients and providers, ensuring timely care while reducing the need for travel and in-person visits.

Which is better synchronous or asynchronous?

Determining whether synchronous or asynchronous telehealth is “better” depends on the patient’s specific health care needs and the nature of the medical condition being treated. Synchronous telehealth is useful for situations requiring immediate feedback, however this telemedicine modality requires a fast internet connection from both ends to be stable and it requires that both parties are available at the best time. Asynchronous telehealth works best in scenarios where the condition can be assessed without real-time interaction, such as reviewing dermatological photos. It offers flexibility for both patients and providers, allowing for consultations and evaluations to take place at each party’s convenience.

What are some popular telemedicine services in the United States?

Some of the most popular telemedicine in the U.S. are Miiskin (for skin problems), SkyMD, Teladoc, Sesame, Hims and Hers.

What is the difference between telemedicine and remote monitoring?

While telemedicine facilitates direct interaction between patients and healthcare providers for the purpose of delivering care, Remote patient monitoring (RPM) focuses on the continuous, automatic collection and transmission of patient health data for monitoring and management purposes. Both digital health solutions play integral roles in enhancing patient care, improving health outcomes, and increasing healthcare access.⁠

References:
https://newsroom.cisco.com/c/r/newsroom/en/us/a/y2013/m03/cisco-study-reveals-74-percent-of-consumers-open-to-virtual-doctor-visit.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765770/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231765/
https://www.mckinsey.com/industries/healthcare/our-insights/helping-us-healthcare-stakeholders-understand-the-human-side-of-the-covid-19-crisis
https://pubmed.ncbi.nlm.nih.gov/19035797/
https://www.liebertpub.com/doi/abs/10.1089/tmj.2017.0078