https://www.techtarget.com/searchhealthit/definition/telemedicine
Telemedicine, also referred to as telehealth or e-medicine, is the remote delivery of healthcare services over the telecommunications infrastructure.
The principal goal of telemedicine is to provide a better experience for patients when dealing with healthcare providers. Telemedicine makes it possible for healthcare providers to evaluate, diagnose, communicate with and treat patients without the need for an in-person visit. Patients can communicate with physicians from their homes or offices using their own personal technology, such as a laptop or smartphone or by visiting a dedicated telemedicine kiosk.
A typical telehealth exam involves downloading an application or calling a telemedicine number, provided by a physician's office or a patient's employer as part of health insurance benefits. After sharing information about medical history and symptoms, the remotely located patient will be connected to a clinician or other qualified healthcare provider. Based on the medical professional's evaluation, the call typically ends with the patient receiving further instructions, including perhaps an over-the-counter or prescription medication to take, and a follow-up appointment, if needed.
Trust plays an important role in the delivery of healthcare of all kinds. Patients need to trust that their doctors and other medical professionals have their best interests at heart. The need to feel confident that any medications being prescribed will be effective and not show any detrimental side effects. They need to trust their surgeons, anesthesia doctors and other attending personnel during surgical procedures.
Telemedicine is one option for delivering healthcare. It is certainly not the only way to deliver patient care. Trusting telemedicine means trusting the technology connecting doctor and patient, that it will work when needed and not fail. Patients need to be confident that telemedicine costs can be covered by insurance. They need to trust that medical institutions, ranging from major hospitals to same-day clinics in drug stores, can support telemedicine and are committed to its effective use.
Technologies associated with the various forms of telemedicine are generally quite mature, as are the network services connecting doctor and patient. For patients with mobility challenges or in remote locations, telemedicine may be the best way to obtain the healthcare services they need. As such, they must be able to trust that telemedicine will be available when they need it, and that they can be connected to a provider -- even if it is not their primary care physician (PCP) -- who will provide the appropriate care they need, and ensure that other key players, such as their PCP, will receive the information needed to deliver the proper services.
Ideally, patients who use telemedicine as a primary means of obtaining healthcare should also have access to alternative ways to receive care, such as a family member or neighbor who can drive them to a medical facility. As such, patients should generally be able to trust telemedicine and, hopefully, depend on it without the fear of a bad experience.
Telemedicine can be classified into four main categories that, in some cases, overlap.
Telemedicine is asynchronous and synchronous in how it works. Synchronous telemedicine occurs when a patient can connect in real time and one-on-one with a healthcare provider. This, for many patients, especially older adults, represents the ideal use of telemedicine by allowing patients to connect immediately with the doctor or other professionals. A subsequent in-person appointment may be needed and can be set up at the end of the call. Follow-ups to in-person or remote calls can also be conducted using telemedicine.
By contrast, asynchronous telemedicine makes a connection but not in real time. For example, prior to a doctor visit, an automated healthcare system requires that a patient answer a variety of health-related questions before checking in for the appointment. Calling into an automated system to order prescription refills is another example.
Depending on the telemedicine technology being used, the level of interaction with the system before the actual call will vary. As noted, an asynchronous call may be needed to collect relevant patient data and the issues to be addressed. Data on healthcare insurance, family history, allergies, previous medical procedures, existing health conditions, recent travel within or outside the country, medications being used, and other information may need to be collected. The system will coordinate an appointment date and time, often on the same call. It may list the items needed for the call.
The synchronous part of the process occurs when the actual call takes place. At that time, the doctor and patient will go through an interview process, similar to an in-person visit. The doctor will recommend a treatment regimen, prescribe medications, and perhaps write up orders for medical tests or even surgical procedures. Once the issues have been addressed, doctor and patient agree on the next steps and proceed accordingly.
Advancements in telemedicine have grown steadily over the past decades, making it a viable alternative to in-person healthcare visits. While the positive aspects are obvious -- convenience, timeliness -- a few downsides must also be noted.
The benefits of telemedicine for patients include:
Telemedicine benefits healthcare providers in the following ways:
Some of the challenges associated with telemedicine include:
Healthcare providers may be concerned with some of the potentially negative aspects of telemedicine, including:
For both patients and providers, telemedicine healthcare visits often are a less expensive way to provide medical care. Patients considering the use of telemedicine should check with their insurance provider to see if the services are covered.
Various payment models are used in telemedicine. Some health systems offer remote consultations as part of their regular care services; patients are charged based on insurance plans or government reimbursement schedules. A patient's employer may offer a virtual care option as part of health insurance coverage premiums. Patients without suitable insurance coverage may be able to use a telehealth vendor for a flat fee.
In recent years, many states have passed laws that make telemedicine easier to provide. Federal health regulators have explored ways to extend Medicare reimbursements for telemedicine services beyond December 2024, and they are currently set to expire September 30, 2025.
The Patient Protection and Affordable Care Act (PPACA) of 2010 has governed telemedicine in certain situations under Medicare, but telemedicine regulation for the most part falls to the states, with reimbursement delivered using Medicaid.
State-specific telemedicine legislation in the U.S. varies widely, especially related to these issues:
While the states are generally responsible for administering telemedicine rules and regulations, the following federal agencies also play a role in shaping telemedicine policies and programs in the U.S.
The development of modern telemedicine and telehealth began with development of telecommunication technology and its associated infrastructure, particularly the telephone and telegraph. In the early 1900s, for example, heart rhythms were transmitted over the telephone in the Netherlands. Telemedicine technology was used in military situations during the Civil War when telegraph messages were used to order medical supplies and report casualty and injury lists.
The first transfer of a medical image occurred in 1948 in Pennsylvania, when radiology images were sent over a telephone line. Canadian radiologists created a similar teleradiology system for use in Montreal. In 1959, clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television.
Early computer-based patient records were in use in the 1960s. Electronic medical records (EMR), also called electronic healthcare records (EHR), started to be more widely used in the 1980s. As part of the American Recovery and Reinvestment Act, healthcare providers were required to show "meaningful use" of EMRs by January 1, 2014, to maintain their Medicare and Medicaid reimbursement levels.
In the early days of telemedicine, healthcare professionals used the technology to reach patients living in rural and underserved areas. This is still important today, and the technology continues to expand into urban areas, especially those with healthcare shortages.
Today, telemedicine is used in these applications:
AI and the Internet of Things (IoT) have been supporting the advancement of telemedicine by enhancing these healthcare activities:
Assuming that regulators, government agencies, healthcare organizations and insurers and medical professionals continue to use telemedicine, the future is indeed very bright. Among the trends and developments shaping its future are:
Telemedicine use will continue to expand through advances in technology, development of new applications and a greater focus on preventive healthcare to elevate the delivery of healthcare. As telemedicine use advances, there will be a need for ongoing regulatory oversight and reform to ensure patients are protected.
AI is transforming telehealth by improving triaging, image analysis, patient diagnosis, treatment planning, monitoring, and mental health support. Learn more about how AI is changing telemedicine.
04 Sep 2025