Telemedicine Store and Forward Communications – What’s the difference in Telemedicine?

Telemedicine Store and Forward Communications – What’s the difference in Telemedicine?

June 20, 2018

Telemedicine store and forward

Telemedicine Store and Forward

Telemedicine and Telemedicine store and forward has generally been divided into three modalities:

  1. Real-time (live video, telephone or HIPAA compliant chat/text)
  2. Asynchronous (store-and-forward; sometimes called capture, store and forward)
  3. Remote patient monitoring.

For years the difference between the 3 has been a bit of contention point with providers and the industry as a whole.  Real-time telemedicine consists of not only telephone, nurse based care but can also include online-based video chat, real-time HIPAA compliant text and messaging.  Where store-and-forward involves the gathering of data from a patient which is then sent through a HIPAA secure platform. That information can then be analyzed by a caregiver and triage or care can be given.

Understanding the differences

The biggest difference between store and forward telemedicine offerings differ from real-time telemedicine is that they don’t involve live interaction with patient data. Instead, all the relevant data, including the information stored in an EMR or EHR system, is collected and gathered into a file (typically a SOAP note) and sent to the necessary caregiver via a HIPAA secure platform (either a mobile app or online application like IntellaCare). Once the nurse or physician receive the SOAP note, they can then make a determination on the best course of care to give the paitent.

While the difference between the two may seem straightforward, it can have significant implications for your healthcare organization depending on what your goals are. Real-time care and Telemedicine store and forward is effective for providers see a large number of patients, do frequent follow-up visits or need to provide immediate advice to patients. For instance, a healthcare organization that specializes in chronic care management can use real-time telemedicine solutions, like IntellaTriage Phone Triage or IntellaCare to consult remotely with patients for check-ups, filling prescriptions or resetting a BP Monitor, eliminating the need for unnecessary nurse on call visit or in office visits – as well as the associated cost.

Another important factor between the two is payor reimbursement policies.  Payment policies from private insurers vary between real-time and store-and-forward technologies. According to the CCHP, many private insurers do not reimburse for non-real-time consultations performed via telemedicine, and even Medicaid legislation varies on a state-by-state basis.

Numerous studies show the benefits of store and forward.

In 2016 study conducted by a team of researchers led by Caroline A. Nelson, MD, of the University of Pennsylvania’s Perelman School of Medicine found that a store-and-forward-based teledermatology program “is an innovative and impactful modality for delivering care.”

The study found that a store-and-forward (SAF) service aided both primary care providers and specialists by giving them a platform on which they could collaborate on their own time and in light of their own workflows.

Similarly, a 2015 study conducted by Santanu K. Datta, PhD, MBA, of Duke University Medical Center and the Durham (NC) VA Medical Center, found that a store-and-forward program at the VA Medical Center matched the quality of a conventional referral program and the cost was less expensive.

The VA has been using store-and-forward telehealth for years, beginning with a primary care-based program to screen veterans with diabetes for retinopathy and branching out to both radiology and dermatology.

“In some areas of healthcare pictures can be worth thousands of clinic visits,” the agency points out in describing those programs on its website.

Recently, a diabetic retinopathy program using Telemedicine store and forward technology eliminated more than 14,000 visits to specialty care in one year, improved screening rates for DR by more than 16% and reduced wait times for screening by almost 90 percent.

The deeper implication of this and other studies is that a store-and-forward platform can significantly improve not only clinical outcomes, but workflows for both primary care providers and specialists if properly implemented and used by caregivers and patients alike.

IntellaTriage has been providing telemedicine solutions for over 8 years and has been on the leading edge of both traditional telemedicince care as well as store and forward technologies delivered through its IntellaCare application.  If you want to learn more contact us today to start a conversation.