Asynchronous telehealth is one of the fastest-growing healthcare modalities, receiving significant attention from both the medical and mass media during the COVID-19 public health emergency. To put it simply, asynchronous telehealth (ATH) is the exchange of health information, evaluation and/or treatment involving a provider and a patient without direct communication or interaction between the two individuals. ATH can also be referred to as “store-and-forward technology” for obvious reasons.

Historically, asynchronous care has been part of the U.S. healthcare system for generations. Here’s a classic example: a 25-year-old healthy female visited her primary care provider (PCP) for a urinary tract infection. The PCP prescribed a broad-spectrum antibiotic for the patient. However, during the office visit, the PCP also ordered a urinalysis and urine culture with antibiotic sensitivities. A couple of days later the test results came back indicating a different antibiotic would be more effective, so the provider called in a new prescription based on the test results without seeing the patient back in the office.

With the rise of telehealth – especially in light of COVID-19 and the availability of advanced technological modalities – ATH has taken asynchronous care to the next level. Secure HIPAA-compliant texting, wearable healthcare devices, artificial intelligence, machine learning and an integrated EHR make safe, efficient and cost-effective ATH a must moving forward in the post-pandemic world.

Technological Advancements and Mental Health Focus Spur Evolutions in Asynchronous Care

State telehealth regulations and laws recognize the importance of ATH with recent updates. Almost half of states now recognize ATH modalities as a mechanism to establish the provider-patient relationship. Yet, it should be noted that the provider-patient relationship must be established for new patients before a provider can fully evaluate and treat the patient. The good news is that for established patients, almost all ATH modalities for diagnosis and treatment are allowed across the country.

ATH is also aligned with how modern society utilizes technology in other aspects of life such as news consumption, professional engagements, travel, shopping, banking and so on. In other words, ATH provides healthcare when and how the modern patient wants it delivered.

There are many ATH modalities available to providers and patients, including:

  • HIPAA-compliant texting
  • Artificial intelligence and machine learning
  • Chatbots
  • Diagnostic testing review
  • Specialty consultation
  • Therapeutic sessions not requiring live interaction

Another important point is that ATH can be utilized for medical evaluation and in the behavioral health realm. Possibilities include:

  • Streamlining the initial intake process, allowing clinicians to more quickly address actual behavioral health issues versus spending time on paperwork
  • Opportunities for more digital touchpoints between sessions with the clinician
  • A large variety of digital tools such as breathing exercises, online videos and online content to enhance mental health treatment plans

Each of the possibilities increase the comfort level of patients, many of whom may be receiving behavioral health treatment for the first time.

Artificial Intelligence Opens New Doors

Artificial intelligence (AI) and machine learning systems have moved light years ahead in recent times. Many of these AI systems can interview patients via a chatbot and narrow the possible diagnoses based on the answers given, similar to how a human clinician might obtain the history.

AI systems have the ability to reference a medical database to perform these tasks very efficiently. Such AI systems will become increasingly important moving forward considering that the amount of healthcare information doubles – yes, doubles – every 18-24 months, making it increasingly difficult for clinicians to keep current without the assistance of such technology systems. AI patient interviews also streamline medical record-keeping, allowing clinicians to concentrate on the more important tasks of diagnosis and treatment plans.

Specialty Consults Become More Timely

Another advantage of ATH is the ability to perform specialty consults in a timely and efficient manner. An excellent example is teledermatology, where the exchange of high-definition photographs and video (plus the EHR patient record) of skin diseases allows the dermatologist to diagnose and treat a patient asynchronously in a high percentage of cases. Similar strategies can be implemented for many other specialty consults.

Asynchronous Care is New Standard

These are just a few examples of the advantages of ATH. This is truly healthcare for patients when they want it and how they want it in the 21st century. For these reasons, the adoption and improvement of ATH moving forward will continue to grow exponentially and the state and federal ATH rules and regulations will adapt to these advances, as they are already doing, at an ever-increasing pace.


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