What is Asynchronous Telehealth? How It Can Help Your Patients, Clients & You?

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HERE IS HOW

Most providers have now been acquainted with synchronous, otherwise known as “real-time” telehealth, typically using audio or video connections to hear and see their patients and clients. In asynchronous telehealth, otherwise known as “store-and-forward telehealth, communications between the client and provider occur at different points in time. 

The user sending the message can direct it to the appropriate destination to be stored until the receiving user has time to access it. Books, movies, and newspapers are asynchronous. Some examples of asynchronous methods used extensively in healthcare include:

• Postal service (inexplicably called snail mail by the cognoscenti)
• Telephone voice mail
• Email messages
• Online forums or discussion lists where consumers go for self-help and where professionals go for informal referrals and group consultation
• Faxes for transmitting clinical test results from the laboratory to nurses’ desks, or release of information forms from one office to another
• Text messages as in “texting” that gets retrieved later (smartphones represent a converging technology where both synchronous and asynchronous exchanges can take place)
• Distance learning material posted on the World Wide Web in a host of professional educational programs, including yours truly here at the Telehealth.org

Asynchronous telehealth might involve completing a client intake form, medical, medication, or psychosocial history, symptom checklists, surgical reports, lab reports, file transfer of radiology images, nutritional records, or informed consent documents. In behavioral health, asynchronous telebehavioral health includes the transmission of the information, then the client waits for the provider to examine the information, review, and make notes for questions to ask. The provider reviews this information to diagnose the client and to provide a treatment plan.

In the behavioral world, an example of asynchronous telehealth may involve recording a structured substance use disorder intake conducted by a well-trained addictions professional. The recording of that intake can then be forwarded by a HIPAA compliant cloud storage service to a psychiatrist at a different location to review the interview, render a diagnosis and develop a treatment plan. That treatment plan then would be returned to the addiction professional via secured digital transmission for implementation. Many healthcare specialties are utilizing the convenience of this store-and-forward telehealth option as an adjunct to audio and video visits.

Asynchronous Communication Advantages

Asynchronous communication has two inherent advantages over synchronous communication:

1. Moving information at a leisurely pace to a recipient’s system, where it can be accumulated and then later played back at full speed, imposes less demand on transmission channels and is, therefore, less expensive.
2. Store-and-forward techniques allow one to retrieve material whenever convenient, avoiding scheduling issues.
3. Asynchronous telehealth provides more opportunities to research and organizes a response.
4. It also allows the communicators to work less quickly than when an immediate response is needed.

However, as with most technologies, asynchronous communication modalities also carry some disadvantages in some contexts. By definition, prompt responses to questions or needs are neither assured nor likely. Therefore, asynchronous communication methods are generally unsuited for use in emergencies.

UnityPoint: An Example of Asynchronous Telehealth Usage

UnityPoint is one healthcare system that utilizes artificial intelligence health technology (AI) to conduct asynchronous telehealth services. AI in healthcare is an umbrella term used to refer to computers and other machines to mimic human cognition. These systems are capable of learning, thinking, and making decisions. They also can take actions, such as making recommendations based on data collected. At UnityPoint, an AI-based questionnaire is applied to identify client/patient concerns before the provider reviews the information. An algorithm sorts through client/patient responses and knows the next relevant question to the patient. The provider is then supplied with a recommendation for the client’s/patient’s diagnosis and treatment, which the prover can accept, reject, or modify. The client/patient will receive a message once the provider has reviewed the questionnaire. Clients/patients will either be told through this message that a prescription has been sent to their pharmacy, or they may receive a prompt asking them to see their provider through a video or face-to-face visit. This process begins entirely with asynchronous telehealth.

Benefits & Precautions to Take

Asynchronous telehealth provides efficiency for the client/patient, allowing more flexibility in interacting with their provider. Suppose a client/patient struggles with routine issues rather than an emergency. In that case, they have the option to report their symptoms and receive the treatment they need rather than wait to be seen in person. When used carefully, synchronous telehealth can improve the overall client/patient experience, allowing people to navigate the healthcare system to receive the level of care they need based on their condition. For clients/patients who require a higher level of care, the systems can offer suggestions based on the content of the information gathered. For instance, the communication would tell the patient or client to come into their provider’s office for an in-person visit.

The benefits for providers include many time savings benefits. By the time the provider comes in contact with the client/patient, they have extensive background information. They may have had the time to review the reported symptoms and formulate the next questions or arrange for other tests to be performed. Providers, however, do recommend that asynchronous telehealth be approached with prior professional education, as being unable to see a client’s/patient’s in-person means that the provider can miss important information, and the client/patient may suffer delays in receiving the care they need.

Asynchronous Telehealth in 2022

Asynchronous telehealth services are expected to expand in 2022. Ultimately, providers may work in a call center-type of setting whereby they receive incoming requests from clients/patients, review the information, and provide the needed service. Asynchronous telehealth is expected to be refined with artificial intelligence to become a widespread option and eventually address higher acuity needs.

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