Compared to other facets of modern medicine, telemedicine is still very much in its infancy stage. The tools leveraged within traditional healthcare settings are still being steadily adapted, refined, and advanced to meet the needs of both telehealth companies and patients seeking care. And as the entire healthcare industry continues embracing new and exciting communication technologies, telemedicine delivery models are quickly evolving, as well. 

Store and forward is one such delivery model that is growing and thriving in our ever-connected digital world, especially in virtual care settings. Below is a general overview of the store and forward model, when it is and isn’t beneficial, as well as the implications it can have on telemedicine providers and physicians.

Defining Telemedicine Delivery Models

It’s important to first understand the key difference between synchronous and asynchronous service models in relation to healthcare providers.

• Synchronous – This model is defined by services that occur in real-time without any additional transmissions of data before or after.
• Asynchronous – Commonly referred to as “store and forward”, this delivery model relies on data and information sharing outside of real-time consultations.

Just because synchronous and asynchronous are two very different communication approaches doesn’t mean that a healthcare provider couldn’t combine and leverage both in their organizational services. The two delivery models commonly intertwine.

Regardless, store and forward delivery models are much less reliant on synchronous communications, which might explain why emerging telehealth organizations continue to expand upon their asynchronous processes.

What is Store and Forward?

In the telemedicine industry, store and forward is a type of service delivery model in which a patient’s clinical information is collected and sent electronically to another site for evaluation. The term basically encompasses how telemedicine care providers gather, store, and share access to patient medical information that physicians use to provide effective care.

This data that is stored and forwarded might include medical history, laboratory reports, test results, images, videos, sound files, and so on. It’s important to note that store and forward methodologies are not always appropriate for every field of medical care, but several notable specialties are perfectly suited for this type of care model.

Examples of Store and Forward 

While the concept of store and forward is pretty much the same across various medical specialties, the actual processes involved and files shared might change depending on the ailment, and the type of physicians and specialists doing the collaborating. For example:

• In Primary Care – A  primary care physician reviews stored clinical patient data, makes a diagnosis and implements a treatment plan such as direct-to-consumer pharmaceutical program oversight.
• In Teleradiology – A radiology specialist is provided x-rays that were taken at a remote location or after hours, then reviews them before forwarding them back to the referring physician and/or consulting with the patient.
• In Teledermatology – A  dermatologists receives digital images of a patient’s skin condition and patient data for viewing, diagnosing and treatment.
• Endocrinology – Much of the treatment is based on the data collected from remote patient monitoring (RPMs), so telemedicine endocrinologists rely on store and forward technology to constantly monitor and modify treatment plans (adjustments to medication, hormones, etc.) based on the data collected from the patient.

The above are just a few examples of how specific medical specialists already rely on store and forward applications to handle a mixture of everyday scenarios at their practices. However, the benefits of store and forward go much further beyond just these applications.

Benefits of Store and Forward in Telemedicine

User-Friendly, Secure Applications

Store and forward technology platforms and applications have proven to be extremely easy and inexpensive to use and maintain. Meanwhile, HIPAA compliance is an essential software feature for any providers in this arena; thus, platforms specific to healthcare offer compliance assurances as well.

Scheduling Flexibility

The primary care physician, specialist, and patient do not all have to be available at the same time for a group consultation appointment as long as the data can be shared outside of that face-to-face setting. Instead, the specialist can review the medical data/files at their earliest convenience and reply back to the 

Improves Workloads for Specialists

With the emergence of store and forward, increased access to care and decreased wait times for patients to see specialists has resulted in more work for specialty physicians in general, particularly those who are solely focused on telemedicine.

Convenience

There is no travel involved. Patients can be located anywhere, so long as the patient records are securely accessible. This means doctors can “see” patients from wherever they are and conduct real-time consults on an as-needed basis.

Reduced Wait Times for Diagnosis & Treatment

Reports from medical specialists, especially in telemedicine care processes, are typically made available within a few hours of the request. This information is not only available to the physician specialists and primary care physicians, but the patient as well. He or she can also access their test results much sooner than if they had to schedule an in-person appointment for the physician to read them their test results.

Second Opinions

Store and forward helps expedite the process of obtaining second opinions because the data files can be easily bundled and forwarded to a second physician or specialist, almost instantaneously.

Encourages Thorough Data Review

As patients, we’ve all experienced a situation where an old school physician enters the examining room and barely glances at the charts and files right in front of them, but instead relying primarily on a dialogue with the patient and/or nurse. In a telehealth setting, the files themselves are all that the specialist or physician has to work with, so they must remain especially attentive to the information those files contain – more so than they would in a traditional  clinic or office-based practice setting.

Breaks Down Language and Cultural Barriers

Store and forward all but eliminates the need for physicians, specialists, and patients to speak the same language. This greatly increases the markets and demographics in which healthcare professionals can provide care. 

Disadvantages of Store and Forward

Despite its wealth of advantages, there is certainly some instances and scenarios where store and forward might not be ideal for both patients and telemedicine professionals. For example:

• Incomplete Data – Often times, medical specialists need to conduct their own in-person physical examination or consultation with the patient. With store and forward, these valuable face-to-face consultations and appointments are still certainly possible, but it might only be after the specialist has reviewed the patient records and determined that they don’t have enough information to adequately complete the consultation.
• Delayed Diagnosis & Treatment – In a perfect world where the specialist, patient, and primary care physician are all in the same room (or video conference) at the same time, diagnosis and treatment could be expedited since live consultations help practitioners comprehensively review the information, then conclude and move onto the next phase of care for the patient. Though store and forward typically does reduce diagnosis and treatment times, the aforementioned ideal is not even a possibility, particularly when addressing more complex health issues.
• Insurance Reimbursements – Many private insurers will only reimburse for real-time consultations performed via telemedicine, and even Medicaid legislation (as of this writing) varies on a state-by-state basis. This makes it difficult for larger store and forward telemedicine clinics to leverage this model consistently across multiple markets.
• Tech Complexities – Generally, telemedicine companies, themselves don’t the have the resources or know-how to architect and build complex tech platforms used for storing and forwarding clinical data, let alone securing the entire application. This technology is almost always provided by a technology vendor, and it can be a costly, yet necessary, expense for telemedicine companies to streamline their operations. 

Telemedicine Staffing in a Store & Forward Model

It’s crucial to staff your telemedicine organization with providers that are not only familiar with store and forward methodologies and tools, but also capable of delivering exceptional care in face to face settings. If you have any questions, or need assistance finding top medical talent for your organization, contact Medlink to set up a free consultation.