Understanding Synchronous & Asynchronous Telehealth 

When researching your options for telehealth and telehealth solutions, you will likely hear about the two forms of telehealth: synchronous and asynchronous. Understanding how these forms of telehealth differ and what makes each a worthwhile form to consider is critical to achieving the goals of your telehealth program. In this blog, we will define these forms of telehealth, explain some of their benefits, and then identify a few applications for each form.

Synchronous Telehealth

The Office of the National Coordinator for Health Information Technology (ONC) defines synchronous telehealth as live video-conferencing, which is a two-way audio-visual link between a patient and a care provider. The U.S. Department of Veterans Affairs (VA) states synchronous telehealth requires the presence of both parties at the same time and a communication link between them that allows a real-time interaction to take place.”

Asynchronous Telehealth

ONC defines asynchronous telehealth as store-and-forward video-conferencing, which is the transmission of recorded health history to a health practitioner, usually a specialist. VA states, asynchronous telehealth involves acquiring medical data, then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline.


Synchronous telehealth provides timely care, especially in emergencies or urgent situations, and maintains the concept of the doctor-patient relationship by enabling a face-to-face analysis and treatment. The physician is able to see the patient, conduct, an examination and engage in conversation, much as the patient would in an office visit. Synchronous audio-video telehealth consults resulted in short-term cost savings by diverting patients from more expensive care settings. Overall, synchronous telehealth models improve convenience, access, and efficiency of care by offering walk-in telehealth services.

With asynchronous telehealth, patients can get timely specialty care without needing to travel beyond the location of their primary care providers. Wait times for specialty care are lessened, especially in areas with shortages of medical specialists. The store-and-forward process of asynchronous telehealth can overcome language and cultural barriers. A study published in the Journal of General Internal Medicine that compared blood pressure control and healthcare use between patients who received ‘virtual visits’ structured as asynchronous online interactions and typical hypertension care concludes, “Among patients with reasonably well-controlled hypertension, virtual visit participation was associated with equivalent blood pressure control and reduced in-office primary care utilization.


Applications of synchronous telehealth include the following:

  • Video conferencing connects emergency providers with medical specialists who otherwise would not be available for consults.
  • Primary care providers can consult with medical specialists who are not available locally.
  • Medical specialists can examine patients in remote locations when distance is a barrier, as is the case when patients live in rural and underserved urban areas. This includes situations where the physician needs to directly observe the patient.
  • Language translators can provide video interpretation services to multiple locations, a cost-effective expansion of these programs.
  • Synchronous telehealth is helping improve medication management. Essentially, telepharmacy leverages technology to allow one pharmacist to provide supervision and review prescriptions at multiple locations. Patients pick up medications from a nearby licensed location staffed by pharmacy technicians and have access to the same counseling with a pharmacist at the remote location as they would at the home pharmacy, only it is done via a screen rather than in person.

Applications of asynchronous telehealth include the following:

  • In radiology, physicians at small rural hospitals can forward X-rays or MRIs to specialists at major medical centers for review.
  • In dermatology, primary care providers can take digital photos of their patients’ skin conditions and forward the images to dermatologists for review and determination of treatment if needed.
  • In ophthalmology, eye screenings for diabetic retinopathy, a disease that is a major cause of blindness among individuals with diabetes, can be captured digitally by retinal cameras and transmitted to a specialist for review.
  • In Urology, receiving a computed tomography image or a photo of a genital lesion for expert opinion. 

Even though CMS has expanded telehealth coverage beyond pandemics, most providers are struggling to get accurate reimbursement for telehealth services. In this article, we have defined synchronous & asynchronous telehealth services along with advantages and applications only for reference purposes. If you need any assistance in outsourcing medical billing for telehealth services, contact us at info@medicalbillersandcoders.com / 888-357-3226

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