Table 1.

Classification of telehealth encounters

Platform	Use Case(s)	Opportunities	Limitations
E-consult: Asynchronous clinician-to-clinician communication based on record review (inpatient and outpatient)	During and after initial surge: Assist frontline clinicians with triage of urgent patient referrals Assist frontline clinicians with management of low complexity patients where there is limited capacity among specialists	Time efficient for specialists, consolidates care for patients New inpatient clinician-to-clinician billing codes available Patient-initiated second opinion requests are possible	Potentially shifts work to frontline clinicians Lack of physical exam or direct communication with patients
Remote patient monitoring:Gather patient outside traditional healthcare setting via connected device or patient reported outcomes (synchronous or asynchronous)	All phases: efficient method of patient care, especially those with chronic conditions	Respond to clinical data outside of regular clinic visits Recordings can be automatically sent to clinicians Payers support remote patient monitoring activities	Requires staffing infrastructure Data ideally is integrated into EHR for sustainable workflow
Patient-initiated messaging: Synchronous chats with automated or live agents Asynchronous patient portal messaging	All phases: time-efficient handling of straightforward issues.	Patient initiates communication when convenient Able to get FAQs and use self-service tools Live or autonomous text-based options	Requires technology infrastructure and staffing Potential lack of context, requires tight integration with the EHR to be optimally useful
Telephone visit: Synchronous patient-clinician communication by phone	During and after initial surge: replace some face-to-face visits	Universally accessible, even in the most ill/low socioeconomic status patients	Currently devalued by most payers, inability to conduct a physical exam, loss of nonverbal cues
Video visit: Synchronous patient-clinician communication with both audio and video, with possible ancillary and telemetry equipment	During COVID-19 surge: replaces face-to-face visit After initial surge: expansion of virtual interactions across all sectors of the healthcare system; unbundling of services through technology	Slight improvement in clinical care (nonverbal communication, physical exam depending on bedside facilitator and peripherals) More favorable reimbursement by payers	Technology requirements: Outpatient requires broadband Internet, computer/smart device; may need digital peripherals (eg, stethoscope, otoscope) Most complex/sickest patients may be least able to participate/access care Inpatient requires mobile/zoomable camera with microphone and speaker Need infection prevention/sanitization protocol for devices

COVID-19: coronavirus disease 2019; EHR: electronic health record.