Table 1.

Definitions of telemedicine modalities.

Telemedicine Approach	Performance	Advantages	Limitations
E-consult	Provider to provider electronic asynchronous communication	• Easy access to expert advice • Reduced wait time for answers to consultative questions • Eliminates travel to a specialist • Improved access to care • High provider satisfaction	• Increased work load for the requestor of the e-consult • No insurance reimbursement
E-visit	Patient and provider electronic asynchronous communication	• Progress report without requisite travel to office • Enables treat-to-target with laboratory monitoring	• No insurance reimbursement • Not widely available
Asynchronous visit	Provider to provider transmission of information for interpretation at any time	• Eliminates patient travel to a specialist • Accumulation of data that is forwarded as available to specialist	• Patient is not present for the evaluation
Synchronous visit	Patient and provider May also have provider with patient	• Teleconferencing between patient and specialist; there may be a second provider present with the patient • Eliminates patient travel to a specialist • Two- way communication and interaction in real time between patient and specialist • Ability to obtain additional information in the assessment • Ability to provide clinical evaluation and management recommendations in real time	• Limitations to the physical examination