Telemedicine generally refers to the delivery of health care services using technology when the patient and provider are not in the same location. This broad category includes many methods for remote care, from simple phone calls to complex remote monitoring systems. One specific model is asynchronous telemedicine, which does not require simultaneous interaction between the patient and the clinician. This approach allows medical information to be captured, sent, and reviewed at different times. Asynchronous methods are increasingly utilized to increase efficiency and access to specialized medical expertise.
The Store-and-Forward Model
Asynchronous telemedicine is formally known as the “store-and-forward” model, which describes how medical data is handled. In this model, the initial step involves collecting clinical data from the patient or a primary care provider. This data can include high-resolution digital images of a skin condition, pre-recorded video of a physical therapy exercise, or comprehensive electronic medical history forms.
Once collected, this information is securely stored within a compliant digital platform, typically an encrypted electronic health record (EHR) system. The data is then transmitted, or “forwarded,” to a specialist who may be located hundreds of miles away.
The specialist reviews the complete package of data—including images, lab results, and patient-reported symptoms—at a time that fits their own schedule. This process allows the specialist to dedicate focused time to analysis without the pressure of a live consultation clock. After review, the specialist formulates a diagnosis, a treatment plan, or a professional consultation report, which is then sent back to the referring clinician or directly to the patient.
Key Differences from Real-Time Telehealth
The absence of a real-time interaction distinguishes asynchronous care from synchronous telehealth. Synchronous methods, such as live video conferencing or a telephone consultation, demand that the patient and the provider be present and communicating simultaneously. This difference in timing means asynchronous care provides a delayed response, whereas synchronous care aims for immediate diagnostic and advisory feedback.
The technological requirements also differ. Asynchronous care relies on secure storage and transmission protocols for large data files like medical imaging and clinical documents. In contrast, synchronous telehealth requires stable, high-bandwidth connections to support uninterrupted, live audio and video streaming.
The asynchronous model does not require the patient to be present during the specialist’s review, freeing them from the scheduling constraints of a live appointment. This approach offers greater flexibility for both parties, allowing providers to manage their workload more efficiently by reviewing cases in batches.
Synchronous care requires the patient to be actively engaged during the consultation, much like an in-person visit. This allows for spontaneous question-and-answer sessions and dynamic physical assessments that cannot be performed with stored data alone.
Practical Use Cases Across Specialties
Asynchronous telemedicine is highly effective in specialties where diagnosis relies heavily on the interpretation of static visual or diagnostic data. Dermatology is a prime example, where patients can capture and submit high-resolution images of skin lesions, rashes, or other conditions. Specialists can then review these photographs to diagnose common issues like acne or dermatitis and formulate a treatment plan without needing a video call.
Radiology is another field that operates extensively on the store-and-forward principle, often called teleradiology. X-rays, Computed Tomography (CT) scans, and Magnetic Resonance Imaging (MRI) studies are digitally transmitted from the facility where they were taken to a remote radiologist for interpretation. This allows hospitals in remote areas to access the expertise of subspecialty radiologists instantly, regardless of the time difference or location.
In ophthalmology, digital retinal cameras capture images of the back of the eye, which are then forwarded to an eye specialist for the screening of conditions such as diabetic retinopathy. Pathology laboratories also use this model by digitizing microscope slides, enabling a specialist pathologist to review and analyze tissue samples remotely for cancer staging or disease diagnosis.