Synchronous vs. Asynchronous Communication in Healthcare
As providers and payers continue to look for ways to drive down the cost of health care, more and more focus turns to telehealth and telemedicine – basically, the use of technologies to deliver care in a virtual setting rather than in person.
While telemedicine previously faced barriers of acceptance from both physicians and patients, the COVID pandemic fast-forwarded the adoption of telehealth practices. In fact, the need for alternative treatment options was so great that the U.S. government temporarily relaxed HIPAA requirements to make telehealth appointments more accessible via existing technologies.
The result was many more providers seeing the value of telehealth options – from virtual follow ups to remote well-checks – to not only reduce the in-person traffic to offices and EDs, but to offer better care to patients previously underserved due to location or other factors that made it hard to schedule an appointment with a provider. Patients similarly have begun to see the benefit of connecting with their providers from the comfort of their own home, realizing that in many situations, care can be just as effective as when sitting in the office.
Two Types of Telehealth Communication
As the telehealth movement continues to gain momentum, two distinct branches of telemedicine are evolving based on the type and timing of communication entailed. The terms “synchronous” and “asynchronous” are commonly tossed about when discussing telehealth options, and while many health care professionals understand the basic definitions of the words, the way they are applied to telemedicine deserve a bit more explanation.
Synchronous Communication: Live and in Real Time
When something is synchronized, of course, it is happening in perfect timing with something else. When it comes to telehealth, synchronous communication means the real-time exchange of data and information, typically via a virtual examination or visit. This can mean a video call, a live phone call between patient and doctor, or even a chat.
The value and purpose of synchronous communication is to deliver or ascertain urgent information to make an immediate decision for care. In an emergency setting, for example, the concept of Mobile Integrated Healthcareis gaining traction, allowing EMS staff to use telehealth technology to connect patients in their home with physicians and specialists. Based on this video or phone conference, a better decision can be made as to if and where the patient needs to be transported, rather than taking all patients to the ED. These options drive down the cost of health care by reducing the number of unneeded transports and ED visits, while also getting the patient more appropriate and timely care.
Additionally, new telehealth-enabled instruments, such as a video otoscope or an electronic stethoscope, make virtual visits even more accurate, as in-home health aides, nurses, technicians, or paramedics can use them to deliver detailed data directly to the physician or specialist on the video call. The digital data can be instantly stored and connected to the patient’s records as well and used to track progress during future visits.
Another form of synchronous communication can be found in modern alerting softwareused by EMS agencies for communication with receiving hospitals. Today’s top alerting software can capture critical patient information at the scene using smartphones and tablets, and securely transmit data, photos, and videos to the ED to alert them of incoming EMS transports. This information helps the ED better prepare for high acuity cases, contact all necessary staff, and activate labs, saving valuable time and facilitating better patient outcomes.
Asynchronous Communication: Without Delay but at Your Convenience
The second element of telemedicine that works closely with the first is asynchronous communication; that is, data transmitted to be reviewed at the convenience of either party. Although this information is typically not of the urgent nature, today’s technology does allow it to be transmitted without delay to a physician or a patient.
The value of asynchronous communication is that it allows providers more opportunity to develop diagnosis or treatment plans when they have more time and the ability to reference resources and research. Asynchronous communication also facilitates communication with specialists who may be working in another facility or even another time zone, without the stress of coordinating schedules.
Similarly, patients can receive instructions and follow up guidelines from providers via email, making it easier to save, print, and reference when needed. This communication can also be shared securely with approved caregivers and also stored in the patient’s digital files to be referenced in the future by other providers as needed.
In the world of prehospital care, asynchronous communication can be a valuable learning tool for EMS agencies. Today’s EMS software tools for bidirectional communication with hospitalsallow EDs to share patient outcomes with EMS agencies, providing real-world examples of what was or was not caught in the field, what worked well, and the final diagnosis. EMS agencies previously had little or no information on a patient’s well-being after drop-off. With closed-loop reporting, agencies can make better treatment decisions for future calls based on what they learn. This is especially helpful in hard-to-diagnosis cases like sepsis.
Working Together for a More Accurate Diagnosis
As telehealth undoubtedly will continue to evolve and find its proper place in the healthcare spectrum, the potential benefits to providers, payers, and patients are numerous. Rather than a blanket approach to every 911 call, telemedicine and its associated technology offers more efficient ways to get the patient the proper treatment, at the proper location, in the proper timeframe. No more waiting for endless hours in over-crowded EDs with overburdened staff. Fewer high-priced ambulance transports when a primary care visit the next day would suffice. And fewer patients suffering from avoidable conditions due to their location or their inability to visit a doctor in person.
The key to telemedicine is the balance between synchronous and asynchronous communication, and how it works together to give providers a rich and complete picture of the patient’s condition. It may become apparent that this approach delivers perhaps an even more accurate depiction of the patient’s health and allows for even better patient care in the decades to come.
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