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Will Store-and-Forward Video Technology Overtake Live Video Chat?

There has been a rapid growth in the creation of new technologies aimed at delivering health-related services that promote a cost-efficient, widely accessible link to care

people taking notes at medical conference
What implications are associated with the possibility of asynchronous, or store-and-forward, technology surpassing live video?

The proliferation of technologies to deliver health-related services has grown significantly in the past few years, promoted as a cost-efficient, widely accessible link to care. A white paper published by FAIR Health indicates that between 2016 and 2017, national utilization of telehealth grew 53 percent, and other findings point to the market’s prospective $93.45 billion valuation in 2026.

Several different systems have been deployed for telehealth—primarily video-conferencing, remote patient monitoring, mobile health, and store-and-forward technologies. However, the discussion surrounding telehealth most frequently focuses on live video applications, in which both provider and patient must be present and online simultaneously.

But what if asynchronous, or store-and-forward, technology is beginning to surpass live video?

Asynchronous technology helps the health care safety net

Presenting at the NCCHCA 2019 Primary Care Conference, Nick Galvez—Rural Hospital Manager from the Office of Rural Health at the NC Department of Health and Human Services—outlined the various benefits and drawbacks of each telehealth system, explaining store-and-forward outcomes for health centers. Because store-and-forward systems allow providers to transmit health information to external specialists to solicit information outside of real-time interactions, asynchronous technology gives providers operating in rural or underserved areas a unique opportunity to access specialty medical consults for their patients without compromising on care. Galvez offered an example of a rural provider sending a patient’s X-ray images to a specialist through secure channels, and receiving a diagnosis through email.

Studies support improved outcomes of asynchronous technology

The benefits of store-and-forward technology are multipronged, leading to advantages across the spectrum of care including improved treatment quality and decreased costs. Studies indicate that routine specialist referrals can be replaced by store-and-forward programs, and eConsults improve providers’ treatment plans. Moreover, store-and-forward technology decreases wait times for specialty appointments and significantly lessens the cost of care due to reduced avoidable specialist visits, testing, procedures, and ER visits.

A study conducted by researchers at the Johns Hopkins University School of Medicine and published in Open Forum Infectious Diseases demonstrated the viability of leveraging asynchronous technology like emocha for medication adherence. With costs related to nonadherence exceeding $300 billion annually, the providers harnessed a decades-old public health practice called Directly Observed Therapy through video and human observation: thus making the process affordable and scalable. The study not only achieved medication adherence rates greater than 90 percent, but also cited additional benefits including increased flexibility, convenience, and patient privacy.

Virtual communications tools like emocha leverage asynchronous technology to support patient’s health, but are unrestricted by the limitations imposed on most other store-and-forward telehealth services. Pairing these asynchronous applications with specific supports like human engagement has been clinically proven to enhance outcomes, with a paper in JAMA demonstrating that low-cost reminder devices used in the study would have likely been more effective if coupled with interventions to ensure consistent use.

Future market viability for asynchronous technology

In an article that details how asynchronous services might be well-poised to take over the direct-to-consumer market, prominent telehealth attorney Nate Lacktman—speaking at the Xtelligent Healthcare Media’s Value-Based Care Summit on Telehealth earlier this month—focused on the differences between audio-visual telemedicine platforms and store-and-forward services, determining that the latter could be “the next big thing in consumer-oriented telemedicine.” New billing codes included in the 2019 Medicare Physician Fee Schedule that reimburse providers for specific asynchronous interactions with patients represent further confirmation that store-and-forward technology is gaining traction.

Giving providers an alternative to live video, Lacktman reinforced the flexibility and convenience of store-and-forward technologies, which allow both providers and patients to access the platform on their respective schedules. Given that live video-based programs require the coordination of scheduling and “a huge operational cost” for all involved parties, the platforms can cause friction, coupled with less efficiency and lower adaptability. The main operative difference between live video-based care and asynchronous technologies lies in the latter’s scalability: enabling health centers, hospitals, and health systems to easily integrate into their workflows, and create a sustainable model that works for all members of the care continuum.