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When to use real-time telehealth

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There is no doubt that telemedicine conducted via pre-recorded interaction is more convenient than using real-time interaction: it is not necessary to arrange a simultaneous meeting between ‘client’ and ‘expert’. Furthermore, a lower-bandwidth connection will usually suffice (e.g., the Internet), which will be cheaper, as will the equipment required at each end. 

On the other hand, a real-time consultation allows an immediate result to be obtained. If the expert requires additional information from the client, it can be provided immediately. The delays intrinsic to the use of email, for example, are avoided. In addition, the real-time interaction between client and expert contains a strong educational component. As well as (one hopes) providing an answer to the immediate query, there is an element of continuing medical education in the encounter, if not at first consultation, then certainly as consultations continue over time. This educational benefit of real-time telemedicine is hard to quantify but has been reported by several well-established programs. When should real-time telemedicine be preferred to prerecorded telemedicine? When the importance of an immediate result outweighs the disadvantages of inconvenience and cost. For example, if a teleconsultation was required for a more urgent situation, a store-and-forward interaction would be unsatisfactory.