This guide is directed at patients for personal care. If you are a doctor's office looking to work with telemedicine, refer to our guide on telemedicine for health care professionals.

What is Telemedicine?

Telehealth is a growing industry because of its convenience. Patients can speak to a doctor via an app or other telecommunications program to get a diagnosis or prescription for common ailments. Telehealth physicians aren't just for when you don't want to go to the office for a simple matter. Technology and cloud-based computing has resulted in monitoring equipment that sends results directly to the doctor for temperature, heartbeat, blood sugar levels and other vital signs, which enables doctors to address issues remotely. 

Many insurances and health care centers offer telemedicine as an alternative or supplement. Therefore, we narrowed our examination to 14 telemedicine services that work directly with customers. These are companies take patients on an individual basis; while some will accept insurance, you do not need to go to your insurance company to use them. While this is a new field, you can find many companies that do urgent care consultations, but some offer specialized services such as second opinions or psychiatric care, so we chose some of the best in their areas of expertise.

Best Telemedicine Service for Urgent or Off-Hour Care

Anyone with a child knows that the fever or vomiting hit after the doctor's office closes. Many times, the nurse hotlines simply instruct you to go to the ER if you are concerned, but you can spend hours in an uncomfortable waiting room only to find the child had a bad cold. Many telehealth services have doctors on call after hours who can give you expert advice – or the reassurance you need to get some sleep after tucking your toddler in with his teddy bear and some Children's Tylenol.

American Well

American Well (AmWell) offers 24/7 online doctor visits for one low fee. Doctors can diagnose your ailment and prescribe medications as needed. This service is for general, urgent but non-emergency illnesses only. It offers certified physicians with an average of 15 years' experience each. This telemedicine service accepts insurances and works with major health care programs.

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Best Telehealth Service for Finding a Specialist

Qualified, experienced specialists are joining telehealth organizations to expand their reach, gain new patients and help others outside the local area without putting additional burden on families. 

You can use telehealth venues to find experts for second opinions, consultations and for finding an expert you not only believe can help you but whom you feel comfortable with – all without traveling. This is especially important when you live in a rural area or have a rare condition because the doctor may live in another state. You may still have to travel for procedures, but you do so knowing you have chosen a doctor you can trust, and you might be able to conduct follow-up appointments from your

2nd.MD

2nd.MD is a network of specialists in over 120 medical fields. It's pricier than most of the telemedicine services we examined, but its doctors trained or practice in some of the top U.S. institutions. It provides a consultation (often days after the request), and, when applicable, experts can recommend local experts or facilities that can best help you.

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Best Telehealth Service for a Second Opinion

SecondOpinions.com

SecondOpinions.com can connect you to experts in over 39 fields of medicine, from allergies to oncology, radiology, MRIs and more, in order to get you a second opinion. This service offers three levels – written assessment, phone consultation and video consultation – with varying prices. Its doctors are board certified and experienced in their field. It's an economical way to get a second opinion from a qualified expert when you are unable or unsure about seeking assistance from someone in your local area.

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Best Telehealth Services for Mental Health

Doesn't it seem counterproductive to deal with white-knuckle traffic to see your psychologist about your anxiety issues? Telemedicine can allow you to converse with your mental health professional via webcam. Some psychiatrists say it's actually a better way for them to talk to their clients because they can also gauge their mental state by the state of their dress and living area.

Inpathy

Inpathy connects you to online psychologists and psychiatrists in any of the 50 United States, Washington D.C., or Puerto Rico. Counselors cover a range of issues from substance abuse to bipolar disorder or marriage counseling. Psychiatrists can prescribe medicines electronically. This telepsychology service works with employers and partners with insurance companies, but you can register independently. Prices vary.

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Virtual In-Home Care

It may seem counterintuitive to suggest home health care via telemedicine, but with modern devices that can do things like test blood chemistry and send the results to a physician, it can spare the homebound some of the expense of house calls. In fact, studies have shown that the incorporation of telemedicine in a home health care plan significantly reduces the number of doctor's visits and hospital stays. Telemedicine might be offered to you after a hospital stay or surgery; if not, you can ask about it. However, this telemedicine service is done in conjunction with the hospital or doctor, not as an individually contracted service.

If you are looking for telemedicine in conjunction with hospice, look for home health and hospice organizations that offer telemedicine for some routine checkups or emergency calls. It might require purchasing equipment, such as a blood sugar monitor that uploads results to the physician's system.

Online Security & Telemedicine

HIPAA Compliance. Long story short: If a telemedicine service is not compliant with Health Insurance Portability and Accountability Act regulations (HIPAA), then don't use it. Period. Any reputable service that works with actual licensed health care professionals in the U.S. is going to be HIPAA compliant. Just like a regular doctor's office must comply with HIPAA, so should your telehealth service.

That's because it's way too easy to have personal health information in the most anonymous or vague consultations. The fines for noncompliance are hefty, so any reputable service that wants to have a real presence in the telehealth industry complies with them. If the service you're considering does not, then look elsewhere.

Secure Communications and Payment. Any telemedicine service you choose should protect your privacy, not just with doctor-patient confidentiality but in how it secures your records and protects payment-processing venues. Thus, we highly recommend that you make sure any service you work with is PCI DSS complaint.

PCI DSS stands for Payment Credit Industry Data Security Standards. It's primarily for financial information, but many other online services follow the same standards when it comes to encrypting information for transmission and storage. Remarkably, while encrypted transmissions and data storage are considered "addressable" by HIPAA, that only means is encouraged, not required. This may not be as big a concern when dealing with your local doctor, but online, security is a top concern. It's especially important to ensure your telemedicine service uses PCI DSS level encryption in these cases:

- Completing billing and other financial transactions
- Sending sensitive medical information to the doctor for consideration

What Else to Seek in a Virtual Health Care Professional

Unlike when you go to the ER and are under the care of whichever doctor is on call, you have the ability to choose the best telemedicine service for you. Therefore, whether you choose one of the 10 services on our list or seek out another one, take time to research that the company offers qualified and competent medical staff to fit your needs. Here are some tips to help you:

Licensed in your state as well as their own. Each state has its own licensing laws and regulations, and while most states are enacting laws to take telemedical services into account, not every telehealth service works in all 50 states. Even if the telehealth service does work in your state, with some, you may have limited choices. This is especially important when consulting with specialists, as you are less likely to find one in your state than if you are looking for a family physician. Further, some states require separate protocols for prescribing medication virtually, so be sure to ask about this as well.

Member of the American Telemedicine Association (ATA). The ATA is a non-profit professional association of 10,000 members in the health care industry. It offers its members training through webinars, courses and conferences. Physicians and companies who are members of the ATA have access to cutting edge telemedicine technology and the latest advances, plus continuing education specifically focused on treating patients in the virtual arena.

Vetting processes. Just because a doctor is licensed does not mean they are the best. Check the online bios, FAQs and hiring pages to get a feel for what experience and qualifications the telehealth service considers when bringing physicians and nurse practitioners into its group. Look for:

- Years of practical experience
- Specializations
- Completed background checks
- Training on virtual consultation and protocols

Diagnosis and testing procedures. In cases where you may need more specialized tests, check the procedures. You may need to visit a local lab or purchase or rent specialized equipment. In some cases, especially when looking for a specialist, your local primary care physician may conduct the tests.

When you meet with your new doctor, ask questions and bring up concerns, just as you would with a regular doctor. In addition to making sure you are clear on matters concerning your health, it gives you the chance to see if this is a doctor you might like to "visit" for routine matters in the future

Payments & Health Insurances

Some telehealth companies put you on a plan, where you pay a monthly subscription fee, while others charge per visit. In nearly all cases, however, telemedicine services are not meant to replace your primary care physician but to supplement your care, provide consultations when your regular doctor can't schedule you in a timely manner, or to provide off-hours help in urgent but non-emergency situations.

Telemedicine is proving cost effective across the spectrum. Patients save money in travel costs and time away from work, physicians and health organizations cut down their overhead, and insurances have lower costs to reimburse. Therefore, many medical insurance plans are including a virtual physician system as part of their plans.

In addition, many telehealth services take insurance, including, in some cases, Medicaid and Medicare. Those that don't often work to keep prices as low as possible in order to account for the cost difference. You may find that a visit to the virtual doc costs less than your copay. Even so, it's worth asking if the telehealth service takes your insurance and what the insured rates are.

Equipment Needed

Telemedicine is often as simple as Skyping and downloading an app to use on your computer or phone. In most cases, no extra equipment is needed; just a good internet connection and a video camera on your computer or else a smartphone or tablet.

In most cases, a telemedicine service is used for urgent but non-emergency cases, so you probably don't need a monitoring device for these once-in-a-blue-moon televisits. If you are working with a teledoctor on a longer-term basis, he or she will advise you on the best device to get. The technology is still new. Fitness trackers, in particular, may not be accurate enough for diagnostic purposes.

Other Questions About Telemedicine Services

How can the doctor diagnose me without a physical examination? In many cases, a description of the symptoms and your medical history is enough to diagnose common ailments. With video technology, you can send photos or video to the doctor – such as if he or she wants to see a rash. If they think the issue needs physical examination, they will recommend seeing your doctor or going to the emergency room.

Can I use the same telemedicine company when I'm traveling stateside? Yes! If you have telemedicine services through your insurance company or health care provider, you will need to check the rules. Otherwise, if the telemedicine service can serve the state you are visiting, then you can receive care through it. Some services provide international care; find a service before you go abroad. HealthTap, which is on our list, provides worldwide health care.

Are there budget telemedicine services available or budget versions of the services? Aside from SecondOpinions.com, the services charge a flat rate per visit unless they allow individual doctors to set their own prices. The prices are usually lower than a standard doctor visit, though not always less than a co-pay, and definitely less than an emergency room visit.

Conclusion: When Should You Have a Virtual Doctor On Call? 

There are times when only hands-on medical care suffices. There are times when the human touch makes all the difference in the world. And there are times when a visit to the doctor feels like a waste, even if your medical issue is addressed to your satisfaction. For those times when dealing with a health issue can be just as easily accomplished with a video conversation and perhaps some simple diagnostics, telemedicine offers convenience and expertise without the hassle or expense of traveling to the doctor's office.