The Best Telemedicine Software of 2020

Not all telemedicine software is created equal. Some feature a basic video consultation tool and nothing more. Others have a wide range of features that make them as useful as an EMR system or practice management software. Here are some of the features you might encounter when researching telemedicine platforms.

Video Consultation and Exam

All telemedicine software requires an HD audio and video connection between provider and patient. These connections must be secured to HIPAA standards at a minimum. Many video consultation tools also feature the ability to bring in multiple additional parties as needed, like another healthcare provider or a patient's family member.  

Telemedicine App Some telemedicine platforms offer a mobile app. In some cases, a downloadable app is available for both Android and iOS mobile devices, while in other cases it is only available on one or the other. A telemedicine app generally brings the same features as the desktop software to a mobile format. Some telemedicine software is only available via web browser, however.

Connected Devices The more advanced telemedicine platforms integrate with smart medical devices. These hardware tools allow providers to dispatch a medical assistant or midlevel provider to the patient's location to take readings of their vitals, for example, or examine the patient more closely. Some hardware is capable of sending high-definition video and images, such as the interior of a patient's ear. Telemedicine platforms with connected medical devices offer an opportunity for advanced digital exams, rather than just simple consultations.

Image Capture Most telemedicine software offers some form of image capture, which allows providers to save images from a video exam. This is especially useful for platforms that employ connected medical devices and diagnostic tools, such as those for ear, nose and throat examinations.

Patient Messenger If you need to send your patient additional instructions, educational materials or captured images, many telemedicine platforms offer patient-to-provider chat. On some platforms, the chat can also be used to alert waiting patients if a provider is running late for their appointment.  

Annotation Tools

Some telemedicine programs offer annotation tools that allow you to draw on images to highlight certain areas for the patient. These tools are not necessary but can be a nice for explaining diagnoses or conditions to patients over video chat.

Data Export

If your telemedicine software is integrated with your practice management software or EMR system, you can export data captured during your remote visits and exams directly to those systems. For billing, data export to your practice management software ensures proper coding and claims generation, helping the back office to get you paid for your digital visits. For clinical notes and patient charts, exporting data like vitals and any captured images to an EMR system is useful.

Front-Office Features Some telemedicine software offers front-office tools, such as appointment setters and reminders. These tools make it easy to manage your queue of digital visits separate from or alongside your in-person appointments, whichever you prefer. Another useful feature is a digital waiting room, where patients can queue as they wait for their appointment.

If, like many medical practices, you're new to telemedicine software, it's important to know what you're looking for. You might want a comprehensive platform designed for advanced remote examinations, or a simpler platform mainly for video consultations. The following factors should help you decide which telemedicine platform is right for your medical practice.

Specialty

The needs of a primary care physician are different from the needs of a mental health specialist or dermatologist. Any platform that claims to fit all types of practices is unlikely to meet your practice's unique needs. A hospital might require telemedicine software for remote patient monitoring, for example, while a practice is more likely to engage in video consultations. If you are a multispecialty practice, consider a versatile and comprehensive platform with diagnostic tools. If your focus is mental health, a simpler video conferencing platform could be adequate to run virtual sessions.

Goals

Consider your goals as a practice. Are you looking to offer telemedicine solutions to reduce unnecessary appointments and no-shows? Or are you interested in telemedicine to schedule remote check-ins for patients with chronic conditions? Some practices want a telemedicine solution that can effectively digitize entire exams by sending a medical assistant to the patient's location with connected diagnostic devices. The goals of your telemedicine program will determine the type of platform you need, so carefully consider what you want out of telemedicine software before researching the market.

Implementation and Training

All telemedicine software requires an implementation period, much like EMR software. How extensive it is depends on the complexity of the system. During implementation, the vendor will configure the platform to your requirements and offer training to your providers and staff. Sometimes, implementation and training are included in the setup costs; other times, this is an additional fee. Choose a partner with a good track record of supporting and training medical practices at the outset. The implementation and training period plays a big role in a practice's success with any healthcare IT software.

Ease of Use

You want telemedicine software that is easy for your staff and providers to use. Even an advanced platform with a lot of features and tools can be easy to use if the interface is neatly organized and intuitive. Convoluted software will disrupt your practice's workflows and likely make for a negative patient experience as well.

Integrations

Integrations are a key part of any healthcare IT solution. Ideally, your telemedicine platform will be able to integrate with your EMR software and practice management software. It should also integrate with any third-party applications you use for scheduling, accounting and other regular business operations.

Security

Security is critical in the healthcare space, especially for patient data. Any telemedicine software you consider should be, at the bare minimum, HIPAA compliant. The best telemedicine software employs even stronger encryption than the 128-bit HIPAA standard. It is also important to know whether a telemedicine solution stores any patient health information and, if so, how it secures it. Ideally, no patient health information will be retained by the software or any connected devices.

Additional Features and Hardware

Some telemedicine software offers additional features, such as appointment reminders, follow-up surveys and billing tools. Many platforms also work with connected medical devices, such as stethoscopes and EKGs, which can provide data to providers remotely. To narrow down your options, consider whether you will need these tools.

Pricing and Fees

As always, you should carefully consider pricing and any associated fees. Telemedicine is a relatively new and rapidly evolving space, with models ranging from simple and low-cost to comprehensive and expensive. For example, basic telemedicine software that serves mainly as a video consultation platform is generally less expensive than a platform designed for remote diagnostics and triage. Monthly subscription rates range from less than $100 per provider to more than $800 per provider, depending on the complexity of the system. In some cases, telemedicine platforms are available for purchase by capital expenditure, which can cost tens of thousands of dollars, sometimes eclipsing the $100,000 mark.

Taking each of these factors into account should make the buying journey easier. Remember, the needs of your medical practice and patients should guide your decision. Choose a system with only the features you need. Your requirements are likely very different from many other medical practices, especially those in other specialties.

Many medical practice software solutions and third-party services go hand in hand. For example, an electronic medical records (EMR) system and practice management software are closely related. A medical billing service might work within your practice management software, while a medical transcription service can help you create notes in your patients' charts, which are stored in your EMR system.

If you're looking for a full suite of healthcare IT solutions or additional medical practice services that could help improve the way your practice runs, take a look at our other medical practice review categories.

• Electronic medical records systems: An EMR system contains all the necessary clinical tools for a provider's encounter with their patients. In an EMR system, providers can review their schedules, access patient charts, e-prescribe medication, electronically order lab tests and access lab results. Some EMR systems also include tools to easily review patient histories and map trends in their health over time. An EMR system's ability to integrate seamlessly with practice management software determines how well the administrative and clinical departments work together. It can be an indispensable tool to healthcare providers, but choosing the right one is key. To learn more, see business.com's best picks page and reviews of the top EMR systems on the market today 

• Medical practice management software: Medical practice management software helps your front and back offices carry out their daily tasks. It generally includes appointment-setting software, insurance eligibility verification check features and medical billing tools. Medical practice management software also generally includes reporting tools for viewing financial information about your medical practice and charting performance over time. Integrations with EMR systems are essential for medical practice management software, as the two contain relevant information for both the clinical and administrative departments of any medical practice. To learn more, see business.com's best picks page and reviews of the top medical practice management software on the market today.
  
  
• Medical billing services: Medical billing services, also known as revenue cycle management (RCM) services, offer a way to outsource your billing department. Medical billing and coding can be complex and time-consuming processes. Maintaining an internal staff for billing and coding can become quite costly. Medical billing services generally work directly within your medical practice management software and perform coding and billing services, including follow-ups on outstanding claims and denial management. Many medical billing companies will also work to get providers at a new practice credentialed with the appropriate payers and provide additional reporting tools to contextualize a medical practice's cash flow. To learn more, see business.com's best picks page and reviews of the top medical billing services on the market today.
  
  
• Medical transcription services: Medical transcription services support the creation of internal documentation, patient charts and communications by way of audio dictation. Medical transcription services generally offer multiple ways to securely upload audio dictation and then return a transcript within 24 hours. Some medical transcription services also offer direct EMR entry, plugging in transcribed notes to the appropriate place in an EMR system, saving providers and staff time and effort. To learn more, see business.com's best picks page and reviews of the top medical transcription services on the market today.
  
  

Medical Licenses and Qualifications

While telemedicine allows you to examine and communicate with patients across long distances, federal and state health laws still apply on the internet. You must have a valid license to practice medicine in the state where you work. When using telemedicine to see a patient across state lines, you must also have a medical license for the state they're in.

Any legitimate telemedicine platform will validate your organization's or your credentials when you sign up. While this may bar physicians from practicing anywhere but their home state, as multiple medical licenses can be costly, some states' medical licenses are accepted in other select states. You can check with your state's medical board to find out where your license is accepted.

HIPAA and FDA Compliance

All the services we highlighted for this guide comply with the Health Insurance Portability and Accountability Act (HIPAA), the law that guarantees patients' privacy, and with all state medical statutes.

HIPAA is the main reason why telemedicine cannot be performed over simple live chat programs like Skype and FaceTime. Remote interactions between doctor and patient must meet the law's rigorous requirements, so these services feature not only heavy encryption of conversations, but also secured transfer of a patient's personal information and healthcare data to an approved database. Skype and FaceTime do not meet these standards, while telemedicine programs are specifically developed to meet them.

Healthcare professionals using telemedicine services are expected to adhere to the same standards of privacy and recordkeeping they would practice with in-person appointments. The devices you use to remotely monitor and examine patients must be approved by the Federal Food and Drug Administration. Reputable telemedicine companies provide only FDA-approved products, but it ultimately falls to you to make sure you're practicing medicine with legally certified technology.

Rules for Writing Prescriptions

The rules for prescribing medication over telemedicine platforms vary from state to state. Some states allow doctors to freely prescribe medication remotely, while others restrict the types of drugs that can be prescribed, limiting narcotics and other controlled substances. Some states do not allow remote prescribing at all, requiring an in-person appointment.

Insurance Companies and Telemedicine

Telemedicine is an emerging platform, with the technology constantly changing and improving. While most (not all) private insurers have some type of coverage for remote care, Medicare and Medicaid plans don't always follow suit.

Private Insurers

As of December 2019, 39 states plus Washington, D.C., maintained some version of a telehealth parity law. Telehealth parity laws require private insurers to reimburse telemedicine visits at the same rate as a comparable in-person visit. Because of this, many insurers include telemedicine services and memberships as part of their benefit packages in hopes of keeping clients healthy.

Medicaid

As of December 2019, all 50 states plus Washington, D.C., required some level of Medicaid coverage for telehealth visits, although many of these only allow live video chat and nothing beyond that. Certain state medical boards also have exceptions for telemedicine and Medicaid, so you should check with your local board if you plan to support patients on Medicaid.

Medicare

With Medicare, a patient can expect to generally pay the same copayment as they would to receive services in person. Medicare telehealth services include office visits, psychotherapy, and other uses of live two-way video and audio feeds. The patient must be at an approved medical facility, not at home. This means geography is an important consideration in whether you should implement telemedicine services for elderly patients on Medicare.

Direct Payment

Since insurance can be a tricky obstacle for telemedicine platforms, some allow patients to pay your practice directly through the software, using major credit cards and sometimes FSA or HSA cards.

There are many telemedicine solutions out there, so we asked the experts which ones they use or recommend. The answers varied greatly, as one might expect, depending on an expert's vantage point and particular requirements. Here's what they had to say.

Dilraj Kalsi, lifestyle doctor and founder of Hippocrates Lounge

"As a solo practitioner in my business, I have had to optimize the workflow of my telehealth service, leveraging many different tools and connecting them into a unified experience. Initially, I used Doxy.me, which was really smooth. Unfortunately, they later limited the video quality of the free version and the waiting room became glitchy.

"While I was with Ortus-iHealth, I utilized their app too, which is smooth when a signal is available at either side, but requires a patient login to be set up and an app to be downloaded, making it difficult to integrate with other services from my website.

"Lately I have used Jitsi, as it is free, open source, secure and modifiable."

Brian Harris, founder of dental telemedicine software Smile Virtual

"You can't go wrong with the big players, in my opinion. eVisit has been around for so long they've got a lot of the kinks figured out.

"You want to be careful with more of the small startups, only because you don't know what they don't know. You don't know where they're at as far as security … you're better off just going with market leaders for simplicity's sake and ease of use.

"All of them are different. The ones that work well that I've seen have just got to be seamless. What will keep doctors from using it and keep patients from using it is if it's not user friendly."

Ryan McQuaid, co-founder and CEO of telehealth network PlushCare

"One of the main challenges to [telemedicine] adoption is that you've built your practice and committed to brick-and-mortar infrastructure. Your entire workflow has been seeing patients in person … Virtual care completely changes that dynamic; you need a new workflow and a new system for scheduling that hopefully integrates with your legacy system."

The following are FAQs from healthcare providers researching telemedicine software for the first time. Here are some answers for quick reference to help you get started.

How do telemedicine systems work?

At their most basic, telemedicine systems involve a secure, high-definition video and audio connection between a patient and a healthcare provider. Telemedicine systems range from simple video conference tools to perform a secure medical consultation to sophisticated software and hardware combinations for diagnosing conditions and developing treatment plans.

How do you market telemedicine services?

When you begin offering telemedicine services, it's important to let your patients know it is an option. Placing signage in your physical location and notifying patients on your website and social media platforms are the first steps to make them aware of it. Sign-ups for telemedicine services can reduce unnecessary office visits, cancellations and no-shows, saving your practice time and money.

What type of telemedicine solution do you want – an integrated or stand-alone one?

Integrated telemedicine solutions are generally preferable to stand-alone software. Integrated solutions connect to your existing EMR system, practice management software and other third-party applications your medical practice uses every day. Integrations allow the seamless export and import of relevant data from one system to another. Integrations are essential to realize the efficiencies that healthcare IT solutions promise.

What are the software and hardware of telemedicine?

Some telemedicine platforms consist only of software; however, the more advanced solutions can integrate with web-connected medical devices. These include Bluetooth-capable stethoscopes, EKGs and other tools necessary to conduct a full remote examination. For example, GlobalMed's TotalExam 3 camera can be outfitted with multiple attachments to deliver real-time ear, nose, throat or skin exams. In accordance with HIPAA security requirements, it is important that connected hardware does not retain any patient health information.

Is telemedicine covered by insurance?

Telemedicine is covered by insurance at the same rate as physical visits in 39 states plus Washington, D.C., where there are standing telehealth parity laws. Elsewhere, private insurers have sometimes opted to reimburse telemedicine visits on a case-by-case basis. With Medicaid, telehealth reimbursement varies from state to state, though all 50 states offer some form of Medicaid coverage for telemedicine. Medicare coverage is limited to patients engaging in live two-way telemedicine visits from covered facilities, not private homes.

How do you set up telemedicine?

You'll usually set up telemedicine software in concert with the vendor – a process known as implementation. Implementation can take just a few days for simple software or a few weeks for advanced solutions. During the implementation period, vendors will often customize the software to suit your practice's existing workflow. The company will also usually train your providers and staff on how to use the new software properly.

How much does telemedicine software cost?

Telemedicine solutions vary significantly in cost. Some software is available for a monthly subscription, which can be less than $100 per provider or as much as $1,200 per provider. More complex solutions are also available for purchase as a capital expenditure, which can run from the tens of thousands to hundreds of thousands of dollars. Capital expenditure models are typically used by large hospitals and health systems, rather than small or midsize independent medical practices.

What are the benefits of telemedicine?

Telemedicine offers an easy and cost-effective way for providers to connect with patients. It allows simple consultations to be done quickly over a remote connection, as well as follow-up visits for patients with chronic conditions. It can reduce the number of no-shows and last-minute cancellations, which saves medical practices time and money. Furthermore, it widens the scope of patients a medical practice can accommodate to include those in isolated or rural areas and those who have a difficult time coming in for a physical visit.

What are examples of telemedicine?

Telemedicine can be used in a number of ways. A primary care physician might use telemedicine to ensure a patient's vitals are in check, especially if they are managing a chronic condition. A psychiatrist might use telemedicine for remote or emergency sessions. A dermatologist might employ connected hardware to examine a patient's skin issues remotely. The possibilities of telemedicine are numerous and varied, depending on your practice's specialty and the needs of your patients.

Does telemedicine software integrate with your existing workflow?

The best telemedicine solutions integrate with existing healthcare IT platforms, including EMR systems and practice management software. Telemedicine implementation should not be overly disruptive to a practice's existing workflow. Rather, it should dovetail with the way a brick-and-mortar medical practice is already run. Look for solutions that are compatible with all your existing systems – or vendors that are willing to build new integrations where they do not yet exist.