Telemedicine is the practice of medicine through a remote electronic interface, allowing a doctor to diagnose, treat, or monitor a patient without being in the same room. It’s the largest segment of the broader telehealth industry, and as of 2024, 71.4% of physicians in the United States use it weekly, up from just 25.1% in 2018.
How Telemedicine Works
Telemedicine visits fall into three categories based on how information moves between you and your provider: real-time visits, store-and-forward messaging, and remote monitoring.
Real-time (synchronous) visits are what most people picture. You and your provider connect over video or phone at the same time, just like an in-person appointment but through a screen. These work well for consultations, follow-ups, and mental health therapy sessions.
Store-and-forward (asynchronous) visits don’t require both parties to be online simultaneously. You might submit photos, lab results, or a written description of your symptoms through a portal or app, and a provider reviews them later. This model is common in dermatology, cardiology consultations, and even neurology, where a specialist can evaluate your records without scheduling a live call.
Remote patient monitoring involves devices that continuously or periodically send health data to your care team. Think blood pressure cuffs, glucose monitors, or heart rhythm trackers that transmit readings automatically. Your provider reviews the incoming data and follows up if something looks off. This approach is especially useful for managing chronic conditions like diabetes or heart disease over months or years.
Which Specialties Use It Most
Telemedicine fits some medical fields better than others. Psychiatry leads by a wide margin: 85.9% of psychiatrists conducted a video visit in a typical week in 2024, and 68.2% delivered more than 20% of their total visits through telemedicine. This makes sense. Mental health care is conversation-based and rarely requires a physical exam.
After psychiatry, the specialties with the highest telemedicine use (measured by share of visits exceeding 20% virtual) are neurology at 32.2%, endocrinology at 24.2%, gastroenterology at 20.4%, and family medicine at 20.1%. On the other end, specialties that depend on hands-on examination or procedures use it far less. Ophthalmology sits at just 1.8%, dermatology at 3.7%, and emergency medicine at 4.3%.
What You Need for a Visit
The setup on your end is straightforward. You need a broadband internet connection, a device with a camera and microphone (a smartphone, tablet, or computer), and access to whatever video platform your provider uses. A broadband connection of roughly 50 to 100 Mbps is typically sufficient, though if other people in your household are streaming video or on calls at the same time, you may need more bandwidth. Cellular data connections often produce poor video quality, which can make visits frustrating or unusable.
Most providers send you a link to a secure video platform before your appointment. Some health systems have their own apps, while others use third-party platforms designed for medical visits. You don’t usually need to install anything beyond a standard app or browser.
How Outcomes Compare to In-Person Care
For many conditions, telemedicine produces results comparable to traditional office visits. A large study of nearly 243,000 Kaiser Permanente patients found that those who had early telemedicine contact with primary care were more likely to complete routine blood sugar testing (91% for video patients versus 86.7% for those with no visit) and had slightly better blood sugar control overall. Electronic consultations also tend to be faster: one analysis found a median response time of 3.7 hours for e-consults compared to 7.3 hours for in-person referrals, with more than half of requests resolved electronically without needing a face-to-face appointment.
Telemedicine is not a replacement for every type of visit. Conditions requiring physical examination, imaging, blood draws, or procedures still need an in-person setting. But for follow-ups, medication management, mental health care, and initial consultations for many common complaints, it performs well.
Insurance and Medicare Coverage
Most private insurers now cover telemedicine visits, though the specifics of your copay and which services qualify vary by plan. For Medicare beneficiaries, coverage has expanded significantly. Behavioral health services delivered via telemedicine are permanently covered regardless of whether you live in a rural or urban area, and you can receive them from home.
Medicare also permanently allows audio-only visits (phone calls without video) for patients who can’t use or don’t consent to video technology, as long as the provider has video capability available. This is an important distinction: you won’t be denied a telehealth visit simply because you lack a webcam or aren’t comfortable with video. For non-behavioral-health services, some temporary telehealth flexibilities introduced during the pandemic have been extended through early 2025, with ongoing policy updates determining which services remain on the permanent telehealth list.
Privacy and Security Protections
Telemedicine visits are subject to the same federal privacy rules (HIPAA) that protect your information during in-person care. Providers are required to use platforms with encrypted transmissions, meaning your video call and any health information shared during it should be scrambled in transit so it can’t be intercepted. Recordings or transcripts of sessions, if they exist, must also be secured with encryption and access controls.
On the provider’s side, HIPAA requires that they conduct visits from private settings whenever possible. If privacy isn’t fully achievable, they’re expected to take reasonable steps like lowering their voice and avoiding speakerphone. Providers must also verify your identity before a visit if you’re not an established patient. On your end, choosing a quiet, private room for your appointment helps protect your own information.
The Digital Divide Problem
Telemedicine’s convenience depends on having reliable internet access, and not everyone does. In Cleveland, Ohio, more than 30% of residents lack basic internet connectivity or reliable service. Among Cleveland residents living in poverty, over 70% lacked broadband internet at home as of a 2020 survey. Black residents in the city are six times more likely than white residents to lack a broadband connection.
This gap creates measurable problems. A University Hospitals analysis found that patients relying solely on a cellular data plan with no other internet subscription were significantly more likely to miss scheduled telehealth appointments. Patients without a computer showed the same pattern. The people who could benefit most from avoiding the time and cost of traveling to a clinic are often the same people who can’t reliably connect to a video visit.
Nationally, 17% of Black Americans are considered smartphone-dependent, meaning a phone is their only way online, compared to 12% of white Americans. Younger adults, those with lower incomes, and those with less formal education have the highest rates of smartphone dependency. When telemedicine platforms require stable broadband and a computer with a camera, these populations face a real barrier to access that risks widening existing health disparities rather than closing them.