Real-Time Versus Store-and-Forward Telehealth Technology

This article was originally published in July 2015 but was updated in January 2023.

When it comes to clinical telemedicine, there are two general categories that most “sharing” technologies tend to fall into: live real-time and store-and-forward technologies. Knowing the differences between the two, as well as their unique advantages and considerations, is essential for making the best-informed decisions regarding your facility’s investment in the technology needed for telemedicine within your practice.

Knowing the differences between real-time and store-and-forward telehealth is a matter of clinical appropriateness and will also have an impact on patient and provider experience.

The basics: Store-and-forward vs. real-time technology

The major way in which capture, store, and forward technologies differ from their real-time counterparts is that they don’t involve live interactions with patient data as it is being collected. Instead, all the relevant data — which can include patient records, MRI scans, test results, X-ray photos, and other essential data — is gathered together into a file and sent to the necessary professionals via a secure encrypted internet connection. Once the practitioners receive the data, they can then study and analyze it as though they were in the clinic when it was collected.

Real-time telemedicine technologies, as you might have guessed, are more immediate. They provide remote healthcare providers with live access to the exam site, not just with video conferencing technologies but also via live streaming medical images, documents, and video. This allows for a truly interactive experience between the patient and clinician, making the clinical assessments more “humanized” and similar to those conducted in face-to-face appointments.

“I get very satisfied when I see that I can offer care to a child remotely, follow up with that child, and see that they are back to normal. Let’s use this technology to reach patients and not wait for them to come to us.” — Dr. Renson Mukhwana, Pediatrician at Gertrude’s Children’s Hospital

The differences: When to use each telemedicine technology

Although the difference between live real-time technology and store-and-forward versions is simple and straightforward, it can have significant implications for your practice depending on your goals. These asynchronous telemedicine applications are typically used by specialty practices in fields such as radiology, ophthalmology, dermatology, and others. These fields usually involve doctors and nurses relying on documented information and images rather than physical examinations.

In contrast, real-time technology is very effective for practitioners who see large numbers of patients, do frequent follow-up visits, or must provide immediate advice to patients who require medical attention. For example, a clinic that specializes in geriatric care can use live real-time telemedicine solutions to consult remotely with patients for regular checkups, eliminating the need for arranging transportation to the clinic — as well as the associated costs.

The benefits of real-time telemedicine

Either choice might be sufficient for your practice, but there are certain benefits real-time telemedicine offers over store-and-forward platforms. The most significant advantage is time. Patients, even those in rural areas, no longer have to travel to see physicians. In instances where patients are consulting with specialists, live consultations can help practitioners render immediate, on-the-spot diagnoses or treatment suggestions, rather than patients having to transfer to different facilities for second opinions or consults.

Patient experience, trust, and satisfaction are other significant benefits offered by live technology. The ability for patients and providers to interact directly can boost the level of patient understanding required, better ensuring that transitional care is completed effectively. This is especially important in geriatric cases, where treatment plans and medication schedules must be strictly monitored by transitional caregivers to avoid costly readmissions and unnecessary complications.

Another important distinction is that the reimbursement policies from private insurers vary between real-time and store-and-forward technologies. According to the Center for Connected Health Policy, many private insurers do not reimburse for nonreal-time consultations performed via telemedicine, and even Medicaid legislation varies on a state-by-state basis. 

Related Articles
• A Buyer’s Guide to Telemedicine Platforms
September 16, 2022
• The Effects of Telemedicine on Patient Engagement and Care Options
September 8, 2022
• Telemedicine for Beginners: How to Introduce Staff to Telehealth
July 5, 2022