Telemedicine is defined as the provision of clinical services via telephone or video and is a type of telehealth. Telehealth is defined as the use of electronic information and telecommunications technologies for the delivery of health care, health education, and health information. During the COVID-19 pandemic, telemedicine availability and use of telehealth care significantly increased. The integral role of telemedicine during this time prompted the unprecedented integration of telehealth as a quasi-standard of care. Recent studies have shown telemedicine can achieve comparable or superior quality performance compared with in-office visits for a range of clinical areas in large primary care populations. Implementation of telemedicine at the practice level depends on use of strong clinical workflows across the medical team. Effective telemedicine visits rely on adaptation to a digital environment and patient cooperation for virtual physical examinations. There are subtle differences in coding for billing telemedicine visits (mainly for audio-only visits), and many add-on codes for preventive care are eligible for telehealth. Concerns exist about the ethical implications of virtual care, especially regarding privacy and access. The future success of telehealth will depend on a balance of patient autonomy and health outcomes in the context of health equity.

Case 2. MB is 34-year-old patient who comes to your office with a 2-day history of right-sided low back pain. He says the pain started after he helped a neighbor move a washing machine up a flight of basement stairs. Acetaminophen has not improved the pain, which radiates into the posterior proximal right leg. He contacted your office via patient portal messaging. The medical team e-triages MB for red flag signs and symptoms via messaging, and he is scheduled for a telemedicine visit.