This article was originally published in Medical Economics and is written by Jon Bloom, MD.

One thing the COVID-19 pandemic has made clear is that telemedicine is a public health necessity. However, real-time, or synchronous, telemedicine isn’t sustainable or scalable. We’re already seeing synchronous telemedicine practiced on a small scale put a strain on our healthcare system during COVID-19.

For telemedicine to work at scale, it must also have a one-to-many component. In this model, data can be remotely gathered and consistently monitored over time and then used for timely and targeted communication between patients and providers. This allows care to scale from one-to-one to one-to-many.

Fortunately, a model already exists for how we can use asynchronous, oneto-many remote monitoring at scale for even the hardest-to-reach patients. The health system overseen by the VA is now successfully using asynchronous telehealth to ensure patients who cannot or should not visit a VA facility are still able to get the frequent care they need from a distance.

One such example is the effort to remotely monitor veterans at risk for diabetic amputations. Veterans place their feet on the Podimetrics SmartMat for just 20 seconds a day in their home, and the temperature data captured is automatically sent to a care management team to monitor. When early signs of issues are detected, patients and providers are notified so clinical action can be taken quickly, helping to prevent more serious complications.

Such large-scale preventive care could not be achieved through synchronous, one-to-one telemedicine. There simply are not enough doctors available to check in with every patient for even 1 minute every day. However, remote asynchronous systems can gather data over time to help prioritize synchronous telemedicine, ensuring patients receive the care they need when it matters most.

A key takeaway of the current pandemic has been the importance of telehealth; however, for it to be sustainable, we need a combination of synchronous and  asynchronous patient monitoring tools that allow for targeted communication. We should expect more healthcare providers to incorporate this kind of model to offer access at scale and save lives.

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