Asynchronous Care (E-visit) vs Live Video Telemedicine: Cost, Time & Risk Trade-offs for Pediatric Care

Audience: pediatric

Telemedicine offers two common ways to get medical advice for children without visiting a clinic in person: asynchronous care (also called E-visits) and live video visits. Asynchronous care lets you send your child's health information and questions through a secure platform at any time. A healthcare provider reviews it later and responds with advice or treatment plans. Live video telemedicine connects you and your child with a provider in real time for a face-to-face consultation using video. Each method has benefits and limitations. Asynchronous care is often quicker and can cost less, but it may miss subtle signs that a live video visit could catch. Live video allows for more detailed interaction but usually requires scheduling and may take more time. Choosing the right option depends on your child's symptoms, urgency, and the type of care needed. Understanding these trade-offs can help you decide the safest and most convenient way to get care for your child.

Red flags — go in person / ER

• Your child has difficulty breathing, persistent high fever, or blue lips — seek emergency care immediately.
• Sudden severe pain, uncontrolled bleeding, or signs of dehydration require urgent in-person evaluation.
• If your child becomes unresponsive, has seizures, or shows signs of severe allergic reaction (swelling, difficulty swallowing), call emergency services without delay.

What telemedicine can do

• Minor skin rashes or irritations
• Medication refills or questions
• Follow-up on stable chronic conditions
• Mild cold or flu symptoms without breathing difficulty
• General health advice and education

What telemedicine cannot do

• Severe or worsening breathing problems
• Signs of dehydration or severe pain
• Sudden changes in consciousness or seizures
• Severe allergic reactions or anaphylaxis
• Any emergency requiring immediate physical examination or intervention

What Is Asynchronous Care (E-visit)?

Asynchronous care, or E-visit, is a way to communicate with a healthcare provider by sending messages, photos, or health information through a secure online platform. You do this at any time, and the provider reviews it later and replies with advice, prescriptions, or instructions. This method does not require scheduling or real-time interaction.

What Is Live Video Telemedicine?

Live video telemedicine connects you and your child with a healthcare provider through a video call at a scheduled time. It allows the provider to see your child, ask questions, and observe symptoms in real time. This can help with more detailed assessments and immediate feedback.

Cost and Time Considerations

Asynchronous care often costs less and can be more convenient since you can send information anytime and avoid scheduling. Live video visits may take more time due to scheduling and require a stable internet connection. However, live video may reduce the need for follow-up visits by allowing better evaluation during the session.

Risk and Safety Trade-offs

Asynchronous care may miss important physical signs because the provider cannot see your child live. This can delay diagnosis or treatment for urgent issues. Live video allows providers to observe your child’s appearance and behavior, improving safety for more complex or urgent concerns. However, neither method replaces emergency care when needed.

Choosing the Right Option for Your Child

Use asynchronous care for minor issues like simple rashes, medication questions, or follow-up on stable conditions. Choose live video telemedicine when your child has symptoms that need visual assessment, such as breathing problems, unusual behavior, or worsening conditions. Always seek in-person care if symptoms are severe or worsen quickly.

How to prepare for your tele-visit

• Ensure a stable internet connection for live video visits.
• Gather your child's recent medical history and current medications.
• Prepare a quiet, well-lit space for the consultation.
• Have a list of symptoms, questions, and concerns ready.
• For asynchronous care, take clear photos of visible symptoms if needed.
• Be ready to provide your child's vital signs if possible (temperature, breathing rate).

After your tele-visit

• Follow the provider’s instructions carefully.
• Monitor your child’s symptoms and note any changes.
• Schedule an in-person visit if symptoms worsen or do not improve.
• Keep any prescribed medications accessible and use as directed.
• Contact your healthcare provider if you have questions or concerns after the visit.

FAQs

Can I use asynchronous care for urgent problems?

Asynchronous care is not ideal for urgent or emergency problems because the provider reviews your information later. For urgent issues, live video or in-person care is usually safer.

What if my internet connection is poor?

If your internet is unstable, asynchronous care might be better since it does not require real-time video. However, poor connection can limit the quality of live video visits.

Can telemedicine replace all in-person visits for my child?

Telemedicine can handle many health concerns but cannot replace all in-person visits, especially for emergencies, physical exams, or procedures.

How do providers ensure privacy during telemedicine?

Reputable telemedicine platforms use secure, encrypted systems to protect your child's health information and privacy.

Will my insurance cover telemedicine visits?

Coverage varies by location and insurance plan. Check with your provider or insurer about telemedicine benefits.

Sources

1. Telehealth: What You Need To Know — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Telemedicine: Overview — Centers for Disease Control and Prevention (CDC).
3. Pediatric Telehealth: Opportunities and Challenges — American Academy of Pediatrics (AAP).
4. Telemedicine and Telehealth — Mayo Clinic.

This information about telemedicine options is educational and not a substitute for professional in-person medical care. If your child has severe or worsening symptoms, seek immediate medical attention from a healthcare provider or emergency services.