In this series of blogs, Translating Healthcare, we will highlight and break down the meaning of phrases and terminology that are increasingly used, but not always widely understood. Today, we'll be unpacking the definitions of synchronous and asynchronous and examples of how they apply to the medical world. 

Synchronous vs Asynchronous

On a basic level it might be clear that these two words refer to opposing things and have something to do with time… but how does their meaning they apply to healthcare?

The terms "synchronous" and "asynchronous" are showing up with increasing frequency on medical blogs, websites, and articles, especially after virtual care or telemedicine exploded during the COVID-19 pandemic. You may have even heard them directly from the mouths of healthcare providers, legislators and supporters of synchronous and asynchronous telemedicine.

Though you may be generally familiar with the meaning of “synchronous” and “asynchronous” it’s always helpful to have a refresher of the exact definition. Let’s consult the trusty Merriam-Webster dictionary:

Synchronous: 1) happening, existing or arising at precisely the same time; 2) recurring or operating at exactly the same periods

Asynchronous: 1) Not simultaneous or concurrent in time; not synchronous

Essentially, these terms refer to whether or not something is happening simultaneously, or at the same time. But how does that apply to synchronous vs asynchronous communication in healthcare? 

From Letters to Telemedicine

The healthcare connection fundamentally lies in the use of these terms regarding remote communication. In general, communication methods have experienced a bit of a bell curve between the two over time with the adoption of different virtual technologies.

Letters were, of course, an example of early asynchronous communication. You write a letter, put it in the mail (or send through a similar courier service), and at some other time in the future, the person you want to communicate with will read it.

Then with the advent of the telephone, remote communication became synchronous. People could communicate simultaneously, with no delay, and have a real-time interaction. 

Of course, modern society has reverted in many cases back to asynchronous communication examples. With text-messaging or email, for example, both people don’t need to be available to talk simultaneously. It is asynchronous, but this time, there is no delay reliant on delivery speed. These methods allow communication to occur at each party’s convenience.

Do you see where this is going? Health information communication has gone through the same transition, and these terms generally apply to telemedicine.

Delivering Health Information: Asynchronous vs Synchronous Telehealth

The original communication of health information was done by mail, courier or personal delivery by hand. Which type is this? Asynchronous with a delay.

With the introduction of telemedicine (a new enough phenomenon in the industry that it can be known by a variety of other names as well, including telehealth) synchronous solutions were introduced. Of course, the original synchronous communication in medicine is the face-to-face visit, but telemedicine synchronous solutions provide video conferences and live discussion between providers and patients.

What is Synchronous Telehealth? 

Synchronous telehealth breaks down the geographical barriers between patients and providers.

Synchronous solutions are great for patients that require a face-to-face, time-sensitive communication, but are geographically removed from their provider. An example of this in healthcare is UNC Medical Center’s 24/7 Virtual Urgent Care, which allows patients to tune into a virtual care visit with their doctor on their app.

One misconception about synchronous telemedicine programs such as video-conferencing is that they save physicians time. In reality, synchronous forms of telemedicine don't necessarily save physicians any time. The coordination required to schedule a time when both parties will be available to meet virtually and establish two-way audiovisual link between patient and their care providers may prove as time-consuming to the healthcare institution as their in-person patient appointments. However, it does expand the organization's ability to reach to more patients who may be unable to visit the physician in person —especially for specialists and hospitals located far away from them. It's also great for patients who prefer the convenience of a video call over visiting their primary care provider or local urgent care for simple heath challenges like strep throat. 

More importantly, synchronous telemedicine programs are not ideal for complex cases that require the physician to access the patient's critical diagnostic health information. While a program like the 24/7 Virtual Urgent Care is great for non-emergency conditions such as sore throats, respiratory problems, or common colds, physicians require an alternative method of telemedicine when facing a more critical case like diagnosing or treating a patient with cancer.

So, a solution is required that saves the time and money of not only the patient, but the provider as well, and that goes beyond audio-visual connection. This solution must also enable the delivery of health information and data such as medical images, pathology reports and previous diagnoses. 

What is Asynchronous Telemedicine?

If we follow the bell curve back, we find ourselves at asynchronous communication but without a delay. Meaning, now we can use remote communication to exchange information when it's convenient for each party. 

Halfway there, we find Partners Healthcare, which offers eVisits as an alternative to routine, follow-up visits for patients from Massachusetts General Hospital and North Shore Medical Center. This virtual follow-up program has patients answer a set of clinical questions from their physician online on the secure website platform, and their physician will then review and respond. 

Asynchronous: Anywhere, Anytime Convenience

At the end of the curve, we find fully asynchronous new solutions, like Purview's Expert View, which offers instantaneous delivery of diagnostic health information to a platform that the physician can access at their convenience. No coordination or schedule-shuffling required. This is especially ideal for providing (or receiving) an expert medical opinion on a patient's case. Expert View enables all critical and relevant diagnostic information to be easily and efficiently uploaded to our cloud-based platform, where the receiving physician can review it anywhere, anytime, on any device. A solution like this makes efficient use of both the patient's and the physician's time.

Does Telehealth Have to be Synchronous?  

While some are skeptical about the effectiveness of care without a face-to-face consultation, research is increasingly finding that asynchronous care not only saves time but also improves health outcomes.