Real Time Audio and Video – Quality Level – Telehealth Features Series

In this Telehealth Feature Series, we’re going to cover the long list of potential telehealth features available today.  As you’re considering your own approach to telehealth, we will provide you a look at all the possible features telehealth companies are offering on the market.  Plus, we’ll offer our insight into the nuances of each feature so you can select the right telehealth company or companies you use.  Not all telehealth is created equal, so taking the time to understand all the possible features and options is worth the effort.

The next feature we’re going to cover is Real Time Audio and Video – Quality Level.

It feels like this feature almost doesn’t need to be discussed.  Of course you need to have high quality real time audio and video in order to do a live video telehealth visit.  It’s worth noting that there are a lot of “telehealth” companies out there that don’t do live video.  Instead they opt for asynchronous text messaging to provide care (asynchronous text vs video is a discussion for another day).  That’s one caveat to consider as you decide on the right partner.

The real question most people are asking is if their telehealth company provides a reliable, high quality video stream.  This is a hard question to answer because there are multiple layers to it.  First, “high quality” can mean something very different to different people.  If I’m doing a simple primary care visit for a standard cold, then I don’t need nearly as high quality video as if I’m doing a dermatology or wound care visit where I really need to be able to see what the issue is, the color, etc.

The good news is that most telehealth companies are now at the point that the video is of high enough quality that it’s not a differentiating feature except for these very special cases like wound care telehealth.  One fascinating approach I’ve seen in dermatology telehealth is where the patient sends over high quality pictures (luckily most of us carry a high quality camera in our pockets now) of their wound, skin issue, etc so that the dermatologist can assess the health issue using the high quality pictures as opposed to the generally lower quality video.  This is a great combination of asynchronous text messaging with pictures combined with live video telehealth.

Reliability is a different issue and is really hard to assess.  As of yet, we haven’t seen any services that have assessed the uptime of telehealth companies.  Certainly a number of them had problems when COVID-19 hit and everyone started moving to telehealth, but I haven’t heard of many problems since that initial hit.  In fact, it’s likely that most telehealth companies have scaled up so much that as in person visits return most telehealth companies will have excess capacity now which should make them more reliable.

However, the real problem measuring this is that it takes two to tango when it comes to reliability.  The telehealth service can be up just fine, but if the doctor or patient’s internet connection or computer has problems, that still can cause issues of reliability.  I’m not sure anyone has mastered fully how to ensure that reliability.  Although, some telehealth companies are touting the fact that their live video visits were designed for low bandwidth situations (ie. many rural telehealth situations).  This can definitely be a differentiating point for a healthcare organization to consider if a large part of their patient population doesn’t have high speed internet.

The good news is that this problem is much easier today than it was even 10 years ago.  Many of the live video telehealth solutions can even work with a person’s phone over a 4G cell phone connection.  While there are still pockets of challenges especially in rural areas, internet speeds have gotten better and the video compression has gotten better.  So, this is less of an issue today.

Be sure to check out our full list of telehealth features, our deep dive into each telehealth feature, and our list of telehealth companies.

About the author

John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.