How Telehealth Works
By the UnitedWellness editorial team · 6 min read
Telehealth has become a normal part of how people access medical care, but a lot of people still aren’t sure exactly how it works - what happens in an appointment, who they’re actually talking to, or what online medicine can and can’t do. This guide covers the basics clearly.
What telehealth actually is
Telehealth means receiving medical care through a digital connection rather than in person - typically a video call, phone call, or in some cases an asynchronous questionnaire reviewed by a provider. The care is provided by licensed healthcare professionals: physicians, nurse practitioners, physician assistants, or licensed therapists, depending on the service.
The “tele” part is about the delivery channel. The medicine is real. A licensed provider conducting a telehealth visit has the same credentials and legal obligations as one you’d see in an office.
How appointments work
Most telehealth services follow a similar process regardless of the category of care. The general flow:
- Intake questionnaire - you answer questions about your health history, current medications, symptoms, and what you’re looking for. This is typically done before your first appointment.
- Provider review - a licensed provider reviews your intake. Depending on the platform and state, this may happen asynchronously (they review and respond without a live call) or synchronously (a scheduled video or phone appointment).
- Consultation - the provider discusses findings, asks follow-up questions, and makes recommendations. For prescription services, this is when a clinical evaluation occurs.
- Treatment or referral - if a prescription is appropriate, it’s sent to a pharmacy. If the provider determines your situation requires in-person evaluation, you’ll be referred out.
- Follow-up - ongoing care through the platform, typically including check-ins via message or scheduled appointments to monitor progress.
Synchronous vs. asynchronous care
Synchronous telehealth means a real-time appointment - a video call or phone call at a scheduled time. Asynchronous care means you submit information and a provider reviews it and responds on their own schedule, often within 24 to 48 hours. Many platforms use a mix of both depending on your state’s regulations and the type of care needed.
For some conditions and some patients, asynchronous care works well - GLP-1 prescriptions for straightforward candidates, for example, or follow-up messaging with a therapist between sessions. For others, a live consultation is clinically necessary or simply more useful. Most platforms default to the option their state regulations require.
What telehealth can and cannot do
Telehealth works well for: managing ongoing conditions with established diagnoses, prescribing medications that don’t require physical examination, mental health therapy and psychiatric evaluation, preventive care consultations, lab result review, and follow-up care for conditions being managed by another provider.
Telehealth is not appropriate for: emergencies, conditions where a physical examination is essential to diagnosis (certain cardiac or neurological presentations, for example), or psychiatric crises requiring immediate intervention. If you have chest pain, sudden severe headache, signs of stroke, or are in a mental health crisis, go to an emergency room or call 911. Don’t start a telehealth intake.
State regulations and what they mean for you
Telehealth regulations vary by state. Some states require that a provider be licensed in the state where the patient is located. Some states have different rules about what types of care can be delivered via telehealth. Some require an in-person visit before a provider can prescribe certain medications via telehealth.
In practice, this means a platform might be available in most states but not all, and the consultation format (synchronous vs. asynchronous) might vary by state. Most platforms check your state during signup and will tell you if their service isn’t available there.
Getting the most from a telehealth visit
- Complete the intake questionnaire thoroughly - the provider’s recommendations are only as good as the information they have
- Have a list of your current medications and doses ready, including supplements
- Know your family history for the conditions relevant to your visit
- Have a clear sense of your specific goal for the visit - what you want to understand, decide, or address
- For video calls: good lighting, stable internet, and a quiet private space make a real difference in the quality of the interaction