Telehealth and its 4 subsets might not have been on your radar until the COVID-19 pandemic brought it into the spotlight back in the spring of 2020. But even as the pandemic’s eased up, telehealth doesn’t appear to be going anywhere any time soon. 

It’s become a particularly important tool in providing healthcare to individuals who would otherwise face significant barriers to healthcare services, such as people who live in highly rural locations or those with limited English proficiency (LEP).

Simply put, telehealth is a way for healthcare providers to digitally work with patients and interact with the public — though it’s often viewed as synonymous with live video appointments, this is just one aspect of telehealth. There are four subsets of telehealth, ranging from more intimate one-on-one video sessions with a patient and a doctor, to more wide-reaching public health campaigns. The four subsets of telehealth are as follows:

  • Remote patient monitoring
  • Mobile health
  • Live video
  • Store and forward

For individuals with LEP, telehealth can break language barriers in several different ways. Live video appointments can connect patients with doctors who speak their language but are located far away, while mobile health campaigns can be translated into different languages to ensure LEP individuals are informed about public health issues and other important medical information.

Despite all of this, the COVID-19 pandemic highlighted significant disparities in the health outcomes of patients with LEP. Throughout the early days of the pandemic, populations with significant proportions of individuals with LEP often faced the toughest outcomes when compared to their English-speaking counterparts. From insufficiently accessible (and in turn, discouraging) user journeys on telehealth portals to problems with digital literacy, the rise of telehealth made healthcare less accessible for individuals with LEP. 

As telehealth became more prominent, so too did awareness of the disparities between patients with LEP and those without.

Here, we’ll examine the four subsets of telehealth and how they can impact the care that patients with LEP receive. From remote patient monitoring to store and forward, we’ll discuss ways in which providers can be thoughtful and purposeful in the way they interact with and treat their patients who do not speak English proficiently.

The 4 Subsets of Telehealth 

There are a handful of different types of technology that healthcare providers can use when offering telehealth — each one is unique, serving different outcomes and leading to different outcomes.

Live Video Telehealth

This is the form of telehealth that you’re probably most familiar with — live video telehealth utilizes video conferencing tools like Zoom to connect patients with their healthcare providers. This allows patients to receive care from the comfort of their homes, and healthcare providers can assess a patient’s health status in real-time.

With live video, a doctor’s geographical proximity becomes less important — this allows patients with LEP to more easily connect with doctors and interpreters who speak their language without having to travel long distances.

However, video visits may also require interpreting services to ensure effective communication between the patient and the provider. Telehealth providers should always be prepared to offer virtual remote interpreting services for video visits in case a patient is and provide instructions and training materials in the patient’s preferred language.

Mobile Telehealth

Mobile telehealth includes any sort of public health messaging or medical education delivered to patients via mobile devices like smartphones or tablets. This might include a series of mass text messages sent out to alert a community about a disease outbreak in their area or more general campaigns that simply aim to promote healthy behavior.

Although these types of campaigns may not be as palpable as a one-on-one appointment with a doctor, they do play an important role in engaging individuals with LEP. By working with language service providers to translate these messages into a linguistically and culturally appropriate format, telehealth providers can ensure that these messages are as accessible and meaningful as possible.

When mobile health campaigns aren’t linguistically appropriate, prospective patients might feel alienated or discouraged from pursuing healthcare services — or worse, left in the dark about important public health information like local disease outbreaks.

Remote Patient Monitoring

Remote patient monitoring involves the use of electronic devices to monitor a patient’s health status from the comfort of their own home. These devices monitor things like a patient’s blood pressure, heart rate, weight, and other vital signs — this data can then be sent to healthcare providers to monitor and assess a patient’s health status. Healthcare providers typically use these devices after discharging a patient, in an effort to lower the likelihood of hospital readmission.

For patients with LEP, language access is critical in ensuring that they understand how to use remote patient monitoring devices properly and that healthcare providers can understand and interpret the data correctly. Providers should offer instructions and training materials in the patient’s preferred language, and offer interpreter services when necessary.

Store and Forward Telehealth

Store and forward is a form of asynchronous telehealth that allows doctors to assess a patient’s status without ever having to schedule a real-time appointment (over video or otherwise).

With store and forward, patients and healthcare providers can send photos, videos, and other health records to other specialists for analysis — for example, a patient might send photos of a skin lesion to their primary care physician, who then passes the photo off to a dermatologist for further analysis.

To ensure that LEP individuals benefit from store and forward, healthcare providers can work with language service providers to translate and interpret information about store and forward practices, so that they understand the benefit of this type of telehealth. 


Telehealth can be an undoubtedly powerful tool for improving health equity among patients with LEP. Within the realm of telehealth, there are four subsets that must be applied in different situations. For each type of telehealth service, providers must keep in mind unique considerations for patients with LEP.

To recap, here are the four subsets of telehealth and how they work:

  • Live video includes video appointments with doctors and other healthcare providers.
  • Mobile health involves any sort of public health or medical education campaign delivered via a mobile device.
  • Remote patient monitoring is the use of digital devices to remotely assess a patient’s health status and vital signs, most often after being discharged from a hospital.
  • Store and forward involves the storage and transmission of photos, videos, or other health records to specialists, allowing doctors to provide asynchronous care and assessment.

At Avantpage, we’re proud to help telehealth providers improve their approach to language access and unlock telehealth’s potential to break language barriers for patients with LEP. If you’re looking to make your telehealth services more accessible to individuals with LEP, contact us at [email protected] or (530) 750-2040.