The basic difference
Telehealth.HHS.gov describes synchronous care as a live interaction between a provider and patient. Examples include video visits, audio-only calls, and live secure messaging when appropriate.
The same HHS resource describes asynchronous telehealth, also called store and forward, as information shared between providers, patients, and caregivers at different points in time. Examples can include an intake form, photos when clinically appropriate, uploaded readings, portal messages, or follow-up information reviewed after submission.
When a live visit may help
A live visit can help when the clinician needs to ask questions in real time, observe how you look or speak, discuss symptoms in detail, confirm instructions, or decide whether another care setting is safer. It can also help when you are new to telehealth and want a direct conversation.
Live care still has boundaries. A video or phone visit does not make every condition suitable for online treatment. The clinician may recommend an in-person visit, urgent care, emergency care, testing, or follow-up with another professional.
When asynchronous review may help
HHS describes asynchronous direct-to-consumer telehealth as a model often used for intake or follow-up care. It can help gather standardized information, let patients complete forms on their own schedule, and give the clinician a record to review.
Asynchronous review may still lead to a live visit or a request for more information. It should not be treated as a shortcut around clinical judgment, consent, state requirements, or safety checks.
What patients should expect
Before a visit, ask which format will be used and how you will receive instructions. For live visits, confirm the link, phone number, timing, privacy expectations, and backup contact method. For asynchronous care, confirm what information is required, how long review may take, and how follow-up questions are handled.
For more on the first step, see what happens after telehealth intake. For privacy questions, see telehealth privacy.
Common questions
Is asynchronous telehealth the same as automated approval?
No. Asynchronous care means information is shared and reviewed at different times. A clinician still needs to apply clinical judgment.
Is a video visit always required?
Not always. Requirements can vary by state, care type, clinical concern, and the clinician's judgment.
Can a clinician switch the visit type?
Yes. A clinician may request a live visit, more information, testing, referral, or in-person care if the submitted information is not enough.
References
- Getting started with telehealth
- Asynchronous direct-to-consumer telehealth
- Licensing across state lines
Sources checked on October 1, 2026.