The exact date of the first use of the concept of telemedicine is not known, however, the telegraph was used in the Civil War to transmit casualty lists and order medical supplies. Zundel (2018) reported articles in the MEDLINE database that referenced pre-MEDLINE published articles dealing with the concept of telemedicine, referred by other terms. Some of the terms were telognosis and telepsychiatry, along with phrases of “consults via television”. One of the earliest references found was published in 1950. For the last 30 years, there has been increased research on the use of advanced telecommunications and computer technologies to improve health care. The definition of telemedicine can be defined as the use of telecommunications technology to provide medical services and information. state telemedicine is the practice of medicine when the doctor and patient are widely separated and use two-way voice and visual communication, such as via satellite, computer, or closed-circuit television. Telemedicine/Medicaid.gov (2018) defines telemonitoring/telemedicine as the use of telecommunications and information technology that provides visual and audible access to heal, diagnosis, intervention, consultation, supervision, and access the electronic medical record. Telehealth is defined as telephones, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and interpretation, and though they do not meet the Medicaid definition of telemedicine, they are often considered under the broad umbrella of telehealth services (Telemedicine/Medicaid.gov, 2018). According to Telemedicine/Medicaid.gov. (2018), telehealth can be covered and reimbursed as part of a Medicaid coverable service, such as laboratory service, x-ray service or physician services (under section 1905(a) of the Social Security Act). Telemedicine