The Health Resources Services Administration defines telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet,
store-and-forward imaging, streaming media, and terrestrial and wireless communications. Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. There are several
other ways to define telehealth. See the below websites for further information on telehealth. • World Health Organization [PDF - 3.38 MB] • Centers for Medicare & Medicaid Services •
American Health Information Management Association • Why is telehealth important for rural providers? Telemedicine, also referred to as telehealth or e-medicine, is the remote delivery of healthcare services, including exams and consultations, over the telecommunications infrastructure. Telemedicine allows healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit. Patients can communicate with physicians from their homes by using their own personal technology or by visiting a dedicated telehealth kiosk. For patients at home, a typical telemedicine exam involves downloading an app such as LiveHealth or calling a telemedicine number, which generally is provided by a primary care physician's office or patient's employer as part of health benefits. After sharing information about medical history and symptoms, the remote patient will be connected to a clinician. Based on the clinician's evaluation, the call will end with the patient receiving further instructions -- such as to take over-the-counter medication, fill a prescription, go to a hospital or schedule a follow-up appointment. Telemedicine can be classified into three main categories:
As various parties seek more efficient ways to provide care at less cost to the patient, telemedicine's role has grown. It is often a time-saving way for a consumer to see and speak to a clinician for minor and non-urgent medical needs instead of going to a primary care physician's office or emergency department. In recent years, many states have passed laws that make telemedicine easier to practice, and federal health regulators are also exploring ways to further grant Medicare reimbursements for telemedicine services. Example of a telemedicine visit via smartphone.Advantages of telemedicineSome of the benefits of telemedicine for patients include:
The advantages of telemedicine for providers include:
Disadvantages of telemedicineSome of the challenges of telemedicine include:
Coverage and costThere are a variety of payment models to fund telemedicine services. For example, some health systems offer telemedicine consultations as part of their regular care services, and payers charge patients based on insurance plans or government reimbursement schedules. In other cases, a patient's employer offers virtual care options as part of health insurance coverage premiums. Some people may opt to independently use a telemedicine vendor for a flat fee. Currently, the Centers for Medicare & Medicaid Services is reviewing its proposal to expand telemedicine access and reimbursement in the federal Physician Fee Schedule, including by:
United States telemedicine lawsAlthough the Patient Protection and Affordable Care Act of 2010 governs telemedicine in certain situations under Medicare, telemedicine regulation for the most part falls to the states. As of spring 2018, 49 states and Washington, D.C., provide reimbursement through Medicaid for some version of live video care, according to the Center for Connected Health Policy, a group that promotes telemedicine.
CIO notes telemedicine benefits While laws about prescriptions issued through telemedicine consultations are stringent in many states, the general trend is that more states will allow these types of online prescriptions. A sticking point is that prescriptions require the establishment of a doctor-patient relationship and until recently, some states did not qualify virtual visits as a legitimate relationship. Advances in telemedicine technologyAs the potential -- if not the actual success, yet -- of AI grows in healthcare, telemedicine stands to benefit from it. It's not hard to imagine telemedicine chatbots being the initial party that a patient discusses symptoms with during a smartphone video call, and based on AI deductions of the situation, recommendations could follow or an actual physician could join the discussion. Tied into that theme is how smart speakers may someday play a role in telemedicine, with a consumer at home saying to the speaker, “I need to talk to a doctor about my sore throat right now.” The speaker's virtual assistant software would then search for telemedicine services. Telemedicine vs. telehealthTelemedicine used to be considered a subset of telehealth, but the two terms are now used as synonyms. In the early days of the internet, the label telehealth included nonclinical services such as continuing medical education, provider training and administrative meetings. In contrast, telemedicine originally pertained exclusively to the use of electronic communications to provide clinical services without requiring a patient to come in to a doctor's office or hospital. In the United States, the Federal Communications Commission sometimes uses the term eCare as an umbrella label any electronic exchange of information that aids in the practice of advanced analytics and medicine. History of telemedicineThe development of modern telemedicine began with the invention of the telecommunications infrastructure, including the telephone and telegraph. Early on, telemedicine technology was adopted for use in military situations during the Civil War, such as ordering medical supplies or medical consultations. Casualty and injury lists were also delivered via telegraph. The first example of an electronic medical record transfer occurred in 1948 in Pennsylvania, when radiology images were sent 24 miles between two townships via telephone line. A few years later, Canadian radiologists built on that early application of telemedicine technology and created a teleradiology system for use in and around Montreal. In 1959, clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television. In the early days of telemedicine, health professionals used the burgeoning technology as a way to reach patients living in rural areas. However, the technology quickly expanded into urban areas, especially those that suffered from healthcare shortages. This was last updated in March 2020 Continue Reading About telemedicine (telehealth)
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What refers to the use of electronic communications and information technologies to provide or support clinical care at a distance?As defined here, telemedicine is the use of electronic information and communications technologies to provide and support health care when distance separates the participants.
Which of these refers to the variety of technologies that provide healthcare practitioners with diagnostic and treatment recommendations?A clinical decision support system (CDSS) refers to the variety of experiences with former patients that provide healthcare practitioners with diagnostic and treatment recommendations.
What is the name of the act that introduced the meaningful use program that makes physicians and hospitals?Two recent, related major regulations have implemented the HITECH Act. Most significantly in this regard, the HITECH Act called for establishment of an incentive payment program for eligible professionals (e.g., physicians) and eligible hospitals that achieve “meaningful use” of qualified EHRs and interoperable HIT.
What is the name of the act that introduced the meaningful use program?With the introduction of the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare EHR Incentive Program, commonly referred to as meaningful use, was transitioned to become one of the four components of the new Merit-Based Incentive Payment System (MIPS), which itself is part of MACRA.
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