What is Telehealth?

What is Telehealth?

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Telehealth is 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 video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

There are both clinical and non-clinical uses of telehealth technologies. Examples of clinical uses of telehealth technologies include the transmission of medical images for diagnosis; groups or individuals exchanging health services or education live via videoconference; transmission of medical data for diagnosis or disease management; advice on disease prevention and promotion of good health; and health advice by telephone for emergency cases.

Non-clinical uses of telehealth technologies include education from a distance, such as medical education and patient education; administrative uses such as meetings among telehealth networks, supervision and presentations; research; online information and health data management; healthcare system integration; general healthcare system management; asset identification, listing and patient to asset matching and movement; and patient movement and remote admission.

Telehealth can be classified into three main types: store-and-forward, remote monitoring and interactive services.

Store-and-forward telehealth: In store-and-forward telehealth, digital images, video, audio, observations of daily living (ODLs), and clinical data are captured and "stored" on the client computer or mobile device; then at a convenient time they are transmitted securely ("forwarded") to a clinic at another location where they are studied by relevant specialists. The opinion of the specialist is then transmitted back. Based on the requirements of the participating healthcare entities, this round trip could take between 1 minute to 48 hours. In the simplest form of telehealth application, basic vital signs like blood pressure, weight, pulse oximeter, and blood sugar values are monitored and trended for long term chronic care. In many specialties, such as dermatology, radiology and pathology, an immediate response is not critical, making these specialties conducive to store-and-forward technologies. Automated screening and diagnostic tele-audiology is fast becoming another specialty conducive to store-and-forward audiology.

Real-time telehealth: In real-time telehealth, a telecommunications link allows instantaneous interaction. Videoconferencing equipment is one of the most common forms of real-time (or "synchronous") telemedicine. Peripheral devices can also be attached to computers or the video-conferencing equipment which can aid in an interactive examination. With the availability of better and cheaper communication channels, direct two-way audio and video streaming between centers through computers is leading to lower costs.

Remote monitoring: In remote monitoring, the patient has a central system that feeds information from sensors and monitoring equipment, e.g. blood pressure monitors and blood glucose meters, to an external monitoring center. This could be done in either real time or the data could be stored and then forwarded.

There are a range of benefits of telehealth, which directly apply to individual patients, family members, and healthcare providers, as well as to community organizations, healthcare facilities, and governments.

Direct and indirect benefits of telehealth include improving the way patients and their families access information; improving health outcomes for patients; empowering consumers and communities by providing accessible health education and decision-making options; improving the way healthcare providers deliver care and access information; enhancing recruitment and retention of healthcare providers in rural/remote areas; lowering healthcare costs, reducing travel, minimizing time off of work, and decreasing patient wait time; decreasing patient anxiety, eliminating unnecessary repeat diagnostic procedures or tests; improving early diagnostic capabilities; improving administrative and communication capabilities; and improving emergency triage.

On the downside, legal issues about physician licensing, liability, and patient confidentiality exist. As physicians are licensed by states, this presents a legal problem when physician consults cross state lines. It is necessary in order to fully benefit from telemedicine that states engage in interstate provision of service.

Telehealth was built with the premise in mind that telecommunications technology is a tool that can drastically improve the distribution of medical care services. The utilization of telehealth systems in the United States will undoubtedly continue to rise upward. According to the aforementioned survey on telehealth, 84% of agencies stated that fewer than one in ten of their patients refused such systems, and fewer than 1 in 20 people refused telehealth services. Based on surveys such as this, as well as the overall consensus of telehealth in the healthcare industry, it is clear that consumers are clearly ready for telehealth in the home. Not only do telehealth services increase patient satisfaction, but they also produce far greater quality outcomes and a reduction in on-site visits, unplanned hospitalizations, and emergency room visits.

~ Steve Barnes

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