Telehealth refers to the practice of caring for clients remotely when the provider and client are not physically present with each other. Modern technology has enabled clinicians to consult clients by using HIPAA (privacy) compliant video-conferencing tools.
What is Telehealth
Telehealth is simply defined as, “the remote delivery of healthcare services“.
How is it Conducted?
Telehealth is conducted in a number of ways. The most basic is just a simple video call (like you normally do with family and friends), however most countries required secured HIPAA compliant video conference tool, so we have partnered with a telemedicine company called VSee , who provides us with this kind of secure and simple to use solution.
What are the difference between Telehealth and Telemedicine?
In the last decade, rapid advances in medicine and technology has resulted in the use of new terms. Although the words are often used interchangeably, there is certainly a difference between the two.
What is Telemedicine?
The World Health Organization (WHO) refers to telemedicine as “healing from a distance“. It is the use of telecommunications technology and information technologies to provide remote clinical services to patients. Physicians use telemedicine for the transmission of digital imaging, video consultations, and remote medical diagnosis.
Today, individuals no longer have to schedule an in-person visit with a physician to receive treatment. The use of secure video and audio connections makes it possible for specialists to treat patients who reside in locations with limited access to care.
What is Telehealth?
HealthIT.gov defines telehealth as “the utilization of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health education, public health and health administration.”
While this definition sounds a lot like telemedicine, there is one distinct difference. Unlike telemedicine, telehealth also covers non-clinical events like administrative meetings, continuing medical education (CME), and physician training. Telehealth is not a specific service, but a collection of methods to improve patient care and education delivery.
In general, one can think of telehealth as all-encompassing, as telemedicine and telecare fall under its umbrella.
History of Telemedicine
Contrary to popular belief, telemedicine is not a new practice. In fact, the concept of telemedicine is dated back to the 19th century! What began as a few hospitals wanting to reach patients in remote locations became an integrative system across the care continuum. The history of telemedicine will unveil how we got to where we are today.
Telemedicine in the 19th Century
The creation of telemedicine began with the inception of the telecommunications infrastructure, which included the telegraph, telephone, and radio. Casualties and injuries were reported using the telegraph during the Civil War, in addition to the ordering of medical supplies and consultations. This is considered one the earliest adoptions of telemedicine technology.
By 1879, a Lancet report discussed how using the telephone can reduce the number of unnecessary office visits. This was only the beginning of what would be a patient care transformation.
Telemedicine in the 20th Century
In 1922, Dr. Hugo Gernsback featured the teledactyl in a science magazine. Gernsback predicted that this sensory feedback device would permit physicians to see their patients through a television screen and touch them from miles away with robot arms.
The first radiologic images were sent via telephone between two medical staff at two different health centers in Pennsylvania by 1948. The health centers were 24 miles apart from one another! Then in 1959, physicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television. Five years later, a closed-circuit television link was built that allowed physicians to provide psychiatric consultations 112 miles away at Norfolk State Hospital.
Telemedicine Today
Today, most people have access to basic telemedicine devices like mobile phones and computers. With improved accessibility, individuals in rural areas and busy urban areas can connect with a provider with ease. Home-use medical devices make it possible for caregivers to monitor everything from vitals to glucose levels. Physicians can gather essential medical information and make a diagnosis without patients stepping foot in a doctor’s office.
By 2020, telemedicine is expected to be an imperative piece of modern healthcare delivery. The history of telemedicine shows that we’ve come so far from where we started, and yet still have a long way to go.
What are the benefits of telemedicine and telehealth
Known as a technological advancement that is changing the entire healthcare infrastructure, telemedicine is here to stay. Today, patients, providers, clients and payers alike are able to benefit from the emergence of telemedicine.
How Telehealth Benefits Patients
Because of telemedicine, patients who previously had limited access to health care services can now see a clinician/ physician without leaving their home. Seniors who would prefer to age in place can now do so with the use of medical streaming devices and mental health support services.
Telehealth also benefits clients in the following ways:
Transportation: Patients can avoid spending gas money or wasting time in traffic with video consultations.
No missing work: Today, individuals can schedule a consultation during a work break or even after work hours.
Childcare/Eldercare Challenges: Those who struggle to find care options can use telemedicine solutions.
What are the applications of Telehealth
Thanks to telemedicine, clinicians and physicians have the wonderful opportunity to connect with clients wherever they are. Clients who once could not see a therapist or physician due to access to care issues, can now do so almost seamlessly.
Medication Management
Those in the healthcare industry recognize that medication management is a big deal, especially among seniors. Older adults are more likely to forget to take their medications, which is where telemedicine comes in. Providers and other healthcare professionals can use telemedicine technology to monitor when and if their patients took their medicine. As a result, this leads to fewer hospital readmissions and enhances medication compliance.
Sharing Medical Information
Store and forward, a type of telemedicine that allows providers to share information over a distance, has been a game changer. Today, primary care professionals can connect with specialists who are in another location than them. Healthcare information like diagnostic images, blood analysis, and more can be shared for appropriate patient assessment in real time.
Disaster Relief
When a disaster occurs, the local healthcare resources are immediately pulled in to provide both emergent and non-emergent care. This usually results in a shortage as the demand for services is much higher than what can be supplied.
With telemedicine and telehealth, clinicians and physicians in other locations can provide assistance by conducting video visits. In fact, when Hurricane Harvey occurred in 2017, healthcare professionals provided emergency and behavioral health video visits. This allowed practitioners to focus on high demand, complex cases in-person versus low level cases that can be managed remotely.
Telemedicine for Remote Clinics
In many Walmart stores, retail consumers can walk up to a kiosk for a doctor consultation. The doctor is not physically present inside the store. Instead, the customer uses a touchscreen computer to type in their symptoms and enter a virtual waiting room. They are then connected by a video link to a doctor. This use-case is HIPAA-compliant because the video link is encrypted to protect patient health information.
Mobile Health
Sometimes the answer to the question “What is telemedicine?” is simply mobile medicine. It doesn’t require a heavy desktop computer or a lot of equipment. Activities that used to happen only in person are now easy to do on a smartphone. Modern consumers are accustomed to downloading apps and using their smartphones for simple transactions. The same is true for doctor visits. For example, with MDLIVE the patient simply opens the app and clicks to choose a doctor, with whom they can speak either by phone, instant message, or video.
There are many advantages to offering immediate access to a mental health counselor for crisis interventions. Emergency rooms could have on-call therapists available for addiction and mental health interventions. Nonprofit organizations could have greater access to services.
Mental Health
Likely one of the most popular specialties for telemedicine is Behavioral Health services. Telehealth can streamline patient flow, and provide counselling sessions from anywhere. With telehealth, clients in rural areas can now access mobile and web apps to speak with their therapist. In addition, cancellations and no-shows are less likely to occur. Mental health practices that implement telehealth can also see more clients and still provide a high level of clinical care.
Business Association Agreement (BAA) and HIPAA for Telemedicine
Healthcare systems, policymakers, vendors, and providers alike can attest to the many gray areas within telemedicine. One particular area that requires more clarity is the legalities surrounding telemedicine. With it being an industry that is constantly growing, it has become difficult to create a concrete solution. In addition, each state follows different laws for telemedicine, which makes it increasingly difficult to keep up with it.
What is HIPAA?
Health Insurance Portability and Accountability Act, also known as HIPAA, is a
US legislation that provides security provisions to safeguard medical information. To date, it currently serves a few purposes:
To continue providing health insurance coverage to those who lost their jobs or are changing jobs,
Alleviate financial and administrative burden by standardizing financial and administrative transactions and,
Avoid waste, fraud, and abuse in healthcare delivery and health care insurance.
Because personal health information is transferred via multiple avenues in health care, HIPAA has created guidelines that ensure information is shared securely.
HIPAA and Business Associate Agreements
HIPAA requires that healthcare organizations have a Business Associate Agreement with their technology provider to ensure that everyone involved is responsible. However, HIPAA does not apply to telemedicine.
Providers are responsible for protecting patient information. They should ensure that patient information in digital visits are safeguarded in the same way they would in-office visits. HIPAA does not require encryption to meet compliance, but providers should aim to find a business that encrypts data.
The Laws Vary By State
While those 33 states do have telehealth parity laws, all of them may not have payment parity. Payment parity protects providers from unjustified cuts in reimbursement for telehealth services. Currently, some health plans do not pay providers the same rates that they would for in-person services.
The payment also varies from provider to provider. Those larger organizations that have strong negotiating powers may be able to receive higher payment rates. However, there is a disparity here because small practices may not have this privilege and have to accept what is offered to them.
When providers cannot receive reimbursement and are not able to bill their patients for the service, many of them forego offering telehealth solutions.
Patient Consent
In addition to the parity laws, some states require providers to obtain patient consent before using telehealth services. Failure to obtain patient consent may result in physicians not being paid. Providers also have to be aware that while some states do not legally require consent, if they bill telemedicine through Medicaid, they will need written consent.
What are the barriers of Telemedicine
While telemedicine has shown to be a game changer in the field of medicine, there are still a number of barriers to overcome. Physicians face challenges regarding how they’ll be paid and where they can practice, while patients voice security concerns. Once these barriers are removed, we can anticipate greater access to care and improved patient outcomes.
The Future of telehealth
Annually, millions of Americans receive care using telemedicine solutions and the numbers are increasing. With more patients using the service and more physicians offering it, telemedicine has no choice but to expand. Here is what the future of telehealth looks like:
Online Medical Centers
Imagine a 24/7 online collaborative platform for patients, providers, and staff. The future of telehealth may look like a group of remote physicians treating hospitalized patients from all over the state. With digital monitoring devices and video conferencing, physicians can treat and diagnose more patients in less time.
Telemedicine Across Borders
With technology becoming more robust, the future of telehealth could include international collaboration. Some countries offer medical advances that the United States does not have readily available (and vice versa), but telemedicine would lessen the barriers.
Great Acceptability
As patients experience the reduced wait times and greater access to care, the hesitation regarding telemedicine will decrease. Physicians will also notice better patient outcomes and more revenue without an increased workload. In addition, private payers, Medicaid, and Medicare will respond to the demand after solidifying best practices.
Health System Collaboration
Today, it is still difficult to share electronic medical record information with a health system that uses another EMR platform. The future of telehealth will likely include enhanced sharing capabilities that will allow for patients to adequately care for no matter where they are.
In addition, experts predict that the electronic medical record will become more seamless and allow for advanced automated patient billing.
Telemedicine Terminology
Those new to the telemedicine arena may not understand the jargon used amongst healthcare organizations. This guide will go over commonly used terms in the telemedicine field so you can understand them in the future.
Telemedicine
The most important term to clarify is ‘telemedicine’ itself. Telemedicine is the use of telecommunications technology and information technology for clinical services.
Telehealth
The second most important term is ‘telehealth’. This term is frequently used interchangeably with telemedicine, but their meanings are slightly different. While telemedicine focuses on clinical services, telehealth focuses on all health services. An example would be a video-conference platform for nurse education.
Digital Medical Devices
Items that would be considered digital medical devices include blood pressure cuffs, glucometers, pulse oximeters, and more.
Distant Site
Distant site is the place that the physician is located at the time of which the service is provided. This term is often used when discussing reimbursement, as certain locations are not covered.
Electronic Medical Record (EMR)
EMR’s allow healthcare organizations to store, retrieve, and modify patient records.
Electronic Health Record (EHR)
Often confused with an EMR, electronic health records are a collection of patient information that can be shared across healthcare settings. EHRs commonly contain billing information, vital signs, medical history, and more.
Encryption
Encryption is a term often used when discussing the sharing and security of patient information. It is a system of encoding electronic data where the information can only be decoded by those given computerized access.
HIPAA
HIPAA is an acronym for Health Information Portability and Accountability Act. It is mostly known for providing standards and requirements regarding how confidential patient information is protected and handled. To learn more about HIPAA, visit this website.
Originating Site
Also known as the patient site, the original site is the patients location when they received telemedicine services. This specifically relates to Medicaid and how and if they will reimburse a provider.
Remote Monitoring
Remote monitoring refers to the utilization of digital medical devices transferring data to practitioners and staff in real time.
Video Conferencing
The transmission of digital video images in real-time between multiple locations.
Our thanks to team at VSee for assisting us with this overview.
