What is Telehealth?

The terms telehealth and telemedicine are often used interchangeably by the public, even though they describe distinct processes. In the most generic sense, telehealth and telemedicine involve conducting health care services remotely. The difference between the two terms arises when one examines the medical portion of telemedicine. The nuance isn’t just a lexicological typo, it ties a specific clinical component to the provided services. 

Telehealth, on the other hand, is more inclusive. Non-clinical activities related to education, staff training, healthcare administration, professional conferences, or patient-provider clinical services all fall under the telehealth label. Three of the main telehealth modalities are live patient-provider video sessions, the store-and-forward technique—which collects clinical data and sends it to a separate location for evaluation—and off-site patient monitoring that studies clinical data as it elapses in real-time.

History of Telehealth Services

The telehealth revolution found its footing in a 1925 science fiction premise, which questioned the possibility of remote-based medical procedures. Matt Novak of Smithsonian Magazine pointed to entrepreneur and author, Hugo Gernsback, who imagined a world where doctors could interact with patients using radio waves—an insight that has helped clinicians grow their virtual presence and deliver patient-centered care over the internet. 

Kane and Gillis (2018) found that 15.4% of physicians employed telehealth services as part of their healthcare delivery model in 2016, noting that larger practices—typically greater than 50 employees—substantially raised the buy-in for telemedicine. The American Academy of Family Physicians have said that telehealth services not only expand choice for patients, but they increase provider efficiency as well. The evolution of telehealth practice has many iterations ahead of it, but research suggests it already offers distinct advantages over brick-and-mortar services. 

Benefits of Telehealth and Telemedicine

 For patients who lack the means to reach medical facilities for treatment, telemedicine visits help them stay in touch with their medical team. Patient portals equip users with an on-the-go method for checking provider reports, lab results, or asking pertinent follow-up questions. Distance communication gives the gift of freedom, comforting patients who are undergoing stressful medical interventions. With telehealth platforms, providers customize their delivery system to meet patient and business-related parameters. 

Limitations of Telehealth Practice

The financial burden of acquiring, mastering, and implementing telehealth services can be great for individual practitioners. Economic uncertainty has been one of the biggest hesitations for clinicians interested in using a telehealth modality in their practice. Another economic concern is the lack of smart phone holders or internet connectivity in vulnerable communities across a provider's client load. With over 30% of rural residents in 2019 lacking access to a smartphone, emerging technology is not the only focal point for success.

State licensure requirements are another area of consideration for providers, as failure to obtain licensure—or in some cases, an out-of-state agreement—can upend a prospective telemedicine practice. Nine states currently offer special assistance for out-of-state telemedicine practice through their respective medical or osteopathic licensing boards. Twenty-four states, and the District of Columbia, follow the Federation of State Medical Board’s Medical Licensure Compact (IMLC) to expedite out-of-state license approvals. 

Tips for a Smooth Experience

If providers commit to a little legwork upfront, they can rest assured that their telehealth and telemedicine practices will be set up for success. There is no lifetime guarantee in the telecommunications field, but the American Academy of Allergy, Asthma, and Immunology have recommended prerequisites to take before connecting online. Reliable broadband internet, a video platform, reachable IT support contacts, and access to medical devices used in a patient’s care plan, are essential steps.  

Reimbursement policies are another grey area affecting the success of a telehealth or telemedicine practice. Avoiding common mistakes can save providers ethical, legal, or financial headaches in the long run. Participating in educational coursework, such as the THTC certificate program through the Telehealth Certification Institute, protects clinicians while they integrate best practices into their care plans.

 

Sources

American Academy of Allergy, Asthma, & Immunology. Technology requirements in telemedicine. (Discusses recommendations for using telehealth and telemedicine services).

Kane, K. C., & Gillis, K. (2018). The use of telemedicine by physicians: Still the exception rather than the rule. (Looks at the popularity, efficiency, and split of telemedicine services between medical professions). 

Novak, M. (2012). Telemedicine predicted in 1925. Smithsonian Magazine. (An article that highlights an unlikely visionary in the telehealth movement). 

Rural Health Information Hub. (n.d.). Barriers to telehealth in rural areas. (Examines how rural and underserved populations face limitations when accessing telehealth services via computer or smart phone devices).

The National Telehealth Policy Resource Center. (2018). State telehealth laws & reimbursement policies. (An overview of state telehealth guidelines with a focus on insurance reimbursements and licensure restrictions).

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