Telehealth is a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies.
Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.
CCHP and other members of the National Consortium of Telehealth Resource Centers finalized a Telehealth Definition Framework to help policy makers, practitioners, payers, and the public understand how to accurately apply “telehealth” and its key components.
Telehealth or Telemedicine
“Telemedicine” is often still used when referring to traditional clinical diagnosis and monitoring that is delivered by technology. However, the term “Telehealth” is now more commonly used as it describes the wide range of diagnosis and management, education, and other related fields of health care. These include, but are not at all limited to:
- Physical and occupational therapy
- Home health
- Chronic disease monitoring and management
- Disaster management
- Consumer and professional education
Defining Telehealth in Policy
State and federal agencies often differ on how they define telehealth. For example, California law defines telehealth as:
“The mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.”
Meanwhile, the federal Health Resources and Services Administration (HRSA) 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.”
These varying definitions influence the policies and regulations surrounding how telehealth is allowed to be used, and these policies vary as much across states as the definitions themselves. CCHP’s free, interactive map of telehealth policies can help clarify the confusion with updated information according to eleven distinct categories of telehealth-related laws, regulations, and state Medicaid policies.
Telehealth encompasses four distinct domains of applications. These are commonly known as:
Live video (synchronous): Live, two-way interaction between a person (patient, caregiver, or provider) and a provider using audiovisual telecommunications technology. This type of service is also referred to as “real-time” and may serve as a substitute for an in-person encounter when it is not available. CCHP’s micro-documentary series video, Telehealth Saves Lives, illustrates an instance where live video telehealth can be a life saving technology. Live video can be used for both consultative and diagnostic and treatment services.
Store-and-forward (asynchronous): Transmission of recorded health history (for example, pre-recorded videos and digital images such as x-rays and photos) through a secure electronic communications system to a practitioner, usually a specialist, who uses the information to evaluate the case or render a service outside of a real-time or live interaction. As compared to a real-time visit, this service provides access to data after it has been collected, and involve communication tools such as secure email. CCHP’s micro-documentary video, Telehealth and Access to Care, shows how store and forward technology can be utilized to help access specialty care, even when there are limited board-certified specialists in their community.
Remote patient monitoring (RPM): Personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a provider (sometimes via a data processing service) in a different location for use in care and related support. This type of service allows a provider to continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates. CCHP’s micro-documentary series video, Telehealth and Quality of Care, demonstrates how remote patient monitoring can help individuals stay healthy in their home and community, without having to physically go to the providers’ office.
Mobile health (mHealth): Health care and public health practice and education supported by mobile communication devices such as cell phones, tablet computers, and PDAs. Applications can range from targeted text messages that promote healthy behavior to wide-scale alerts about disease outbreaks, to name a few examples. South Central Telehealth Resource Center’s video on mHealth exemplifies many of the most popular forms and uses of mHealth mobile applications.