Tele-what?
Telemedicine, telehealth—what do they actually refer to, and which one should you use?
Both terms describe the remote delivery of healthcare services using telecommunications technology. Often used interchangeably, telemedicine tends to mean the delivery of remote care between provider and patient, whereas telehealth is a bit broader, encompassing a variety of digital technologies and methods for delivering virtual medical, health, and education services (i.e. information swapping and mentorship among providers).
According to the Center for Connected Health Policy, telehealth can be broken down into four main categories:
- Video Conferencing (synchronous)
- Store and Forward (asynchronous)
- Remote Patient Monitoring (RPM)
- Mobile Health (mHealth)
The concept of telehealth or telemedicine is not new—the World Health Organization reported that its history can be traced to the nineteenth century. But in the ever-evolving mobile telecommunications landscape of today, the concept is expanding in scope and size. More than ever before, healthcare organizations are exploring telehealth strategies or programs that generate cost savings while maintaining (and even improving) the quality of care.
Here now, our list of the top five trends in telehealth.
1. Telehealth for Mental Health
Agoraphobia is a mental disorder that prevents people from leaving home. Its debilitating, sometimes disabling, and the resulting anxiety can be costly. Telehealth offers these patients access to mental health resources 24-hours a day in a place where they often feel most comfortable to do so–home.
Specifically, telepsychiatry allows for the training of emergency medical personnel in de-escalation techniques when faced with high pressure, even life-threatening situations. These moments, requiring split-second decisions, can have dire or fatal consequences if not handled properly. With a counselor on call to prepare emergency service personnel with the proper technique for the situation, telehealth saves lives. More than a call to 911, telehealth provides a personalized approach to vulnerable patients with the potential to foster trust and safety in the midst of crisis.
2. Telehealth for Rural Healthcare
Telehealth has been particularly championed for connecting patients to quality healthcare in rural areas, which often lack specialized medical facilities and struggle with provider shortages. Rural hospitals, which have been shutting down at alarming rates due to shortages and a lack of financial stability, can cut down on costly patient readmissions by launching remote monitoring programs and can increase patient and provider confidence by making remote specialists available for consultation. Some healthcare organizations that support rural patients are also turning to mobile device solutions for patient monitoring and disseminating care resources—for example, a mobile app that delivers daily lessons to pre- and post-op patients on how to best manage recovery.
What is the biggest roadblock to telehealth in rural areas? A lack of requisite broadband capacity. However, interest in the benefits of telehealth for rural populations is piquing interest in developing connectivity in rural areas. Statistics indicate that more than half of non-metropolitan clinics are only using 1 percent of the gigabit capacity that is encouraged by the FCC to properly conduct internet business (telehealth included).
3. Telehealth for Provider Support
What happens when a family physician in a small town encounters an unfamiliar condition that requires specialized care? Think about an ICU nurse with a question seemingly too small to bug one of the few on-call physicians in the middle of the night. Increasingly, telehealth has been offered as a resource to leverage the expertise of providers in other locations and time zones to support the work of other providers. The Project ECHO model has been tested for connecting primary care physicians with specialists for training, allowing primary care physicians to further develop relationships with the patients they know best, while decreasing the need for sending patients far from home to receive specialized treatment. Telehealth has also been used to connect physicians in Australia with ICU wards in the United States: The remote physicians support overnight staff, who tend to be less experienced and may be less alert, in monitoring patients and recommending action.
4. Telehealth for Emergency Care
In a medical emergency, seconds matter. Some patients will die because they are not close enough to a medical facility with the right resources. Sometimes patients could avoid a costly emergency room visit through proper preventative care, but may miss the warning signals before an emergency occurs. In the Emergency Room itself, long wait times and staffing shortages put enormous pressure on both patients and providers trying to connect patients with the care they need most efficiently.
Telehealth has been tapped for its potential to remotely connect patients to life-saving care, as well as help decision-makers determine whether a patient needs a trip to the emergency room or can be treated remotely under the digital supervision of a licensed physician. The University of Mississippi Medical Center has saved the state hundreds of thousands of dollars in costly ER visits by implementing remote monitoring for diabetes patients and providing live conferences via tablet with injured high school football players.
5. Telehealth for the Opioid Crisis
A bill creating new rules for healthcare organizations targeting the opioid crisis has been introduced in the Senate as the Opioid Crisis Response Act of 2018. Among other provisions, the bill establishes new guidelines for providers to prescribe using telemedicine. The introduction of this bill comes as the federal government moves to expand its support for telehealth. Medicaid reimbursement and differing state license requirements have been roadblocks for telehealth growth for some time; however, the VA’s recent move to allow providers to remotely treat patients across state lines (even outside VA facilities) should be cause for change. The VA, citing “federal preemption,” will supersede existing state regulations to allow VA telehealth providers to connect with veterans across the country.
Telehealth is nothing new but the momentum to drive the technology ahead is gaining steam, an effort that is sure to transform the healthcare industry into a seamless, easily accessible, and affordable utility for patients across the board. The IT challenges will be many (and ever-changing) but Telehealth and Telemedicine are here to stay.
