Education & Training

What is Telehealth

Introduction to Telehealth

We here at the Northwest Regional Telehealth Resource Center (NRTRC) believe that Telehealth is or should be a basic in delivering care to all populations. We hope that the information you find here will help you along as you learn more about Telehealth.

The American Telemedicine Association (ATA) defines telemedicine as: “The delivery of any healthcare service or transmission of wellness information using telecommunications technology.” Closely associated with telemedicine is the term “Telehealth,” which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and Telehealth.

Benefits of Telehealth

What benefits does Telehealth provide and who enjoys them? There are a lot of advantages to using Telehealth. The following list discusses a few:

Patients Benefit

• Travel to distant specialists is not necessary when Telehealth is used. That means patients can save the cost of travel, the expense of staying in the ‘big city,’ if the distance is such that an overnight stay is necessary
• Hospitalized patients whose care is supervised by a specialist via Telehealth have the advantage of staying in their home community where family and friends can easily visit. Studies have shown that recovery is faster when patients are close to home.
• The danger of traveling in winter weather is removed
• Patients don’t need to take whole days off work to see a specialist or to take their children to the doctor
• Children miss less school when they can be seen via Telehealth
• Patients can receive care rather than foregoing treatment to save time and money

Providers Benefit

• “Circuit-riding” specialists who start providing care through Telehealth can save a lot of “windshield time,” converting the hours spent traveling to hours spent seeing patients
• Practices can become more efficient by seeing distal patients
• Providers can serve more patients, thus easing provider shortages
• Rural providers can receive continuing education with Telehealth connections, avoiding travel time and out-of-practice time
• Quicker access to specialty providers for consults

Critical Access Hospitals Benefit

• More revenue from patients kept local and managed by a distal specialist
• More control over what services are offered
• Better image in the community because of expanded services
• Staff can receive training over Telehealth connections, reducing the need for travel
• Administrators can save travel time and funds by attending meetings over Telehealth

Communities Benefit

• More specialty care available locally
• Money spent for health care in the community cycles through community businesses
• With increased availability of care, small communities become more attractive to businesses looking to relocate

Payers Benefit

• Reduced costs for emergency transport possible
• Costs for care in Critical Access Hospital often less than large facilities
• Patients may receive care sooner, avoiding escalation of illness, thereby saving costs in the long run

Telehealth Applications

Technology

Telehealth technology falls into several categories.

First, there’s the critical communication technology. This is the technology used to connect the endpoints of the Telehealth encounter. There are several options. The classic H.323 connections are probably the best-known technologies, connecting videoconferencing equipment via secure, encrypted, often dedicated connections. Recently, Internet-based systems have stated to take market share. These systems use the commodity Internet to transmit data and are often less expensive than the videoconferencing equipment that was the standard for several years. We suggest that if you are considering the Internet-based solutions, you investigate their ability to comply with HIPAA regulations regarding the security of Protected Health Information (PHI), as the level of HIPAA compatibility is often unclear with some solutions.

Second, Telehealth Technology includes instruments and cameras used to measure and transmit patient information. Whether these be digital stethoscopes, otoscopes, retinal cameras, or other devices, selecting the right equipment is a challenge. We suggest you take a look at the Telehealth Technology Assessment Telehealth Resource Center (TTAC). Our colleagues at TTAC will be happy to help you learn to evaluate equipment to meet your network’s special needs.

Applications

Clinical Services - Patient consults can be provided in two modes: 

Live Real Time - provides live patient to provider encounters.  

Store and Forward - allows specialists to review patient findings at convenient times without depending on the presence of the patient.  

Patient and Clinical Education Services - Educational Services can be provided through a Telehealth Network. Networks provide up-to-date and timely continuation education opportunities to healthcare providers and patients.  

Video Conferencing Support - Video conferencing allows face-to-face meetings while eliminating employee travel expenses.

Clinical Specialities

NRTRC has recently conducted a poll of our member networks, asking what Telehealth specialties are provided in their states. The list is pretty impressive, and this is probably not wholly complete. But a look at the list will give you a good idea of what’s possible with Telehealth. In fact, there are very few limits to what can be done with technology.

• Physical Therapy
• Occupational Therapy
• Emergency Care
• Intensive Care
• Burn Care
• Cardiology
• Oncology
• Pediatric Emergency
• Behavioral Health
• Dermatology
• Remote care of chronic illness (diabetes, COPD, heart failure, etc.)
• Diabetic Retinopathy
• Pre- /Post-surgical care
• Primary care
• Virtual “Walk-in” Clinic
• Stroke
• Hospitalist/Nocturnalist
• Radiology
• Ultrasound imaging
• Echo Cardiography stress test
• Pharmacy
• Orthopedics
• OB/GYN
• ENT
• Neurology (non-stroke)
• Adult Speech Therapy
• Wound Care
• Case Management (hepatitis C)
• Case Management (advanced liver disease)
• Case Management (tumor conferences)
• Case Management (substance abuse and mental health)
• Education (Grand Rounds, didactic education, etc.)

This list is not exhaustive, but it will give a good view of what’s possible with Telehealth and, hopefully, stimulate some ideas about what your network can do for your patients.