Telemedicine: News and Information Regarding Modern eHealth
Disabled World: Revised/Updated: 2019/04/10
Synopsis: Information regarding telemedicine the term used for the exchange of medical information from one place to another through modern electronic communications. Telemedicine uses telecommunications technology to provide clinical health care at a distance. The largest impact of telemedicine is to the person, their family members and community.
Telemedicine (telehealth, eHealth) is defined as the use of medical information exchanged from one site to another through electronic communications with the goal of improving a person's health status. Although there were distant precursors to telemedicine, it is essentially a product of 20th century telecommunication and information technologies. Telemedicine uses telecommunications technology to provide clinical health care at a distance. It helps improve access to medical services that often would not be available consistently in distant rural communities.
It was the story heard around the world when Dr. Rafael Grossmann became the first surgeon to use Google Glass in the operating room, allowing a group of medical students to virtually view the procedure through his experienced eyes remotely and in real time.
Today, telemedicine includes a growing number of applications and services using two-way video, smart phones, email, wireless tools and additional forms of telecommunications technologies.
More than 40 years ago, with demonstrations of hospitals extending care to people in remote areas, the use of telemedicine spread quickly and is now becoming integrated into the ongoing operations of hospitals, home health agencies, specialty departments, private doctors offices, and people's workplaces and homes.
Telemedicine is Not a Separate Medical Specialty:
Services and products related to telemedicine are many times part of a larger investment by health care institutions in either information technology or the deliver of care. Even in the reimbursement fee structure there is usually no distinction made between services provided on site and services provided through telemedicine and often no separate coding required for billing related to remote services.
'Telemedicine,' and, 'telehealth,' are many times considered to be interchangeable terms which encompass a wide definition of remote health care. Consultations through:
- Nursing call centers
- Transmission of images
- Continuing medical education
- Remote monitoring of vital signs
- e-health including patient portals
- Consumer-focused wireless applications
Among other applications, are all considered to be parts of telemedicine and telehealth. While the term, 'telehealth,' is at times used to refer to a broader definition of remote health care that does not always involve clinical services, the terms are used in the same way one would refer to medicine or health commonly. Telemedicine is closely allied with the term, 'health information technology (HIT).' However, HIT more commonly refers to electronic medical records and related information systems, while telemedicine refers to the actual delivery of remote clinical services using types of technologies.
Services Provided by Telemedicine
A person is seated and writing in a notepad. An open laptop is to his right on the desk top.
Perhaps telemedicine is best understood in terms of the services provided and the mechanisms used to provide those services. For example:
Primary care and specialist referral services might involve a primary care or allied health professional providing a consultation with a person, or a specialist assisting a primary care doctor in rendering a diagnosis. It may involve the use of live interactive video, or the use of store and forward transmission of diagnostic images, video clips, or vital signs along with patient information for later review.
Remote patient monitoring, to include home telehealth, uses devices to remotely collect and send information to a home health agency or a remote diagnostic testing facility for interpretation. The applications might include a particular vital sign such as a heart ECG or blood glucose, or a number of indicators for people who are at home. The services may be used to supplement activities by a visiting nurse.
Consumer health and medical information includes the use of the Internet and wireless devices for people to obtain specialized health information, as well as on-line discussion groups, to provide peer-to-peer support. Medical education provides continuing education credits for health care professionals and special medical education seminars for groups located in remote areas.
Telemedicine Delivery Systems
Networked programs link hospitals and clinics with community health centers and clinics in suburban or rural areas. The links might use dedicated high-speed lines, or use the Internet for telecommunication links between the sites. An estimate of the number of existing telemedicine networks in America is roughly 200; they provide connectivity to more than 3,000 sites. Point-to-point connections using private high-speed networks are used by hospitals and clinics that deliver services directly or outsource specialty services to independent medical services providers. Outsourced services may include:
- Mental health
- Stroke assessment
- Intensive care services
Monitoring center links are used for pulmonary, cardiac, or fetal monitoring, home care and related services that provide care to people in their own homes. Many times, usual land-line or wireless connections are used to communicate directly between the patient and the center, although some systems use the Internet. Web-based e-health patient services sites provide direct consumer services and outreach over the Internet. With telemedicine, these sites provide direct patient care.
Benefits of Telemedicine
Telemedicine has been growing at a rapid rate because it offers 4 fundamental benefits. These benefits include the following:
- Improved Quality: Studies have consistently revealed that the quality of health care services delivered through telemedicine are as good as those provided in traditional in-person consultations. In some specialties, especially in mental health and ICU care, telemedicine delivers a better product with greater outcomes and patient satisfaction.
- Cost Efficiencies: Reducing or containing the cost of health care is one of the most important reasons for funding and using telehealth technologies. Telemedicine has been shown to cut the costs of health care while increasing efficiency through improved management of chronic diseases, reduced travel times, shared health professional staffing, and fewer and shorter hospital stays.
- Improved Access: For more than 40 years, telemedicine has been used to bring health care services to people in distant areas. Not only does telemedicine improve access to people, it also permits doctors and health facilities to expand their reach beyond their own locations. Considering the provider shortages around the world, in not only rural but urban areas, telemedicine has an incredible capacity to increase services to millions of people.
- Patient Demand: People want telemedicine. The largest impact of telemedicine is on the person, their family members and their community. Using telemedicine technologies reduces stress on the person and cuts travel time. Over the past 15 years, study after study has documented patient satisfaction and support for telemedical services. The services offer people access to providers that might not otherwise be available, as well as medical services without needing to travel over long distances.
Telemedicine Facts and Statistics
- The American Telemedicine Association, ATA, defines telemedicine as "the use of medical information exchanged from one site to another via electronic communications to improve patients' health."
- Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations.
- The CDC reports that 84 percent of seniors have at least one chronic condition. Using the latest communications technology empowers healthcare providers in treating these patients and helps educate patients about their care.
- Mortality rate dropped from 13.6% to 11.8% after tele-ICU was implemented, and length of stay in the ICU fell from 13.3 days of 9.8.
- The U.S. Veterans Administration reports reductions in utilization of between 20% and 56% when care coordination and home monitoring are employed.
- Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care.
- California prison officials provided roughly 9,000 telehealth consultations in 2004, saving taxpayers more than $4 million in transportation and escort costs.
- For over 40 years, telemedicine has been used to bring healthcare services to patients in distant locations.
- 55 percent of urban and rural physicians reported that cost of telemedicine equipment is the main barrier to accessing this technology.
- Barriers to telehealth use include concerns about costs and return on investment, clinician resistance, lack of broadband connectivity, and interstate practice issues.
- 21 percent of physicians reported that broadband capability was a barrier in their use of telemedicine. In addition, about 60 percent of rural areas have broadband compared to 70 percent of urban areas.
Also see our our list of definitions of telemedicine fields.
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