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The common terms thrown around in discussions of telehealth and telemedicine are as fluid as the technology itself. We choose some of the more useful terms and descriptions here, in search of a shared language as Colorado moves deeper in to this brave new world.
Telehealth – the delivery and exchange of health information, education, patient encounters and provider consultations through any technology other than traditional face-to-face office visits. Some evolving definitions of the word exclude older services delivered only by voice-over-phone connection, but most consider it to include all exchanges made that are not in-person.
Telemedicine, telepsychiatry and telemental health – Telemedicine refers to delivery and exchange of physical medicine through technology. Interestingly, “telemedicine” was the semiofficial state government term for all telehealth services but was statutorily changed to “telehealth” in House Bill 15-1029. Telemental health is an emerging term meant to cover mental health access through technology, whether by client appointments on video link, telephone consultations or other means. Telepsychiatry is a subset of telemental health, indicating the presence of a psychiatric MD and any accompanying prescription drug management or inpatient hospital requirements.
Telemonitoring – a more passive form of telehealth than a live video appointment. It often involves providing a homebound patient with tools to record and transmit important health information, such as blood pressure, blood sugar levels or weight, to a central case manager.
Telehome care – home technology that is quickly moving beyond monitoring and straight to video visits using the consumer’s own smartphone, tablet computer or desktop with camera. The “visits” must be routed through the provider’s security or encryption systems for patient privacy.
Telepresence – using a robot camera or other remotely controlled health tool to make a diagnosis or assessment of a patient by long distance. See descriptions for telestroke programs elsewhere in this magazine.
Teledermatology – one of the fastest-growing forms of telehealth, thanks in part to cheap high-resolution cameras now ubiquitous on everyone’s smartphones and tablets. A remote dermatologist can ask for live video and suggest camera angles to the patient, or a health system can store images taken by patients and attached to emails for review by the provider at a convenient and efficient time.
Real time – usually refers to a live videoconference or link to patient, where the provider and patient can see each other and can interact nearly as they would in a face-to-face encounter.
Latency – any delay in transmission of the picture or audio in a telehealth encounter. (Anyone who has Skyped on a bad connection has seen this phenomenon.) It can create awkward stepping on each other’s sentences or long pauses.
Peer-to-peer telehealth – providers talking to each other over a video link, often for specialists to offer education to general providers or consult on individual cases. This is commonly occurring now in specialties from renal to burn care, and expanding every month.
Patient portal – a secure internet sign-on that allows patients to contact their provider, review medical tests and records, access health education materials and seek appointments. Most provider networks develop a patient portal before they move to full video appointments.
Peripheral devices – measurement or monitoring devices that plug into, for example, a tablet computer providing a video link. The peripherals can be stethoscopes, blood pressure cuffs, audiology tools or a pulse oximeter, among others.
Telehealth Clinical Technician (TCT) – a designated job category in the Department of Veterans Affairs with alternative titles in other provider organizations. The TCT works at the patient’s end of the telehealth link, handling the cameras or other technology, educating the patient and following the remote provider’s instructions to gather information, among other duties.
Store-and-forward – uploading a patient record or a digital photo for a distant provider to review at another time. The technology is used often in dermatology and other specialties.
Originating site – the location of the patient when telehealth is used, whether at home using a smart device or in an office at a local primary or mental health clinic.
Distant site – the location where the distant provider is housed and offering health information or treatment by remote means to the originating site.
This article was originally published in the Fall 2016 issue of Health Elevations.