Telehealth patient and physician

Defining the telehealth landscape

Telehealth, telemedicine and related terms generally refer to the exchange of medical information from one site to another through electronic communication. The Centers for Medicare and Medicaid Services (CMS) defines telehealth as a two-way, real-time interactive communication between a patient and a physician or practitioner at a distant site through telecommunications equipment that includes, at a minimum, audio and visual equipment. 

While telemedicine has historically referred to remote clinical services, telehealth can refer to broader services including:

Telehealth

Synchronous

  • Real-time, audio-video communication that connect physicians and patients in different locations. (Note: This definition is used for telehealth for CMS coverage and payment.)
  • Real-time audio and telephone communications.  

Asynchronous

  • Store-and-forward technologies that collect images and data to be transmitted and interpreted later. 
  • Online digital visits and/or brief check-in services furnished using communication technology that are employed to evaluate whether or not an office visit is warranted (via patient portal, smartphone).
  • Interprofessional internet consultations between physicians and/or other qualified health care professionals to improve care coordination for patients by sharing verbal or written reports for further assessment and/or care management.

While many consider remote monitoring services to be a subset of telehealth, CMS does not currently consider remote monitoring as telehealth since it is inherently a non-face to face service.

Remote patient monitoring

Remote patient monitoring (RPM) refers to patient data being collected and transmitted outside of the office, mostly asynchronous, which results in clinical decision making and care management follow up that may be provided in-person or virtually.

  • Tools and wearable devices (which may involve the use of mHealth apps) that measure weight, blood pressure, pulse oximetry, respiratory flow rate, musculoskeletal system status, therapy adherence, therapy response and other patient generated data for review and treatment management.
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