What is Telehealth?
“Telehealth is the integration of telecommunication systems into practice of protecting and promoting health, while telemedicine is the incorporation of these systems into curative medicine” (World Health Organization, 1997)
How is it used?
First used successfully in the military to provide care for wounded soldiers in the field, telemedicine is expanding not only within the government but spilling over to the private sector. You can guess what’s driving this enormous change in how we deliver care — the pressure to cut costs! The move towards telehealth is also prompted by Obamacare pressures to improve quality, reduce ER visits and readmissions, and allow for better access to care by the elderly, disabled and rural residents.
Patients who find it hard to visit a doctor or specialist can now teleconference their office for personalized medical advice…from the comfort of home. When heart failure patients are remotely monitored on a daily basis for any subtle changes in weight or vitals, their doctor will be alerted immediately and will make timely adjustments in their diuretic and blood pressure medications to keep them from returning to the hospital with fluid overload. Providers can push text messages to clients needing a daily nudge with their diet and exercise regimen and help them stick to an exercise and diet plan they designed with their providers. This technology is an excellent way to deliver patient-centered care. How many times has a simple injury or infection been ignored because it was a hassle to see the doctor, only to have it explode into a fulminating painful medical emergency? With monthly prepaid contracts with the primary doctor, people will be less likely to delay seeking help and more inclined to fire-off a text or video call to their provider that is covered in their plan.
Real-time communication using online voice and video interactions or “teleconferencing” allows providers to conduct consultations and deliver care, health education and health coaching at a distance. Providers can also gather real-time data from patients through store-and-forward imaging, streaming media and remote wireless devices that detect subtle day-to-day changes in their physical and mental states.
Patients and providers can save a lot of time and money engaging in this electronic information exchange. They use a variety of platforms that suit the needs of both provider and client, such as smartphones, mobile apps, cloud-computing, tablets and laptops. For $49 per cyber visit, people seeking medical advice on common symptoms like coughing or on how to better manage their chronic illness can quickly access a doctor 24/7. To enroll, they simply use their smartphones to download a mobile app such as “Amwell” by American Well.
What does the research show on its effectiveness?
Studies on hypertensive and diabetic patients that were telemonitored at home reported a significant decrease in blood pressure and glucose level, respectively. Also, cardiac patients on such monitors showed significant improvement in their quality of life. Data transmitted is reliable and well received by patients. Research on home-based telemonitoring of chronically ill patients is promising; it’s data is reliable and accurate, it empowers and influences their behaviors, and this technology might improve their medical status.
What are the laws on telehealth?
Reimbursement for telehealth services is crucial in its expansion. Medicaid reimbursement for telehealth services is required on some level in a total of 43 states and the District of Columbia. Telehealth is covered by private insurance plans that are based in 19 states and the District of Columbia, and soon in Arizona. Fortunately, Michigan has passed laws to allow for both state and private insurance reimbursement for telehealth services in the state.
Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base. Guy Paré, PhD, Mirou Jaana, PhD, and Claude Sicotte, PhD