Telehealth is defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
The amount providers are reimbursed for telemedicine will vary depending on a state’s legislation. Some states specifically mandate that private payers reimburse the same amount for telemedicine as if the service was provided in-person. However, most states with reimbursement mandates leave this determination up to the payers. We have found the majority of private payers still reimburse at levels equivalent to in-person visits.
A question popular among organizations that want to implement telemedicine solutions is regarding how their physicians will be reimbursed. With telehealth regulations varying for each state and with payers setting up different policies, it is difficult to find consistency. What does remain consistent is that telemedicine is advancing and its becoming difficult for the key players to keep up.
Whether on vacation with your kids, away from your home base for business, or in between family doctors, the use of online medical care opens windows and doors to around the clock consultations and medical services. The internet has made it possible for people in rural towns to reach city doctors, for men and women on the road to access much needed prescriptions, and for busy parents to get medical help without packing the kids up and hauling them down to the nearest clinic.
In Pakistan three pilot projects in telemedicine was initiated by the Ministry of IT & Telecom, Government of Pakistan (MoIT) through the Electronic Government Directorate in collaboration with Oratier Technologies (a pioneer company within Pakistan dealing with healthcare and HMIS) and PakDataCom (a bandwidth provider). Three hub stations through were linked via the Pak Sat-I communications satellite, and four districts were linked with another hub. A 312 Kb link was also established with remote sites and 1 Mbit/s bandwidth was provided at each hub. Three hubs were established: the Mayo Hospital (the largest hospital in Asia), JPMC Karachi and Holy Family Rawalpindi. These 12 remote sites were connected and on average of 1,500 patients being treated per month per hub. The project was still running smoothly after two years.
It has not only expanded and improved access to healthcare services, but also increased patient engagement and enabled more efficient care models. The Department of Veterans Affairs (VA) is one of the largest providers of telehealth services. Last year, more than 700,000 veterans accessed VA telehealth services, which include everything from mental healthcare to surgical specialist consultations. But it’s not just veterans who are benefiting.
A patient might find themselves in need of services from Express Med Refills for a variety of reasons, the most common being inaccessible family doctors. From time to time, even the most dedicated physician takes a vacation, and while most leave a proxy, or address patient needs before departing, there is the odd case of a patient being left in dire need of a prescription refill. Through our website, Americans can gain access to a U.S. registered online doctor, conduct a one on one consultation, and have a prescription sent to a nearby local pharmacy all on the same day.
Kaitlin Brasier has worked in primary care since 2012 and provided virtual care since 2013. She received her Doctor of Nursing Practice from the University of San Diego in 2012. In addition to providing virtual care, she works in a dermatology clinic. She has extensive experience in family practice nursing and women's health and has conducted research on childhood obesity prevention. She enjoys outdoor activities, including hiking, snowboarding and horseback riding. She also likes cooking, reading and travel.
Bao Ng has worked in primary care since 2013 and provided virtual care since 2013. Obtaining her Doctor of Nursing Practice from the University of Washington, she began working in telemedicine shortly thereafter. Her medical interests include international health, and maternal and child health. She works at an international community health clinic near her home, and is fluent in Vietnamese and proficient in conversational Cantonese. She volunteers as a caregiver in her church nursery and is an executive board member for a local pediatric and behavioral health clinic. Outside of work, she enjoys spending time with her husband and children and exploring new cuisines.
Telemedicine companies that are consumer-facing offer the huge benefit of on-demand care for patients. A sick patient can simply login online and request a visit with one of the company’s doctors and get treatment. But this model, similar to the retail health movement, leads to a breakdown in care continuity. A random doctor who doesn’t know the patient, doesn’t know their whole medical history. The best approach to telemedicine? Providing tools to providers to easily connect with their own patients.
Teladoc does not guarantee prescriptions. It is up to the doctor to recommend the best treatment. Teladoc doctors do not issue prescriptions for substances controlled by the DEA, non-therapeutic, and/or certain other drugs which may be harmful because of their potential for abuse. Also, non-therapeutic drugs such as Viagra and Cialis are not prescribed by Teladoc doctors.
The range and use of telehealth services have expanded over the past decades, along with the role of technology in improving and coordinating care. Traditional models of telehealth involve care delivered to a patient at an originating (or spoke) site from a specialist working at a distant (or hub) site. A telehealth network consists of a series of originating sites receiving services from a collaborating distant site.
Several decades later, in the 1950’s, a few hospital systems and university-based medical centers experimenting with how to put concept of telemedicine into practice. Medical staff at two different health centers in Pennsylvania about 24 miles apart transmitted radiologic images via telephone. In 1950’s, a Canadian doctor built upon this technology into a Teleradiology system that was used in and around Montreal. Then, in 1959, Doctors at the University of Nebraska were able to transmit neurological examinations to medical students across campus via a two-way interactive television. By 1964, they had built a telemedicine link that allowed them to provide health services at Norfolk State Hospital, 112 miles away from campus.
As the CCHP notes, different organizations have different definitions for telehealth. California very specifically defines it as “the mode of delivering healthcare services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient's healthcare while the patient is at the originating site and the healthcare provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.” The Health Resources and Services Administration (HRSA), meanwhile, defines it as “the use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health-related education, public health and health administration.”
Once shared, that knowledge takes on a life of its own, growing and moving in all directions. Primary-care clinicians learn from their specialist mentors at the university hubs, but they also learn from each other. And by applying the knowledge they gain in the field, they produce new knowledge, which they then relay to their specialist and primary-care colleagues in their learning community.
There are a variety of payment models to fund telemedicine services. For example, some health systems offer telemedicine consultations as part of their regular care services, and payers charge patients based on insurance plans or government reimbursement schedules. In other cases, a patient's employer offers virtual care options as part of health insurance coverage premiums. Some people may opt to independently use a telemedicine vendor for a flat fee.
Even the American Telemedicine Association also considers telemedicine and telehealth to be interchangeable. “While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services, (the) ATA uses the terms in the same way one would refer to medicine or health in the common vernacular,” the organization states.
34 states and the District of Columbia require that private insurers cover telehealth the same as they cover in-person services. Many other insurers cover at least some telehealth service--and many more have expressed interest in expanding their telehealth coverage. To find out if your insurance company covers telehealth services, please contact your benefits manager.
Monitoring center links are used for one type of telemedicine – remote patient monitoring. This type of telemedicine link creates a digital connection between a patient’s house and a remote monitoring facility, so that a patient’s medical data can be measured at home and transmitted electronically to a distant medical monitoring facility. These links usually take the form of internet, SMS, or telephone connections. They’re most commonly used for monitoring of pulmonary, cardiac, or fetal medical data.
Policies and regulations in the telemedicine arena can be confusing for providers, vendors, and payers. Organizations interested in implementing telemedicine should be familiar with the laws in their state. For example, some states require informed consent from patients, while others do not. Some payers may not pay the same rate for telemedicine services as they do for in-person services. Practices should identify how providers will be paid, as some organizations seek grant funding.
These emerging models produce virtual communities of learning and practice that embrace all members of the healthcare team. They are the latest point on the telemedicine continuum that began with the point-to-point connection achieved by Einthoven's pioneering electrocardiogram. Building out the connection established under telemedicine into an ever-expanding knowledge-sharing network can create new potential to improve health and save lives.
Telemedicine for trauma education: some trauma centers are delivering trauma education lectures to hospitals and health care providers worldwide using video conferencing technology. Each lecture provides fundamental principles, firsthand knowledge and evidenced-based methods for critical analysis of established clinical practice standards, and comparisons to newer advanced alternatives. The various sites collaborate and share their perspective based on location, available staff, and available resources.
Patient Exam Cameras – These cameras are used to examine the patient’s overall condition. The different types of patient exam cameras are handheld cameras, camcorders, gooseneck cameras and those which may be placed above the set-top units. Analog and digital cameras are available and the ones that should be used depend on the connection to the set-top unit.
Telemedicine was originally created as a way to treat patients who were located in remote places, far away from local health facilities or in areas of with shortages of medical professionals. While telemedicine is still used today to address these problems, it’s increasingly becoming a tool for convenient medical care. Today’s connected patient wants to waste less time in the waiting room at the doctor, and get immediate care for minor but urgent conditions when they need it.
Teledermatology allows dermatology consultations over a distance using audio, visual and data communication, and has been found to improve efficiency. Applications comprise health care management such as diagnoses, consultation and treatment as well as (continuing medical) education. The dermatologists Perednia and Brown were the first to coin the term "teledermatology" in 1995. In a scientific publication, they described the value of a teledermatologic service in a rural area underserved by dermatologists.
In addition to medical assistance, there are psychologists and psychiatrists you can schedule appointments with for online therapy. They treat depression, additions, social anxiety, trauma and workplace stress as well as social issues. Like the doctors, psychiatrists can prescribe medication. Doctor on Demand provides an online assessment to help you determine if you could benefit from telepsychology.
The Health Resources Services Administration defines telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Healthcare systems that are thinking about implementing telemedicine solutions should consult with experts in the industry. VSee, a leading telemedicine organization, suggests that practices do not rush into telemedicine without having the right equipment. They offer a variety of practical solutions for practices wanting to add telemedicine to their clinic and can make the integration more seamless.
Teladoc charges an annual subscription fee for its service plus a $40 co-pay per video or phone appointment with a doctor, though employers sometimes subsidize or cover the co-pay completely for their employees. Health insurance startup Oscar (co-founded by venture capitalist Joshua Kushner), for one, has promoted its ACA-compliant health plans with the perk of getting to talk to doctors 24 hours a day—through Teladoc—for free.
Teleradiology : This is the transfer of radiological images. X-Rays, MRIs and CTs are all types of radiological images. These images are used for consultation, diagnosis or interpretation. They can be transferred through satellite connections, local area networks or even standard telephone lines. The Picture Archiving and Communications Systems allow centralized storage and the access of these images over information systems such as computers.
Initially, Medicare only reimbursed providers for very specific health services provided via telemedicine, often with strict requirements. In the past few years with the rapid growth in the telemedicine industry, Medicare has expanded the list of reimbursable telemedicine services but still imposes many restrictions on how the service is provided.
Blue Sky Telehealth is committed to making specialty healthcare services more accessible to patients nationwide. We partner with hospitals to create a customized telehealth system that integrates with the facility’s existing processes and technology. Through our service, medical facilities can contact highly experienced medical specialists 24/7 to assist with patient care, diagnosis, and treatment. This saves hospitals the cost of keeping a medical specialist on-call full time and ensures that a qualified medical professional will always be available to tend to a patient with special care needs.
But getting doctors to jump on board is easier said than done, and takes time. Many are afraid of liability, as it's possible to miss something during a remote visit. And for years, it wasn't clear whether they would get paid as much as an in-person visit. Reimbursement questions are still getting resolved across different states, but most of the commercial and government plans are on board with the idea of telemedicine -- at least in specific circumstances.
Not all state and federal agencies define telehealth in exactly the same terms, but most are fairly consistent with the federal Health Resources and Services Administration, which defines telehealth this way, “The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”
Visit Teladoc and set up an account using the information provided on your GuideStone/Highmark BCBS ID card. You'll also complete a medical history so that it's easy for the Teladoc physician to access when providing treatment. Or you can set up your account and provide your medical history by calling 1-800-TELADOC (1-800-835-2362). If they ask for your employer's name, be sure to tell them your coverage is provided through GuideStone/Highmark BCBS and provide the identification information from your ID card. Learn more about How to Register.
Telehealth has emerged as a critical tool in providing health care services.  The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.
Sharla Peterson has worked in primary care since 2007 and provided virtual care since 2011. She received her Master of Nursing from Washington State University. In addition to her career in telemedicine, she works part-time in a plastic surgery office and volunteers at a free clinic near her home. She serves as Medical Director for local Camporee events with the Boy Scouts of America and works with youth in her church. When she is not working, she enjoys cooking, family time and outdoor adventures of all kinds.