If the state decides to cover telemedicine, but does not cover certain practitioners/providers of telemedicine or its telemedicine coverage is limited to certain parts of the state, then the state is responsible for assuring access and covering face-to-face visits/examinations by these "recognized" practitioners/providers in those parts of the state where telemedicine is not available.
Telehealth specialists with specialized training in talking with patients and diagnosing over the phone and via online video, while adhering to Teladoc's set of 130 proprietary, evidence-based, clinical practice guidelines for the telephonic and audio-video treatment of common, uncomplicated medical conditions (the only guidelines in the industry specific to telehealth).
While this definition sounds a lot like telemedicine, there is one distinct difference. Unlike telemedicine, telehealth also covers non-clinical events like administrative meetings, continuing medical education (CME), and physician training. Telehealth is not a specific service, but a collection of methods to improve patient care and education delivery.
When a healthcare service decides to provide telehealth to its patients, there are steps to consider, besides just whether the above resources are available. A needs assessment is the best way to start, which includes assessing the access the community currently has to the proposed specialists and care, whether the organisation currently has underutilized equipment which will make them useful to the area they are trying to service, and the hardships they are trying to improve by providing the access to their intended community (i.e. Travel time, costs, time off work). A service then needs to consider potential collaborators. Other services may exist in the area with similar goals who could be joined to provide a more holistic service, and/or they may already have telehealth resources available. The more services involved, the easier to spread the cost of IT, training, workflow changes and improve buy-in from clients. Services need to have the patience to wait for the accrued benefits of providing their telehealth service and cannot necessarily expect community-wide changes reflected straight away.
In the future, experts say, internet-connected sensors—such as blood pressure monitors—could be paired with e-visits to help people manage chronic conditions from home. So far, such devices aren't widely used. But the list of conditions that patients and doctors can manage remotely is “ever expanding,” says Eric Topol, M.D., director of the Scripps Translational Science Institute.