What is Telehealth?

Definition

Telehealth is the remote provision of healthcare services and health education, mediated by technology. You may hear other similar terms such as telemedicine, e-health, connected health and health telematics – we consider the differences between these terms to be so minor that they are essentially equivalent. The important common thread between all of these terms is that technology is used to break down barriers of geography and access to health care and education.

If you are really interested in pursuing the semantic differences between these terms, we invite you to check out these links:

American Telemedicine Association – Defining Telemedicine and Telehealth
http://www.atmeda.org/news/definition.html

American College of Nurse Practitioners – What is Telehealth?
http://www.acnpweb.org/i4a/pages/Index.cfm?pageID=3470

American Academy of Family Physicians – Telehealth Discussion Paper
http://www.aafp.org/online/en/home/aboutus/specialty/rural/telemed/telehealth.html

Oh, H, Rizo C, Enkin M, Jadad A. What Is eHealth (3): A Systematic Review of Published Definitions. Journal of Medical Internet Research. 7(1), 2005.
http://www.jmir.org/2005/1/e1/

Sood S, Mbarika V, Jugoo S, Dookhy R, Doarn CR, Prakash N, Merrell RC. What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings. Telemedicine Journal and E-Health. 2007 Oct; 13(5):573-90.
http://www.ncbi.nlm.nih.gov/pubmed/17999619?

Wikipedia Definitions:
Telemedicine http://en.wikipedia.org/wiki/Telemedicine
Telehealth http://en.wikipedia.org/wiki/Telehealth
e-Health http://en.wikipedia.org/wiki/Ehealth

Operational Modes of Telehealth

There are two primary modes of telehealth: (1) real-time (synchronous) and (2) store-and-forward (asynchronous). Real-time telehealth sessions are live and interactive, and frequently use videoconferencing technologies. Often, special telehealth-enabled instruments (peripherals), such as a video otoscope (to examine the ear) or an electronic stethoscope, are operated by a nurse or technician at the consulting provider’s direction to remotely perform a physical examination. In store-and-forward telehealth, data (such as digital photographs) are captured locally, then temporarily stored (cached) for transfer at a later time, either via a secure web server, encrypted e-mail, specially-designed store-and-forward software, or electronic health record. The consulting provider then reviews the stored data and makes diagnosis, treatment, and planning recommendations that are electronically transferred or faxed back to the referring provider. UM TeleHealth uses both modes in different projects – for example real-time in our CMS applications (hyperlink) and store-and-forward with the Great Plains Regional Medical Command (link).

Recently, a hybrid approach has been developed, that has both real-time and store-and-forward elements. For example, a hybrid teledermatology method may use a digital camera to capture high resolution pictures of the skin that the consulting dermatologist reviews prior to a real-time videoconferencing session.