By Ofer Zur, Ph.D.
Telehealth has also been referred to as Telemedicine, TeleMental Health or E-Health. It refers to the general term of delivery of medicine via digital means in a non in-person situation.
When it comes to psychology, counseling and mental health services, it has been called TeleMental Health, TelePsychology, E-Counseling, E-Psychotherapy, TelePsychiatry, Internet-based psychotherapy, and other similar names, including TeleAnalysis for conducting psychoanalytic psychotherapy via telehealth technologies.
TeleMental Health Activities May Include
using the telephone, text, e-mail, or interactive tele-video-conferencing technologies for:
- Crisis intervention or other contacts between in-person sessions.
- Conducting sessions with patients who are not able to attend in-person sessions for a period of time.
- Conducting psychotherapy with an individual in a different geographical area with or without in-person face-to-face contact.
- Providing assessment, prevention or treatment of mental disorders or related services to an individual in a different location.
- Conducting psychotherapy via phone or Internet synchronistically (i.e., at the same time, such as on the phone or via video-conferencing) or a-synchronistically (i.e., sequential, via text, e-mail or chat).
The literature on telehealth from professional organizations, insurance companies, and state and federal regulatory agencies all offer similar but also somewhat different definitions. In other words, no universal definition exists for telehealth services, also known as telemedicine.
In most general terms, telehealth is defined as the use of technology to provide clinical services.
Additional Definitions From A Variety Of Sources Include:
- Telemedicine or telehealth is the use of electronic communication and information technologies to provide or support clinical care at a distance.
- The use of telecommunications and information technology to provide access to health intervention, consultation, assessment, supervision, education, and information across distances.
- The use of the telephone, e-mail, chat rooms, and other Internet and satellite-based technologies to provide direct clinical services.
- Internet-based psychotherapy is the use of electronic media, via the Internet, to deliver psychotherapeutic services and treatment.
- “When used broadly by regulators and others, the term telehealth services may refer to all interactions between health care professionals and their patients that do not happen in person.” (This one is from APA Practice)
- Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status.
- Telemedicine is the combined use of telecommunications and computer technologies to improve the efficiency and effectiveness of healthcare services by liberating caregivers from traditional constraints of place and time and by empowering consumers to make informed choices in a competitive marketplace. (Bauer and Ringel)
- The use of advanced telecommunication technologies to exchange health information and provide health care services across geographic, time, social and cultural barriers. (Reid, 1996)
- The use of telecommunication technologies to provide health care services and access to medical and surgical information for training and educating health care professionals and consumers, to increase awareness and educate the public about health-related issues, and to facilitate medical research across distances. (Mosby’s Medical Dictionary)
- Telenursing refers to the use of telecommunications technology in nursing to enhance patient care. It involves the use of electromagnetic channels (e.g., wire, radio and optical) to transmit voice, data and video communications signals. It is also defined as distance communications, using electrical or optical transmissions, between humans and/or computers. (International Council of Nursing, ICN)
American Telemedicine Association (ATA) Defines Telemedicine In These Terms:
- Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. Telemedicine encompasses different types of programs and services provided for the patient. Each component involves different providers and consumers. (American Telemedicine Association)
Tele-Definitions From The American Nurses Association Discuss Telemedicine In These Terms:
- Telecommunications refers to the transmission, emission or reception of data or information, in the form of signs, signals, writings, images and sounds or any other form, via wire, radio, visual or other electromagnetic systems.
- Telehealth is the removal of time and distance barriers for the delivery of health care services or related health care activities. Some of the technologies used in telehealth include: telephones, computers, interactive video transmissions, direct links to health care instruments, transmission of images and teleconferencing by telephone or video.
- Telenursing is a subset of telehealth in which the focus is on nursing practice via telecommunications.
- Telemedicine, similarly, is another telehealth subset. Telemedicine includes many medical specialties, such as teleradiology, teledermatology, telepsychiatry, etc. (American Nurses Association)
Medicare Includes A Number Of Limitations In Its Definition Of Telemedicine:
- Technology is limited to real-time, interactive audio-video telecommunications, not “store-and-forward” technology such as email.
- Eligibility for reimbursement is limited to services provided to a Medicare beneficiary located at an eligible site in specified geographic areas – either a “rural health professional shortage area” or a county outside a Metropolitan Statistical Area.
- CMS limits the sites where a Medicare beneficiary may be located when receiving telehealth services. Eligible sites include a provider’s office, hospitals, skilled nursing facilities, rural health clinics and federally qualified health clinics.
Different States Have Defined Telehealth Differently.
- California law states: Telemedicine means the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, and education using interactive audio, video, or data communications. Neither a telephone conversation nor an electronic mail message between a health care practitioner and patient constitutes ‘telemedicine’. . . ‘interactive’ means an audio, video, or data communication involving a real time (synchronous) or near real time (asynchronous) two-way transfer of medical data and information.
- New York State: Telepractice is defined as the provision of professional service over geographical distances by means of modern telecommunications technology. (www.op.nysed.gov/reports/telepractice.pdf)
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