Medical Care

Update on Telehealth

“Telehealth” or “telemedicine” have been used more or less interchangeably over the past 50 years to describe the provision of health care services and exchange of health information by electronic means. The initial concept of telephonic and later computer-based medical interaction and education was defined by the Institute of Medicine as “the use of electronic information and communications technologies to provide and support health care when distance separates participants”. The uses of the two terms have diverged in intervening years, and the American Telemedicine Association recently defined the telemedicine and telehealth as “the use of medical information exchanged from one site to another via electronic communications to improve the patients’ health status….telemedicine is sometimes associated with direct clinical services and telehealth is sometimes associated with a broader definition of remote health care services.”

The initial contribution of electronic means of health-related communication was to facilitate the delivery of health care when distance or socioeconomic factors limited the availability or accessibility of medical services, and to mitigate shortages in the workforce of various medical specialties and subspecialties. The provision of medical services by electronic means may also assist in the reduction of health care costs, and the easier availability of comprehensive health information, particularly in emergent medical situations, may speed and simplify evaluation and treatment, and thereby improve outcomes as well as lowering costs.

Ongoing changes in the American health care system may increase demands on available clinical services and personnel, as has been seen in the health care systems of some other countries, and electronic adjuncts to traditional medical practice may help to alleviate these pressures. In addition, the evolving model of care in most health systems is patient-centered and team-based, and electronic communication and information exchange can efficiently link team members. Whereas the costs of many kinds of health care service are rising and modern scientifically-based medicine tends to become more complex as it advances, the costs of many telehealth technologies are dropping and they are becoming easier for patients and caregivers to use.

These technologies are also readily used for educational purposes, and have the capability of generating much data that can be used in quality improvement processes. These much greater capacities for the retention, distribution and analysis of health information also pose significant new questions and challenges regarding confidentiality and privacy.