Telehealth versus Telemedicine
The terms telehealth and telemedicine are constantly evolving; however, the U.S. Department of Health and Human Resources 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.”
On the HealthIT.gov website, the following distinction is made: “Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote nonclinical services, such as provider training, administrative meetings and continuing medical education, in addition to clinical services.”
Telehealth as a Learning Tool
A blog post that was brought to our attention on RadIQ, an online training program for radiology CME used by Massachusetts General Hospital, piqued our curiosity about the system behind the technology and offered some interesting statistics with respect to the role online learning plays in the digital world.
The blog post, written by Calgary Scientific VP of Alliances Randy Roundtree, cites a recent article from elearning.com, which estimates that about 46% of college students are currently taking at least one course online. Recent studies conducted by Britain’s Open University have found that e-learning consumes 90% less energy than traditional courses, and according to a study conducted by the Research Institute of America, e-learning has the power to increase information retention rates by up to 60%.
In an environment where radiology residents can see up to 400 images for a single patient, speed and detail is critical, and the platform used for image viewing, ResolutionMD, does not appear to disappoint. Garry Choy, MD, MBA, codirector for RadIQ, director of informatics for the MGH Cardiovascular Imaging Core Lab and assistant chief medical information officer for Massachusetts General Physicians Organization, is quoted in the blog as saying, “We’ve been able to maintain image quality and the real-life imaging interpretation experience of being at a workstation (by using ResolutionMD)… Users do not want to experience any delays when viewing images, and this is often a challenge in web-based viewers. Slow load time is not an option, particularly for busy physicians. ResolutionMD is fast and simple to use.”
Given the workload of today’s radiologist, the ability to safely and securely view images in high resolution on a mobile device not only provides an opportunity for advanced learning through CME, but has the potential to foster in a new generation of health care that takes its roots in the emergence of telehealth in the 1950s, namely providing the best care to patients regardless of their location.
The Case for Advancing Telehealth
A white paper presented by Calgary Scientific, in conjunction with Bluepath Health, a California Health IT Consulting Firm, makes a strong case for mobility in today’s telehealth environment. It cites that 83% of physicians already use mobile technology to provide care, according to a HIMSS (Health Information and Management Systems Society) 3rd Annual HIMSS Analytics Mobile Survey. Given this high rate of current use, the devices are already in play for a large majority of physicians.
Further, it addresses the issues of both payment and licensing across state lines by citing the role of health care reform’s role in the advancement of telehealth, stating that in May 2014 the AMA released guidelines to support the “appropriate coverage of and payment for telemedicine services,” including uniform compensation for professional services, whether they are delivered via telephone, fax, email or real-time audio and video technology, and that the Federation of State Medical Boards (FSMB) has drafted a model law that would allow providers to practice in multiple states. According to the document, “The FSMB’s interstate compact would have a significant impact on access to care for rural patients. California providers located in the state’s urban centers, for example, would be able to treat both the state’s own rural population as well as rural patients in the neighboring states of Oregon, Nevada and Arizona.”
Despite these movements toward overcoming telehealth barriers and the readily available technology for deployment, a 2013 HIMSS survey cited in the white paper reveals that of 4,727 hospitals, 34% of rural hospitals and 32% of urban hospitals use telehealth services. By category, radiology tops the list of highest adoption rate at 15.7%.
Notwithstanding this low adoption rate, the white paper cites successful adoption at key health care facilities, including Nebraska Medicine and its use of ResolutionMD for mobile-viewing with its telestroke technology; the U.S. Department of Veterans Affairs, which is widely recognized as the nation’s largest integrated health care system; at Intermountain Healthcare, where ResolutionMD was used to integrate eight data archives, providing 22 hospitals and 185 clinics a common image storage and access platform; and at the Mayo Clinic, which conducted a study that incorporated smartphones into a telestroke network, revealing a strong level of agreement among reviews whether on a smartphone or PACS viewer. The Mayo Clinic study also revealed that accessing patient images on iPads with image-viewing software was six times faster than using a high resolution PACS viewer or viewer developed by the clinic.
Calgary Scientific touts the benefits of ResolutionMD not only in platform, but in scope of implementation. It has FDA Class II clearance for diagnosis, scalable architecture for fast, high-quality image-viewing of 2D and 3D images regardless of the size of health care setting, HIPAA compliance and PHI security, a low IT footprint through self-administered implementation (“apps”) and cloud-based storage, and ease of use.
What are Your Thoughts on Telehealth and Mobile Platforms?
Most of you reading this have one of technology’s most powerful tools, either in your pocket, briefcase, or both. The smartphone and tablet have revolutionized the way we view information, and their integration into the practice of medicine continues forward, though not quite at the rapid pace one would expect due to concerns over privacy, proper accreditation and the infrastructure required for implementation. What are your thoughts on the use of mobile technology and its role in advancing telehealth, both in overall access to quality health care and education? If you are using mobile telehealth currently, we want to hear from you. Comment below.