Visit most any restaurant these days and you’ll quickly interact with one of the “winners” of this pandemic. I’m talking about QR codes. These “bar codes on steroids”, now used to launch menus and online ordering apps, made a roaring comeback in 2020 thanks to their usefulness in the socially-distanced era of COVID-19.
That same can be said for telemedicine. While telemedicine has been around for decades, it’s acceptance by both patient and provider was somewhat anemic, at best, until the pandemic hit. Before COVID-19, it wasn’t at all uncommon to see telemedicine utilization rates in the single digits. Now it’s not unusual to see utilization rates in the 60 to 70 percent range.
While it’s wonderful to see a more widespread acceptance of this highly convenient and efficient healthcare delivery method, there is immense confusion over the set of terms used somewhat haphazardly (and interchangeably) to describe these virtual health services.
In the past year, we’ve heard carriers, employers, patients, policy makers, payers, and providers use everything from “telemedicine”, “telehealth”, and “telecare”, to “virtual medicine”, “virtual health” and “virtual care” to describe health services delivered via telecommunication technologies.
This post attempts to shed some light on the difference between these terms. While the differences might not seem all that important, they can be when working across different organizations, especially where reimbursement, data exchange, and data protection is concerned.
The Federal Communications Commission (FCC) defines telemedicine as “… using telecommunications technologies to support the delivery of all kinds of medical, diagnostic, and treatment-related services, usually by doctors.” The American Academy of Family Physicians (AAFP) defines telemedicine as “… the practice of medicine using technology to deliver care at a distance.” Finally, the Centers of Disease Control and Prevention (CDC) defines telemedicine as “…the use of electronic information and telecommunication technology to get the healthcare you need while practicing social distancing.”
In layman’s terms, it’s easiest to think of telemedicine as virtual office visits, often over the phone or through video, between patients and healthcare providers. Think of it as modern telecommunication solutions to clinical health services.
The FCC states that telehealth is similar to telemedicine but “… includes a wider variety of remote health care services beyond the doctor-patient relationship.” The AAFP says that telehealth “… refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance.”
In layman’s terms, it’s easiest to think of telehealth as a much broader set of remote healthcare services. The Center for Connected Health Policy (CCHP) identifies four different telehealth modalities: 1) live video; 2) mobile health; 3) remote patient monitoring; and 4) store-and-forward.
To further illustrate this, telehealth includes such things as the ability of a pharmacist to access prescriptions at other locations or for a nurse to place outbound calls to patients to monitor medication adherence, gaps-in-care, and assist with appointment setting.
Unlike telemedicine, telehealth includes remote non-clinical services, such as provider training, administrative meetings, and continuing medical education. Net, while telemedicine often serves as a substitute for an in-person clinical session, telehealth enables a considerably more extended list of healthcare-related applications.
The FCC states that telecare “…generally refers to technology that allows consumers to stay safe and independent in their own homes”. While this is a term that is more commonly used in Europe, it is gaining traction in the United States.
In layman’s terms, it’s easiest to think of telecare as the use of more advanced technologies, such as mobile apps, sensors, and other digital tools. Net, while telemedicine typically involves a patient and provider, telecare might not involve people at all.
VIRTUAL MEDICINE, VIRTUAL HEALTH, VIRTUAL CARE
As the term telehealth has emerged in more recent years, some have chosen to merge the term with telemedicine. The American Association of Retired Persons (AARP) blurs the lines even further by introducing a new term, virtual care. They go on to say, “Also referred to as telemedicine or telehealth, ‘virtual care’ involves the remote diagnosis and treatment of patients by medical experts who are miles or even continents away.”
While there doesn’t seem to be any consensus regarding these three terms, we’ve primarily seen all of them used interchangeably with telemedicine, which again, at least according the CDC, is “…the use of electronic information and telecommunication technology to get the healthcare you need while practicing social distancing.”
That said, all of this is still in flux. Not only does the AARP blur the lines between virtual medicine, virtual health, and virtual care, but they do the same with telemedicine and telehealth when trying to define virtual care!
Our advice is to use terms and definitions that are easiest for your organization to understand and implement and simply be consistent.
We’ve seen some organizations distinguish between telehealth and telemedicine by defining telemedicine as providing users with instant 24/7 access to medical professionals who can diagnose medical conditions and dispense medications in a virtual setting.
They distinguish this from telehealth by describing telehealth as providing plan participants with the ability to schedule virtual appointments with their current doctors, providing that those medical professionals offer virtual services.
It remains to be seen if the average consumer of healthcare can discern between “instant access” and “scheduled appointments” as a meaningful difference between these two types of services.
ONE NOTE OF CAUTION
As we stated earlier, when working with other organizations, especially where reimbursement, data exchange, and data protection might be involved, it’s essential that you use definitions that are the most widely accepted for these various terms.
When in doubt, discuss these issues with your healthcare partners and document the shared understanding of what these various terms mean.
For example, Medicare reimburses for a fairly wide array of services that most people consider to fall under the telehealth umbrella, but it only labels services with an "in-person equivalent" as “telehealth.”
Additionally, in response to COVID-19, HHS waived some HIPAA rules as they relate to "telehealth". This was done in an effort to expand not only how physicians can practice but also whom they are able to treat. In this instance, it is therefore critical to examine how HHS is exactly defining the term telehealth.
FOR MORE INFORMATION
Contact us for more information about how the JP Griffin Group is working with employers to introduce telemedicine and other virtual care solutions.