What are Telehealth and Telemedicine

Telehealth and Telemedicine both describe the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health status.

Telehealth
Telehealth is a broad term that encompasses several different potential applications of Telehealth technology. This includes everything related to health care services like research, disaster response, education, and administration.
Telemedicine
Telemedicine is under the Telehealth umbrella. When you think of the term telemedicine think of the patient. For example, conducting an ultrasound or psychiatric consultation over Telehealth technology would be considered practicing telemedicine. A Telemedicine event might consist of a physician or specialist at a “distant site” or “hub site”…and a patient at what’s called the “originating site” or “spoke site”. The goal is to close the distance gap between the two.

Common Telehealth Applications

As the telehealth industry grows and becomes more widely adopted it becomes a challenge to list all the uses available.


Telehealth Providers

If you are a telehealth provider or are practicing telemedicine in some capacity and are not listed here please edit this page or send an email to info@learntelehealth.org

Here is a list of Telehealth Network Grants given by HRSA

Arkansas

In 2010, UAMS was awarded a large grant from the NTIA through the BTOP program. Here is a page with detailed information, http://cdh.uams.edu/?id=8500&sid=34. The project is now named Arkansas eLink. Much more is available here: http://www.arkansaselink.com/.

For training, both general and equipment-specific training go to http://learntelehealth.org/elink/ and explore the options.

For a complete list of sites on the eLink network go here – http://learntelehealth.org/elink/elink_connections/

University of Arkansas for Medical Sciences (UAMS) provides telemedicine services and network management. Services provided include OB-GYN, Genetics, Pediatrics and others.

Baptist Health System of Arkansas provides telemedicine services and has an e-ICU program.

There are numerous tele-mental health providers in the state.

Mississippi

The University of Mississippi in Jackson has a Tele-emergency program.

Here’s a link to the Mississippi State University Extension Service e-Beat Program –  http://msucares.com/ebeat/ . According to the site the program, “was created as part of a grant from the Governor’s office to help Mississippians use broadband and information technology to further community and economic development opportunities.” A presentation from Chip Templeton, who serves as a regional broadband coordinator with the e-Beat program, was given at the 2013 South Central Telehealth Forum and is available here, https://vimeo.com/66910633 . Here’s the most recent annual report, http://msucares.com/ebeat/files/ebeat_first_year_report.pdf.

Tennessee

The Tennessee Telehealth Network (TTN), a program of the Tennessee Primary Care Association (TPCA), has approximately 50 Telehealth units located in various clinics and medical centers throughout the state. This is a managed network with 24/7 tech support. The focus is on connecting rural patients with clinical specialists, and the largest usage is in behavioral health. Please contact Terry Eagleton (615.425.5849) or Larry Jones (615.425.5857) for more information.

The University of Tennessee Health Sciences has a telemedicine program.  Web site link is broken as of December 2011.


Telehealth Technology

Mobile Systems

Pros:
Ideal for clinical use (if properly equipped), relatively small, light and easy to transport, Screen, camera, microphone and speaker on one cart, operates with a single remote control, easy setup.

Cons:
Not good for larger groups, can be costly if equipped with medical equipment ($20-30K)

Mobile systems are very useful in clinical environments where the unit must travel from room to room. Built on a sturdy, low center-of-gravity cart, mobile systems often consist of one or two small to medium size monitors and a built-in microphone and speaker system. It is important to have a mobile system with multiple video inputs. This will allow for external medical devices like laptops, scopes and cameras to be connected.

Some mobile systems are only designed for administrative or educational use. Those systems often have a larger display screen and sometimes have the ability to plug into a larger room system. Mobile systems can usually accommodate 3 to 5 participants in the conference.

Desktop Systems

Pros:
Easy to use and setup, requires one remote, affordable ($150 and up for software-based systems; $5 to 9K for hardware-based systems), screen, camera, microphone and speaker built in.

Cons:
Not good for larger groups, limited ability to control and move camera (typically only focus), quality can be poor (for software-based systems).

Desktop systems are designed for convenience in mind. Ideal for one to three people, the average desktop system only needs power and an Internet connection to operate. Desktop systems can allow for a clinician to view a patient or medical images in an office setting. Users can participate in administrative or educational activities. A computer or laptop can be connected easily and give the participant ability to send images over the teleconference

Room Systems

Pros:
Good for educational teleconferences, large group conferences, grand rounds or case conference type interactions

Cons:
High cost for installation and maintenance ($60-100K), impersonal for small group discussions, more difficult to operate

Room systems are typically built around a larger display screen and include multiple cameras. Therefore, they are ideal for larger groups in a teleconference activity.

In multi-camera rooms there is typically a touch screen control unit to allow control and switching of the cameras. In some cases, remote controls can be used to control the cameras. There needs to be a robust audio system. This means that speakers and microphones are needed as well as microphone mixers and digital signal processors. Computers or laptops can be connected to the system.


Telehealth Sustainability

Billing and Reimbursement

Contracts

Grants

See the Grants page for information on telehealth grants.


HIPAA Compliance

HIPAA and Videoconferencing Document from CTEL


Frequently Asked Questions area.

Check here first before posting your question to the Knowledge Base

I need help with all the Telehealth terms. Can you help?
Sure, check out our interactive glossary by clicking here. You can also download the glossary PDF and print out if you would like.
I would like to develop a telehealth program. How can you help?
Great news! We have a lot of information to offer:
  • Register with our site and create a FREE profile.
  • Check out our online courses to brush up on the overall concepts.
  • Contact us so that we can set up a one-on-one dialog to help with your needs.
How can I get reimbursed practicing Telemedicine?
So you want to get paid? According to the Centers for Medicare & Medicaid Services, Medicare will pay for a limited number of services that are furnished by a physician or practitioner to an eligible beneficiary via a Telecommunications system. For more Click Here.
Where can I find information about physician licensure in my state?
The Center for Telehealth and e-Law is a great resource for licensure information. Some of their information is free while some of it requires a paid membership. Click here to go to CTEL’s website.
My facility is supposed to receive equipment and/or line charges through the Arkansas BTOP or FCC stimulus project. When can I expect to hear from someone?
The project team is currently engaging in a strategic planning phase, which will allow for the most efficient and effective implementation, which will take place for just under three years. Upon completion of the strategic planning phase, partnering sites will be contacted to coordinate grant-related activities. For now, we thank you for your patience, as we begin to lay out the best plans to implement this statewide project. Please visit the BTOP FAQ page for more information.
How do I know if my unit is HIPPA compliant?
There are generally two items to consider when ensuring your unit is HIPPA compliant. First your unit should be on a secured network. Second you should follow normal HIPPA guidelines by providing a private and secure location for your video unit for all participants in the video conference.

For professionals who may consult from a private residence, your internet provider can assist you in securing a static IP address on a business rather than residential internet connection.

How do I know the type of Telemedicine unit I need?
This is a difficult question to generalize to a wide audience. It depends on what you want to use the unit for and where you will be using it. We suggest you contact us or your local Telehealth Resource Center for assistance.
You may contact us by email Click Here
To find a TRC in your area Click Here.
How much does a Telehealth unit cost?
The cost will depend on your location and your needs. We would be happy to assist you with this question. You may contact us by email Click Here
Where do I order a Telemedicine unit?
There are many vendors that will be happy to assist you in your purchase, however if you are part of a network already in place then the network organizer might be able to assist you in your purchases. We suggest you contact your regional TRC for more assistance.
You may contact us by email Click Here
To find a TRC in your area Click Here.
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