• How is a secure and dependable internet connection established?
• How is my privacy protected?
• How is my health assessment going to be done?
Technology is key to answering these questions. The essential technology tools required for a successful Telehealth/Telemedicine experience include:
1. Secure and dependable internet connection
2. Custom-configured hardware and peripherals
3. Custom software (Electronic Medical Records/EMR)
Secure and Dependable Internet Connection
Because Telehealth/Telemedicine involves consultations from a distance, a dependable and secure internet connection is crucial.
Not all areas of the U.S. have internet access; however, efforts are being made to build a stronger broadband infrastructure. In 2010, the U.S. government initiated the National Broadband Plan to ensure that all communities have access to broadband service by 2020. As it relates to healthcare, the plan states, “Broadband-enabled health information technology (IT) can improve care and lower costs by hundreds of billions of dollars in the coming decades…” Congress dedicated billions of dollars in funding to support the National Broadband Plan.
While healthcare providers are responsible for their own internet connections, some providers, especially those in rural and underserved areas of Arkansas, may benefit from a technology grant.
In 2012, Arkansas received significant funding to improve internet capabilities for Telehealth/Telemedicine as well as distance and continuing education programs. The University of Arkansas for Medical Sciences (UAMS) and the Arkansas e-Link team was awarded $102 million by the National Telecommunications Information Administration (NTA) to support a statewide $128 million broadband infrastructure to serve community institutions across the state. The Arkansas e-Link team has installed and/or upgraded broadband, interactive video units and public access personal computers in communities all over the state. The Arkansas e-Link infrastructure has impacted more than 3,900 community institutions, 61,000 businesses and reached more than 185,000 underserved families.
Patient privacy is protected in a Telehealth/Telemedicine consultation in the same way it is protected in a face-to-face visit.
Prior to a Telehealth/Telemedicine clinical consultation, patients are generally provided with an overview of how their consultation will be managed and are asked to sign a consent form that explains how their information will be used and who will have access to it.
When Telehealth/Telemedicine hardware is used, customized software encrypts patient information. Encryption software must meet HIPAA Federal security standards and guidelines. If mobile devices are used (such as phones and tablets), additional security efforts should be made through the use of passwords and the ability to remotely disable mobile devices that are lost or stolen.
It is important to know that the Health Insurance Portability and Accountability Act (HIPAA) was passed in the U.S. in 1996. This law protects a patient’s right to privacy in both a face-to-face visit and a Telehealth/Telemedicine consultation. Healthcare providers are legally bound by this law.
Common types of hardware used in Telehealth/Telemedicine consultations include carts, desktop/laptop computers and tablets.
Carts are portable systems used for clinical and educational purposes. Clinical carts are used for patient care while educational carts are used for training, meetings, interviews, etc. Carts are customized to meet specific needs and specialties.
Carts generally include a monitor, camera, Codec (to encrypt information), keyboard and remote control. Clinical carts also have a PC to store patient information. Clinical carts provide healthcare professionals with the capability of viewing live images as well as taking pictures to store and forward to other healthcare professionals at a later time, if needed.
Hardware is developed by several different companies and can be customized to meet the needs of individual Telehealth/Telemedicine providers.
Carts are designed to use tools that assess patient needs. These tools, called peripherals, are very similar to the tools used in a face-to-face visit. Peripherals include items such as vital sign monitors, digital stethoscopes, probes, spirometers, etc. Cameras are also available for specific types of care, such as dermatology or radiology.
A desktop computer (stationery) or a laptop computer (mobile) can be used for consultations. HIPAA-compliant software required for encryption and privacy is installed on these devices when used for Telehealth/Telemedicine purposes.
Tablets, such as iPads, are often used in emergency medicine and other healthcare areas. Mobile technology enables an immediate connection between patient and healthcare professional regardless of location. Sometimes, patients use tablets to monitor conditions and consult with their healthcare team.
Custom Software (Electronic Medical Records/EMR)
Customized software provides a digital patient record that can be forwarded to other healthcare professionals and facilities as needed. Patient data is encrypted to ensure privacy.
Software is developed by several different companies and can be customized to meet the needs of individual Telehealth/Telemedicine providers.
In the future, we could see more mobile apps and self-monitoring devices that feed information directly to a patient’s digital record and automatic notifications to a healthcare team if issues develop.
As cost-effective Telehealth/Telemedicine services become more accepted and used, the technology will continue to change to meet patient and healthcare provider needs.