The state of California uses the term telehealth, though some providers and payors may use the term telemedicine when referring to the provision of health care at a distance. While the term telemedicine has been commonly used in the past, telehealth is a more universal term that covers a broad array of applications in the field. Its use crosses most health service disciplines including dentistry, counseling, physical therapy, and home health, among other domains.
Ideally, there should not be any regulatory distinction between a service delivered via telehealth and service delivered in person. Both should be held to the same quality and practice standards. The “tele-” descriptor should ultimately fade from use as these technologies seamlessly integrate into health care delivery systems. Note that while a connection exists between health information technology (HIT), health information exchange (HIE), and telehealth, neither HIT nor HIE is considered telehealth.
What is Telehealth?
Virtual Care This broad term encompasses the full range of digital modes by which health providers remotely interact with patients in the course of delivering care. Similar terms include connected health care. Providers and patients may use a blend of synchronous and asynchronous digital technologies to complement care delivered in person.
Direct to Consumer (DTC) or Direct to Patient (DTP) Telehealth is when a patient is not required to physically go into a health care center to receive medical or mental health services. The patient can connect directly with a provider from their home using a mobile phone, tablet, computer, or any device that connects to the internet to receive care.
Asynchronous Telehealth or Store and Forward: Is when someone from a medical or mental health office collects and records medical health history in the form of data, images, audio, or video that they send over to another provider for evaluation using a secure portal to be review at a later time by a clinical health provider for interpretation, diagnosis, consultation and/or treatment.
Audio-only Telecommunication is communication through the use of a telephone.
In-Person Visit is when a provider and patient are physically present in the same room
A distant Site is a telehealth site where the provider/specialist sees the patient at a distance or consults with a patient’s provider. Other common names for this term include – hub site, specialty site, provider site, and referral site.
Face-to-Face Is when a patient physically goes into a health center to see a provider.
Originating Site means the site where the patient is physically located at the time a telehealth service or telehealth consultation is provided. Usually, a home or health care center.
eConsult services are a type of store-and-forward service by which primary care provider consults with a specialist via electronic messages including lab and imaging results and other information documented in the patient chart. eConsults can expedite a specialist referral when a higher level of care is needed.
Virtual Check-In Brief services are administered in real time between a practitioner and a patient via digital communications technologies such as secure live video, telephone, or online patient portal.
Remote Patient Monitoring/Remote Physiological Monitoring (RPM) describes self-collected patient health and medical data gathered in one location and transmitted via electronic communication technologies to a provider in a different location for use in care and related support. RPMs include digital devices self-administered by patients to monitor a health condition from home. Examples include wireless blood pressure cuffs, glucometers, and continuous glucose meters (CGMs). CMS uses the terminology Remote Physiological Monitoring to describe these activities.
Remote Therapeutic Monitoring/Remote Treatment Management (RTM) describes the self-collection and electronic transmission of patient health information captured with medical devices that track non-physiological data such as medication adherence, responses to medications, or levels of pain.
Consent is when a patient is agreeing to receive care treatment virtually. Consent is required before a healthcare service is provided via telehealth
Communication Technology-Based Services (CTBS):
Medicare’s Definition of Telehealth
Medicare only includes virtual care services that have an in-person equivalent under the umbrella definition of telehealth.
All other reimbursable Medicare services delivered via telehealth technologies are considered to be communication technology-based services (CTBSs). Examples include:
• Virtual Check-In: Established patient-initiated secure messaging or transmission of images and/or pre-recorded video via asynchronous store-and-forward methods followed up with a brief phone call or video chat between patient and provider
• E-Visit: Asynchronous or synchronous medical evaluation conducted via a patient portal
• E-Consult: Interprofessional online consultation