Is There a Difference between Telemedicine and Telehealth?
June 03, 2016 | Eric Wicklund | mHealthIntelligence
While telemedicine is the older of the two phrases, telehealth is rapidly gaining acceptance, in large part because of the evolution of the healthcare landscape.
Today’s healthcare ecosystem is filled with references to and examples of telemedicine and telehealth – in some cases, the two terms are used interchangeably. Whether they mean the same thing is a topic of considerable debate.
In general terms, telemedicine is considered the clinical application of technology, while telehealth encompasses a broader, consumer-facing approach – “a collection of means or methods, not a specific clinical service, to enhance care delivery and education,” according to the federal network of telehealth resource centers.
“While ‘telemedicine’ has been more commonly used in the past, ‘telehealth’ is a more universal term for the current broad array of applications in the field,” the TRC network states in its online resource guide. “Its use crosses most health service disciplines, including dentistry, counseling, physical therapy and home health, and many other domains. Further, telehealth practice has expanded beyond traditional diagnostic and monitoring activities to include consumer and professional education. Note that while a connection exists between health information technology (HIT), health information exchange (HIE) and telehealth, neither HIE nor HIT are considered to be telehealth.”
ORIGINS OF TELEMEDICINE
A landmark 2010 report by the World Health Organization found that telemedicine – literally meaning “healing from a distance” — can be traced back to the mid-1800s, was first featured in published accounts early on in the 20th Century, and adopted its modern form in the late 1960s and early 1970s, primarily through the military and space industries. Owing to the fact that much of the technology encompassed in today’s telemedicine platform wasn’t around back then, and noting a 2007 study that found 104 different peer-reviewed definitions for the word, the WHO settled on its own broad-based definition:
“The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.”
Even then, the WHO noted the presence of telehealth:
“Some distinguish telemedicine from telehealth with the former restricted to service delivery by physicians only, and the latter signifying services provided by health professionals in general, including nurses, pharmacists, and others. However, for the purpose of this report, telemedicine and telehealth are synonymous and used interchangeably.”
WAXING AND WANING OF "TELEMEDICINE"
While telemedicine is the older of the two phrases, telehealth is rapidly gaining acceptance, in large part because of the evolution of the healthcare landscape. The rise of consumer-directed healthcare and the shift from fee-based care to quality- and outcomes-based care has put more of an emphasis on health and wellness and care management. And in that atmosphere, telehealth fits the mold.
Even the American Telemedicine Association also considers telemedicine and telehealth to be interchangeable. “While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services, (the) ATA uses the terms in the same way one would refer to medicine or health in the common vernacular,” the organization states.
“Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status,” the ATA writes. “Telemedicine includes a growing variety of applications and services using two-way video, e-mail, smart phones, wireless tools and other forms of telecommunications technology.”
“Telemedicine is not a separate medical specialty,” the organization continues. “Products and services related to telemedicine are often part of a larger investment by healthcare institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. ATA has historically considered telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth.”
In its mHealth Roadmap, the Health Information and Management Systems Society (HIMSS) muddies the waters a bit. It uses the Health and Human Services Definition for telehealth — “the use of electronic information and telecommunications technologies to support remote clinical healthcare, patient and professional health-related education, public health and health administration” — then goes on to say that “telemedicine usage ranges from synchronous video chat between a patient and a doctor, to conferencing between doctors, to conferencing between doctors and allied health professionals (e.g., nutritionists, physical therapists), to providing live or recorded presentations to groups of patients who are geographically separated.”
In 2014, the Department of Health & Human Services Department sought to clarify the two terms in a post on HealthIT.gov:
“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 non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.”
And according to the Center for Connected Health Policy, “telemedicine” often refers to traditional clinical diagnosis and monitoring that is delivered by technology, while “telehealth” describes the wide range of diagnosis and management, education and other related fields of healthcare.