William Shakespeare, the famous writer of “Romeo and Juliet,” did not believe that names should matter too much.
He wrote Juliet’s line to say:
“What’s in a name? That which we call a rose
By any other name would smell as sweet.”
But many of us would disagree with Mr. Shakespeare on how much a name matters, including the use of healthcare lingo.
Our collective medical community is comprised of both telemedicine and telehealth — and in many cases — the terms are used interchangeably. But, do they mean the same thing? That is a topic of debate. Many believe there is a distinction.
Telehealth promises to considerably influence some of the toughest hurdles of our healthcare system as we know it, such as availability to receive care, greater access to providers, and cost effective delivery of care. Telehealth is fundamentally changing the paradigm of healthcare by offering more cost effective options, and enabling better access and better health outcomes.
As explained in our blog, telehealth has been defined as the delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, self-care via telecommunications and digital communication technologies.
Industry Points of View
Generally speaking, ‘telemedicine’ is considered the clinical application of technology, whereas ‘telehealth’ includes a wider, consumer-facing delivery – “a collection of means or methods, not a specific clinical service, to enhance care delivery and education,” according to the National Consortium of Telehealth Resource Centers (TRC).
“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 explains. “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.”
A report by the World Health Organization (WHO) found that telemedicine – which translates to “healing from a distance” — has 104 different peer-reviewed definitions for the word. However, the WHO concluded its own definition:
“Telemedicine is 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.”
Although telemedicine has been around the longest of the two phrases, telehealth has been gaining acceptance as the terrain of healthcare continues to evolve. The climb of consumer-driven healthcare and the transition from fee-based care to outcome-based care, has put a greater prominence on care management. Telehealth is perfectly suitable in this new model.
The American Telemedicine Association (ATA) believes that telemedicine and telehealth can 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, 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 goes onto explain. “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.”
The organization continues, “Telemedicine is not a separate medical specialty. 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.”
The Department of Health & Human Services Department attempted to clarify the terms in a 2014 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.”
The Center for Connected Health Policy (CCHP) has a similar stance on the subject, stating that ‘telemedicine’ often refers to standard clinical diagnosis and monitoring that is delivered by technology, while telehealth illustrates the full extent of diagnosis and management, education and other related specialties of healthcare.
Terminology Causes Uncertainty in Public Policy
The cross uses of telemedicine and telehealth has caused confusion within healthcare policy, too. As the CCHP pin points, definitions of telehealth are not consistent among state and federal agencies. For example, the law in California established that telehealth is specifically restricted to patient-centered care. However, the Health Resources and Services Administration (HRSA) defines telehealth on a more expansive playing field, past just patient-centered care:
“The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration,” the CCHP explains. “These varying definitions influence the policies and regulations surrounding how telehealth is allowed to be used, and these policies vary as much across states as the definitions themselves.”
In our next blog, we will cover predictions on the future of virtual care, as it relates to telehealth.