What is telemedicine and how is it different from telehealth?
Telemedicine is defined as the delivery of health care by a physician
to a patient using some type of interactive video technology when
distance separates the two. It is often used between urban medical
centers and rural communities, but can also be used in underserved
urban areas. Telehealth is a broader form of telemedicine that involves
additional technologies, other types of health providers and distance
education. Telehealth also uses both interactive and asynchronous
communication.
What type of health services can be done via telemedicine?
Virtually any medical, nursing, or allied health service can be provided
via telemedicine for follow-up or consultation purposes. A traditional,
in-person visit may still be needed for a physical examination or procedure,
followed by telemedicine visits for short checkups. The type of visit
needed is determined by the provider in conjunction with the patient.
At the Unversity of Kansas Medical Center, a wide range of specialty
services have been provided over the years, including cardiology,
developmental pediatrics, diet and nutrition, mental health, oncology,
pediatrics, psychiatry, stroke, and many others.
What equipment will I need?
A wide variety of equipment can be used. The particular choice of
equipment is determined by the clinical need to be served and how
the equipment will be used.
For telemedicine, a secure videoconference system
with high-speed internet connection is commonly employed. These systems
can be stand-alone units or ones built around a personal computer
(PC). Peripheral devices, such as electronic otoscopes and stethoscopes,
are also used.
Telehealth applications also use video systems, digital cameras,
store-and-forward software (which captures a video-intensive test
so it may be viewed at a later time), and many other integrated systems.
What is the minimum bandwidth requirement?
Many connection speeds are used for live telemedicine interactions,
and partly depend on the comfort level of the patient and the provider.
A commonly used speed is 384 Kbps, although lower speeds have been
used successfully. For high-definition video systems, which are now
widely available, higher transmission speeds, between one and two Mbps,
are needed to achieve the full resolution and color available with
high-definition systems.
If telemedicine is used for clinical purposes, will it be
the only method of care for some patients?
Some patients are entirely served by telemedicine consultations in
collaboration with their healthcare provider, most often for mental
health services. However, most telemedicine occurs in combination
with occasional, traditional in-person visits to their doctor. This
hybrid model has worked well for the majority of patients and providers.
How are clinical telemedicine visits paid for?
Does it cost the patient anything?
Most insurance providers cover interactive telemedicine consultations
conducted in rural areas, including Medicare, Kansas Medicaid, and most
private Kansas insurance companies. Patients may still be responsible
for a co-pay or deductible, the same as a traditional in-person visit.
Will patients need assistance with the technology?
Currently, most telemedicine consultations occur in a community hospital
or clinic with the assistance of a local nurse, site coordinator or physician.
Patients rarely need to control or manage the technology. In the case of
home telehealth monitoring, patients enter their own information on user-friendly,
simple touch-screen devices.
What about security for patient or personal information?
The Health Insurance Portability and Accountability Act (HIPAA) does not
consider an interactive video consultation to be protected health information
(PHI), so does not govern telemedicine encounters. However,
device encryption and a private internet connection are recommended for patient
security and privacy. Most telemedicine equipment in use today has encryption
capability as a standard feature. Other types of telehealth, such as the
transmission of patient data or images, are considered PHI and must be managed
according to HIPAA requirements.
What paperwork is required for telemedicine?
The paperwork is much the same as a traditional office visit. It usually usually
includes, but is not limited to, a consent form, intake form, HIPAA forms, and
insurance information. Some clinics may require an additional assessment or
questionnaire.
How will the implementation of the new Google Fiber in
Kansas City, Kan. affect telemedicine at the
University of Kansas Medical Center?
The Google initiative is an exciting opportunity for telemedicine services
in Kansas City, Kan. Planning teams at KU Medical Center are discussing the
many possibilitiesafforded by this opportunity. The high bandwidth provided
to the community, particularly in homes, will permit more personalized, higher
quality telemedicine interactions than were previously achievable. As projects
develop, more information will be provided.
I am a patient or provider who is interested in telemedicine and telehealth
or who wants to learn more about it. How do I get started?
Please call the KU Center for Telemedicine & Telehealth at 913-588-2226.
We will direct you to the person who is best able to answer your questions
and meet your needs.
©
The University of Kansas Medical Center