Telehealth, telemedicine, digital health, connected care and virtual health all refer to the use of electronic information and telecommunications technologies to support clinical health care, patient and professional health-related education, public health and health administration at a distance. While these different terms are sometimes used interchangeably, there is not always agreement on what each one means or how specifically they might differ. Christian Milaster offers this quote in our Vendor Selection Toolkit: "Everybody agreed until somebody defined it".
Ultimately, it does not really matter what term is used. Electronic information and telecommunications technologies are simply tools in a clinician's toolbox. Some key considerations around the use of these tools include:
- Does it work? How do we know? Are there certain conditions where it does not work and should not be used? What is our benchmark for assessment?
- Is it the same or better than in-person care? Some say this should be the benchmark. By what standard do we assess in-person care? What do we do with the huge variability that exists with in-person care? How do we treat applications of telehealth where there is no equivalence to in-person care (e.g., remote patient monitoring)? How do we know if it adds value?
- Is it the same or better than no care? Some say that for certain populations, this is a better benchmark. How do we assess whether the only viable alternative in any particular situation would be no care at all? Who is responsible for making this call?
- Does the clinician know how to use it? What is an acceptable level of competence or proficiency? How and when do we assess this?
- Is it the right tool for the condition being assessed/treated? How do we know? What variables should we be looking at - cost effectiveness? level of accuracy? efficiency? potential for fraud and abuse? Who is responsible for deciding?
Within our current policy landscape, how policy makers prioritize and answer these types of questions impact under which conditions different telehealth tools are considered "acceptable" and/or "reimbursable". For more information about "What is Telehealth" and "Telehealth Taxonomy", visit our Vendor Selection Toolkit.
