Date: May 2 2022
Summary: An outline addressing what is telehealth and core components
Keywords: ##outline #telehealth #background #emergency #framework #quality #care #acute #chronic #archive
Not Available
TODO: Make its own note
[Telehealth Background]
- Telehealth Defined
- History of Telehealth
- Goals of TelehealthEmergency Frameworks
[NOTE](https://jacobzelko.com/05022022153220-evaluating-telehealth)
- [SPROUT Telehealth Evaluation and Measurement profile] [1]
- Utilizes concepts from:
- National Quality Forum
- World Health Organization
- Agency for Healthcare Research and Quality
- Reorganizes concepts into 4 clear measurement domains:
- Health outcomes
- Health delivery
- Experience
- Program implementation and key performance indicators
- Meant to communicate value to:
- Patients
- Providers
- Health systems
- Payer
- [NATO Multinational Telemedicine System]
[NOTE](https://jacobzelko.com/05022022171845-telehealth-global-emergencies)
- American Telemedicine Association Emergency and Response framework and infrastructure checklist [2]Quality Assessment
- [National Quality Federation]TODO: Make its own note
Anthropological concerns
- [Clinician Unwillingness]
- [Socialization][Quality of Care]
[Coding and Renumeration]
[Lack of Access]
TODO: Make its own note
[Provider Benefits]
Specific populations
- [Chronic Conditions]
- [Acute Care]
- [Behavioral Health][Keys for Successful Interventions]
NOTE How to realize a successful telehealth intervention alongside medical professionals according to this paper:
Provide telehealth training
Create telehealth accreditation
Ensure proper funding
Structure care models to incorporate telehealth as a core foundation
Communicate to all stakeholders the best mode that they will receive
Incorporate routine evaluation and management of telehealth interventions
Telehealth is the remote delivery of healthcare via telecommunication tools [3] and the transferral of medical information between sites via telecommunications to improve patient health. [4] The term telehealth is often used interchangeably with the term "telemedicine" as well [4], [5]
Given this definition, one of the most obvious goals of telehealth is to improve patient health and care. [3] Although this is the obvious and most idealistic goal for telehealth, there are other subtle goals of telehealth. For example, it may be to ease the burden to provider care or to assist with triage [6] or to enable cost savings for health systems or payers. [7]
SPROUT Telehealth Evaluation and Measurement profile [1]
- Utilizes concepts from:
- National Quality Forum
- World Health Organization
- Agency for Healthcare Research and Quality
- Reorganizes concepts into 4 clear measurement domains:
- Health outcomes
- Health delivery
- Experience
- Program implementation and key performance indicators
- Meant to communicate value to:
- Patients
- Providers
- Health systems
- PayerNOTE [4]
Current Procedural Terminology Codes
- Get in the way currently of how individuals get paid for telehealth
- CPT Editorial panel working on this circa 2015Interstate licensing and care provision
- Federation of State Medical Boards created the Interstate Medical Licensure Compact
- Ease multistate licensing [8]
- Not all states involved at the time of publicationQuality of Care
- National Quality Forum developing telehealth framework
- Telehealth Framework To Support Measure Development 2016 - 2017
- Developed to identify existing and potential telehealth metricsClinician unwillingness to use telehealth [9]
- Despite high funding in Australia, less than 1% of specialist consultations were telehealth-based [10]
- Clinicians must see telehealth interventions as normal [9]Renumeration is important but is not the only thing that leads to a successful telehealth intervention
Some care cannot be provided remotely
- Such as lab tests
- Some physical examinationsReimbursement issues
- Eligible for clinical facilities where shortage of health professionals (get citation)Lack of socialization
- The digital divide [11]
- Difference of access to telehealth based on:
- Geography
- Social factors
- Worst for the elderly
- Only 58% of persons > 65 years old use Internet [12]Advantages of telehealth
- Activate large number of care providers at once
- Enable better triage
- Provide care services when provider locations are unavailable
- Reduce person-to-person contact of disease transmissionChronic condition patients
- Elderly Americans
- ~2 million elderly that are homebound [13]
- Medical home will be patient's home for best patient-centered care [14]Acute care patients
- Stroke [15]
- Pneumonia [16]NOTE How to realize a successful telehealth intervention alongside medical professionals according to this paper:
Provide telehealth training
Create telehealth accreditation
Ensure proper funding
Structure care models to incorporate telehealth as a core foundation
Communicate to all stakeholders the best mode that they will receive
Incorporate routine evaluation and management of telehealth interventions
Zelko, Jacob. What Is Telehealth?. https://jacobzelko.com/05022022181455-telehealth-explained. May 2 2022.
[1] Macy, Michelle L., Dana Aronson Schinasi, David McSwain, and John Chuo, “SPROUT COVID-19 Measure Framework,” Mar. 24, 2020. https://research.musc.edu/-/sm/research/resources/sctr/f/sprout-telehealth-measurement-framework-for-covid-19.ashx?la=en (accessed May 02, 2022).
[2] C. R. Doarn and R. C. Merrell, “Telemedicine and e-health in disaster response,” vol. 20. Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA, pp. 605–606, 2014.
[3] E. R. Dorsey and E. J. Topol, “State of Telehealth,” N Engl J Med, vol. 375, no. 2, pp. 154–161, Jul. 2016, doi: 10.1056/NEJMra1601705.
[4] R. Tuckson, M. Edmunds, and M. Hodgkins, “Telehealth,” New England Journal of Medicine, Oct. 2017. Accessed: Apr. 29, 2022. [Online]. Available: https://www.nejm.org/doi/pdf/10.1056/NEJMsr1503323?articleTools=true
[5] “About telemedicine. Washington, DC: American Telemedicine Association.” https://www.americantelemed.org/main/about/%20about-telemedicine/telemedicine-faqs (accessed May 02, 2022).
[6] A. C. Smith et al., “Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19),” J Telemed Telecare, vol. 26, no. 5, pp. 309–313, Jun. 2020, doi: 10.1177/1357633X20916567.
[7] J. Chuo, M. L. Macy, and S. A. Lorch, “Strategies for Evaluating Telehealth,” Pediatrics, vol. 146, no. 5, p. e20201781, Nov. 2020, doi: 10.1542/peds.2020-1781.
[8] “Understanding the Medical Licensure Compact,” Federation of State Medical Boards, 2013. Accessed: May 02, 2022. [Online]. Available: http://www.fsmb.org/policy/advocacy-policy/interstate-model-proposed-medical-lic
[9] V. A. Wade, J. A. Eliott, and J. E. Hiller, “Clinician acceptance is the key factor for sustainable telehealth services,” Qual. Health Res., vol. 24, no. 5, pp. 682–694, 2014.
[10] V. Wade, J. Soar, and L. Gray, “Uptake of telehealth services funded by Medicare in Australia,” Aust. Health Rev., vol. 38, no. 5, pp. 528–532, 2014.
[11] P. Norris et al., Digital divide: Civic engagement, information poverty, and the Internet worldwide. Cambridge university press, 2001.
[12] A. Perrin and M. Duggan, “Americans’ internet access: 2000-2015,” 2015.
[13] K. A. Ornstein et al., “Epidemiology of the homebound population in the United States,” JAMA Intern. Med., vol. 175, no. 7, pp. 1180–1186, 2015.
[14] N. Herendeen and P. Deshpande, “Telemedicine and the patient-centered medical home,” Pediatr. Ann., vol. 43, no. 2, pp. e28–e32, 2014.
[15] A. Itrat et al., “Telemedicine in prehospital stroke evaluation and thrombolysis: Taking stroke treatment to the doorstep,” JAMA Neurol., vol. 73, no. 2, pp. 162–168, 2016.
[16] W. T. Summerfelt, S. Sulo, A. Robinson, D. Chess, and K. Catanzano, “Scalable hospital at home with virtual physician visits: Pilot study,” Am J Manag Care, vol. 21, no. 10, pp. 675–84, 2015.