Telehealth, often referred to as telemedicine, is the delivery of health-related services and information via telecommunications technologies in the support of patient care, administrative activities, and health education. As early as 1955, the Nebraska Psychiatric Institute began using closed-circuit TV to monitor patients remotely. Telehealth has evolved as a field to address access to care issues for a wide range of specialties including dermatology and neurology.
Access to care is an issue in regions where physician-to-patient ratios are inadequate or where there are not enough medical specialists available to meet the population's needs. As such, telehealth has become a key component of multifaceted strategies to improve health service delivery in medically underserved areas in both rural and urban settings. Telehealth enables remote interactions among providers and between providers and patients, linking distant resources with more convenient sites of care.
Today, telehealth typically is categorized into three groups:
- Real-time video telehealth - involves the patient and his or her primary care provider or other health care professional interacting with a remote specialist via video-conferencing or other real-time telehealth technology.
- Store and forward (S&F) telehealth - involves the transmission of medical or health information, such as an x-ray, lab results, or prescriptions, from one provider to another for a consultation or interpretation.
- Home monitoring telehealth - involves the use of telehealth to remotely monitor health status. Data (e.g., weight, blood pressure, or glucose level) are captured via medical devices in the patient's home and then transmitted to a provider via the Internet.
Telehealth technology has evolved since the initial projects of the 1950s and 1960s. Closed-circuit television link-ups have been replaced by the Internet, which enables any number of people to share video, audio, and text communications from basic, widely available equipment. Modern devices are as small as pocket-sized and allow more robust performance and functionality than older desktop computers. High-bandwidth communications have become accessible to many Americans and the world community, with wireless technology fast becoming the rule. As telecommunications technologies continue to evolve, telehealth will become integral to health care delivery and education.
The Agency for Healthcare Research and Quality (AHRQ) has funded organizations across the country that are engaged in telehealth. Selected projects include:
Title: Closing the Feedback Loop to Improve Diagnostic Quality
Primary Investigator: Eta Berner
Title: Conversational IT for Better, Safer Pediatric Primary Care
Primary Investigator: William Adams
Title: Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention
Primary Investigator: Carl Stepnowsky
Title: Harnessing Health IT for Self-Management Support and Medication Activation in a Medicaid Health Plan
Primary Investigator: Dean Schillinger
Title: Pharmaceutical Safety Tracking (PhaST): Managing Medications for Patient Safety
Primary Investigator: William Gardner
Title: Using a Telemedicine System to Promote Patient Care Among Underserved Individuals
Primary Investigator: Alfred Bove