Federal efforts to define and advance telehealth are certainly a work in progress as nationwide and state-based laws are developed. A new study in Telemedicine and e-Health explores seven unique definitions of telehealth in current use across the U.S. government.
The definitions were found by 26 agencies represented by more than 100 individuals participating in the Federal Telemedicine Working Group (FedTel). Those individuals responded to a survey on each agency's definition and use of terms associated with telehealth.
Within U.S. Department of Health & Human Services agencies, many definitions were similar. Both the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT define telehealth as the use of telecommunications and information technology to provide access to health assessment, diagnosis, patient care and information.
The Agency for Health Research and Quality, however, has a more fluid definition--as the study points out, as technology changes, the definition changes for individual users. The Health Research Services Agency and the Indian Health Service highlighted some of the technology used to transmit information.
For departments not within HHS, some agencies focus on the actual technology used--such as the U.S. Department of Agriculture. Meanwhile, the National Institute of Standards and Technology uses the American Telemedicine Association's definition. According to the U.S. Department of Veterans Affairs, telemedicine should be given "with the intent of providing the right care in the right place at the right time."
"The creation of the Joint Working Group on Telehealth [JWGT] in the 1990s and the more current FedTel activities, coupled with the extensive research that has been funded by the U.S. government, suggests the need for a better understanding of the interpretation and related terminology being used to frame these efforts," the study authors write.
What's inherent in the definition of telehealth and related terminology is understanding that IT can support remote communications and digital data sharing previously only possible through in-person visits.
"The evidence base suggests that a common nomenclature for defining telemedicine may benefit efforts to advance the use of this technology to address the changing nature of healthcare and new demands for services as a result of health reform," the study's authors conclude.
A bill introduced to Congress in December--the Telehealth Modernization Act--seeks to establish a federal definition of telehealth and clear up the confusion from myriad state policies.
That same month, CMS announced that changes to Medicare's 2014 physician fee schedule would incrementally expand coverage for telehealth services.
To learn more:
- read the full study in Telemedicine and e-Health (.pdf)