Frequently Asked Questions
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What is KUCTT’s role in providing telemedicine in Kansas?
KUCTT is a telemedicine and telehealth research center and is particularly interested in trying new telehealth technologies or models, advancing public policy, conducting research and educating other health care professionals about telemedicine. KUCTT provides some telemedicine clinical consultations but usually in the context of a research or education grant or project. KUCTT generally does not initiate telehealth services for long-term clinical care only and often refers to these types of requests to The University of Kansas Health System.
What is telemedicine and how is it different from telehealth?
Telemedicine is the delivery of health care by a physician to a patient using interactive video technology when distance separates doctor and patient. Telemedicine is part of telehealth, a term that involves the use of additional technologies, other types of health providers and distance education. Telehealth uses both interactive and asynchronous communication.
What type of health services can be done via telemedicine?
Almost 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, but telemedicine visits may be used for short follow-up visits. The type of visit needed is determined by the provider in conjunction with the patient. A wide range of specialty services has been provided via telemedicine at KU Medical Center, including cardiology, developmental pediatrics, diet and nutrition, mental health, oncology, pediatrics, and psychiatry.
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 provider, most often for mental health services. However, most telemedicine visits occur in combination with occasional in-person visits. It saves patients’ traveling time and cost for their clinical visits, many of which are for short, routine checkups and do not require an in-person discussion.
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, so it does not govern telemedicine encounters. However, device encryption and a private internet connection are recommended for patient security and privacy. Most telemedicine equipment encrypts the transmission. Other types of telehealth, such as the transmission of patient data or images, are considered protected health information and must be managed according to HIPAA requirements.
Is KUMC Project ECHO considered telemedicine?
No. While Project ECHO uses similar technology and often works closely with telemedicine departments, no patients are present or directly treated during ECHO sessions. Instead, ECHO is an innovative education model that allows primary care providers to receive specialized information so that they can treat complex diseases in their local communities.
How do I obtain a referral for a telemedicine appointment?
To set-up a telemedicine consult, patients require a referral from their primary care provider, local mental health provider, or their KUMC specialist who would like to utilize telemedicine to see him or her. Typically these referrals would come from the local hospital or clinic that is already engaged in telemedicine services with KUMC. Please contact your local provider or KUCTT to help determine if telemedicine may be available to you.
How are clinical telemedicine visits paid for? Does it cost the patient anything?
Because telemedicine is not a separate specialty, just a way of delivering health care, Medicare, Kansas Medicaid, and many private insurance companies will reimburse for covered services delivered over telemedicine. However, reimbursement for services provided via telemedicine is not universal. Some insurance companies do not provide a telemedicine benefit or may only cover selected billing codes. In addition, 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?
Patients rarely need to control or manage the technology. Most telemedicine consultations occur in a community hospital or clinic with the assistance of a local nurse or site coordinator. Most often, patients just arrive at the time of their appointments and wait for the video consultation with the doctor or specialist, as described in the next question.
How does a telemedicine appointment work?
A telemedicine appointment uses technology to create an experience very similar to an in-person visit.
• On the day of the telemedicine appointment, the patient checks in at the remote site and is taken to an exam room equipped with interactive video technology.
• The provider will connect to the appointment with an interactive video conferencing system. As with an in-person appointment, providers often start by asking about the patient's medical history and the specific ailment or getting updated on the patient’s condition since their last appointment.
• During the appointment, a telemedicine site coordinator (typically a registered nurse) will remain in the room to assist the patient and provider.
• The provider will end the appointment the same as an in-person appointment by providing treatment recommendations, requesting a follow-up visit, ordering lab work, or referring to another doctor.
• Telemedicine providers send copies of their notes to the patient's primary care provider if requested.
How do I get prescription medications if I see my provider by telemedicine? What if I need lab tests?
For some controlled substance medications, your telemedicine provider may need to see you in person once before prescribing medication, or may work in consult with your primary care physician for your medications. Telemedicine providers can send standard prescriptions electronically to your pharmacy or, when required, mail a paper copy of prescription to your home. Your telemedicine provider can often work with the telemedicine nurse at your site to order lab work at facilities close to you.
How do I conduct a consultation or start a telemedicine service or clinic?
For a project that will utilize telemedicine for research or education purposes, please contact KUCTT. For a clinical telemedicine or telehealth service that is purely for clinical outreach purposes and has no research or education component, please contact Jason Grundstrom of The University of Kansas Health System for more information.
What kind of research or innovative telehealth projects can I propose?
KUCTT is interested in guiding or participating in a wide range of telemedicine and telehealth projects that advance our understanding of telemedicine and how it can be best utilized to treat patients and improve the health care system. Projects that test new service locations, emerging technologies, unique therapies, telehealth cost models or other outcomes are of interest to us. Please contact KUCTT for a research consultation if you have ideas for a new telemedicine application.
Where do I have to go to conduct a telemedicine consultation?
While the KUCTT office has several locations from which you can conduct a telemedicine visit, most often the technology can be implemented right in your own office. Options include a separate video system or through software installed on your computer or mobile devices. The advantage of this model is that providers can conduct telemedicine clinics from the convenience of their offices, homes or other locations using the same computer hardware they use to access email, electronic health records, and other information.
Technology and Equipment
What equipment is needed?
The particular choice of equipment is determined by the clinical need and how the equipment will be used. For telemedicine, a secure videoconference system with a high-speed internet connection is common. These systems can be stand-alone units or platforms integrated with a personal computer or laptop. 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 an image or video so it may be viewed at a later time), and many other integrated systems. Today mobile devices such as smartphones or tablets are also commonly used.
What are the connection requirements?
Today's high-definition video systems use the Internet, or Internet Protocol (IP) and work most effectively at 1 Mbps or more, but a high-quality interaction can also occur at lower speeds. Common tools for testing your bandwidth are available at http://speedtest.googlefiber.net/ or https://fast.com/ A general rule is that if you can view a Youtube video with smooth, uninterrupted video, you should have enough bandwidth for HD video conferencing. Several brands of ITV systems are available on the market and most are compatible with one another. KUCTT has connected with ITV systems in Asia, Australia, Europe, West Africa, and South America.
What are peripheral devices?
Peripherals devices are tools that connect to the video system that enhance the ability of the health provider to see and hear the patient even when they are miles apart. These devices differentiate telemedicine from video conferencing. KU Center for Telemedicine and Telehealth uses a variety of peripherals, such as digital stethoscopes, otoscopes (for the ear, nose or throat), dermascopes (skin, burns, wounds), or intraoral scope (teeth, mouth, throat).