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.
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 have been provided via telemedicine at KU Medical Center, including cardiology, developmental pediatrics, diet and nutrition, mental health, oncology, pediatrics, and psychiatry.
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 high-speed internet connection is common. These systems can be stand-alone units or ones built around a personal computer. 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 a video-intensive test so it may be viewed at a later time), and many other integrated systems.
A commonly used speed is 384 Kbps, although lower speeds have been used successfully. Today's high-definition video systems require higher transmission speeds, between 1 and 2 Mbps.
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.
Most insurance providers cover interactive telemedicine consultations, including Medicare, Kansas Medicaid, and most private insurance companies in Kansas. Patients may still be responsible for a co-pay or deductible, the same as a traditional in-person visit.
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.
For home-based telehealth, patients enter their own information on user-friendly, simple touch-screen devices.
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.
Google Fiber is an exciting opportunity for telemedicine services in Kansas City, Kan. Planning teams at KU Medical Center are discussing possible applications for the expanded bandwith, including more personalized, higher quality telemedicine interactions than were previously achievable.