Many in healthcare still see telehealth primarily as a technology.
That is not surprising, since the name “telehealth” invokes a first association with other technologies that have advanced human kind in the last 50 to a 100 years: the television, the telephone, even the telescope, or in medicine, telemetry.
In addition, many organizations seem to have an ongoing battle with the technical aspects of telehealth, such as connectivity and bandwidth issues, patients’ digital illiteracy, and technical integration and interface challenges, e.g., with exam peripherals or integration with the EMR.
Given that experience, many clinicians, especially in primary care, are reluctant to fully embrace telehealth. Which is unfortunate, since the potential for telehealth to do a lot of good for the patient population is very strong.
Telehealth is a Clinical Tool
So, if telehealth is not a technology, what is it then?
First and foremost telehealth is a clinical tool. Just like other clinical tools (e.g., lab tests or imaging tests), telehealth can be consciously selected as the right tool for patient care, if clinicians are aware of their choice.
Telehealth is also a care delivery modality – just like an in-person visit, a phone call, a letter, or a secure message. It’s a different avenue to interact with patients during diagnosis, treatment, and health maintenance.
And telehealth is a great tool in the quest toward improving Population Health.
Population Health, defined
While virtually every larger healthcare organization typically has staff designated toward supporting population health, a commonly agreed on definition is hard to come by, especially when contrasting it with public health.
In simple terms, public health is concerned with creating an environment where people can be healthy, whereas population health focuses on overcoming the problems that drive poor health conditions in the population.
Public Health focuses on policies, research and injury prevention, whereas Population Health focuses on a multi-disciplinary, organization-transcending, collaborative community approach with a focus on health outcomes.
Specifically, the two most important Population Health objectives are Chronic Disease Management and Preventive Health Promotion:
- Chronic Disease Management: ensure that people with chronic diseases live longer with a higher quality of life.
- Preventive Health Promotion: promote a healthy lifestyle, including weight loss, higher activity levels, smoking and drinking cessation, meditation & mindfulness, etc.
Bring in the Telehealth Power Tools
So how can telehealth help to achieve Population Health goals?
It first starts with a mindset shift about telehealth – namely that it is a clinical tool for “delivering care at a distance” that comes in a multitude of flavors:
- TeleEducation – live or on demand information to assist with self-care, lifestyle changes, presurgical education, post-diagnostic information, etc.
- Patient Portal – a virtual self-service kiosk to access various, mostly administrative, services, such as scheduling appointments, sending secure messages, requesting notes or records, etc.
- TeleVisits: live audio/video conversations between a clinician and a patient (what most people think of telehealth)
- TeleExams: a live audio/video visit with the ability to remotely examine the patient either directly or through the assistance of a telepresenter or the patient themselves.
- Telephonic Care: a lesser, but under many circumstances still clinically feasible
- Secure Messaging/Texting: asynchronous but interactive communication between clinicians and patients.
- Remote Physiological Monitoring: the periodic or continuous monitoring of vital signs, including blood pressure, weight, heart rate, blood glucose, etc.
- Store & Forward: sending pictures, video, or voice recordings for asynchronous review by a clinician
- Digital Health Apps: 15 years after the introduction of the iPhone, the adage of “there’s an app for that” is truer than ever for health apps. Most apps fall in one of three categories: educational, tracking, and therapeutic.