Healthcare Anywhere: The Pledge of Telehealth

Laura A. Stokowski RN, MS

Disclosures

October 30, 2008

In This Article

What Is Telehealth?

Telehealth is an inclusive term that describes the wide range of services delivered, managed, and coordinated by all health-related disciplines via electronic information and telecommunications technologies.[4] The great hope is that telehealth (a term that has largely replaced "telemedicine") will provide healthcare beyond diagnosis and treatment to include services that focus on health maintenance, disease prevention, and education.

The concept of telehealth is not really new. When humans first began space exploration in the 1960s, astronauts' health was monitored by transmitting physiologic parameters back to physicians on earth.[5] The possibilities presented by recent advances in communications technology are nearly limitless. In addition to clinical applications, telehealth can support patient and professional health-related education, public health, and health administration.

Technologies used in telehealth typically include videoconferencing, the Internet, store-and-forward imaging, remote monitoring, streaming media, terrestrial and wireless communications, and even robotics. While new applications are being developed for these technologies at a rapid pace, significant barriers remain to making these technologies an integral part of daily healthcare practice.[4]

Store and Forward. In store-and-forward telehealth, digital images, video, audio, and clinical data are captured and "stored" on the client computer; then at a convenient time transmitted securely ("forwarded") to a clinic at another location where they are reviewed by the nurse or other specialist. Because transmission and response can take hours, store-and-forward technology is best suited to situations that don't require an immediate response, such as a consultation for dermatology or radiology.

Real-time Telehealth. In real-time telehealth, a telecommunications link allows the more advanced functionality of synchronous interaction. Video-conferencing equipment allows 2-way interaction, and the nurse has the benefit of being able to see the patient.[6] Peripheral devices that transmit patient data such as blood pressure or heart rate can also be incorporated. This type of telehealth might be used, for example, in mental health, hospice, rehabilitation, cardiology, or neurology.

Remote Monitoring. In remote monitoring, sensors are used to capture and transmit biometric data. Using infrared technology, data are uploaded to a computer and transmitted to the nurse. Remote monitoring can be accomplished either in either real time or as stored and forwarded data. Examples include chronic disease management and home dialysis.

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