This Week in Telehealth 101…
☎️ Telemedicine Models
Telemedicine, also referred to by names such as telehealth, virtual care, and mobile health, is gaining increasing attention in part due to COVID-19. According to the ATA, benefits of telemedicine can include improved access, cost efficiencies, improved quality, and convenience for the consumer in reduced travel times and related stress, among others. Telemedicine encompasses a wide array of services and technologies.
TeleMedicine Models & Mechanisms
There are myriad ways to practice and deliver telemedicine. Examples include secure texting, on-line chats, telephone calls, and real-time audio video interactions.
There are two main ways or modalities regarding how telemedicine is performed:
Asynchronous (or “store-and-forward”) allows files or other information, such as pictures or video clips to be shared between the patient and the telemedicine provider.
Synchronous (or real-time) typically involves an audio-video interaction in real-time between a patient and a telemedicine provider. Depending on the model, this could also include a telemedicine specialist (e.g. stroke neurologist) assisting another physician with a diagnosis.
In practice, these modalities can and are utilized in different ways. Some common models include:
Hub-Spoke: In this model a hub hospital has a telemedicine connection with another hospital (spoke facility or originating site). The spoke site may be affiliated or unaffiliated with the hub hospital. In the hub-spoke model the hub facility is providing telemedicine services out to the spoke site. If it is determined that the patient needs a higher level of care, the patient might be transferred to the facility offering a higher level of care. In some cases the receiving facility may be the hub facility.
Direct-to-consumer: Sometimes called D2C or DTC, in this model a telemedicine provider has a telemedicine connection/session with a patient. For example, a patient may text with a telemedicine provider and then proceed to a real-time audio-video session. Another example includes a patient logging on to a telemedicine website and scheduling an audio-video telemedicine consult. There are many web-based e-health consumer service sites offering different services like primary care, behavioral health and addiction treatments.
Remote Patient Monitoring: In this model the patient is located outside of a hospital, such as their private residence, and has telemedicine equipment with them. Equipment may include a device (e.g. tablet, laptop) and peripherals such as blood pressure cuff, digital thermometer, or electrocardiogram. In contrast to a single telemedicine consult, remote patient monitoring (RPM) can allow for the telemedicine provider(s) to monitor the patient over a period of time.
In our next installment, learn about some back office considerations for operating a telehealth program!
