Better Defining Telehealth: The 4 Key Elements of Virtual Care

Breaking Down Assumptions: Why Telehealth Is More than Just Video Conferencing.

Each year, the concept of telehealth gains more popularity — not just within the healthcare community, where it’s uniquely poised to help achieve the industry’s “triple aim,” but also among the general public, and, perhaps most importantly, among the legislators who have the power to further its utilization nationwide. (See their progress in doing so at this page.)

The reasons for this growing popularity are obvious: Study after study after study has emphasized the benefits of telehealth for all parties within the healthcare continuum — for patients and families; for doctors, nurses, and clinicians; for administrators, executives, and payors. 

The most prevalent of these benefits include: 

  • Enabling patients heal in the comfort of their own home
  • Empowering clinicians to treat more patients more efficiently
  • Expanding access to clinicians for patients in rural areas
  • Expanding access to medical specialists who may be in limited supply
  • Increasing the data-gathering capability of healthcare providers and facilities
  • Enhancing the ability of healthcare organizations to lower costs while increasing quality of care

To that last point, telehealth “improves the bottom line for most medical practices,” write Peter Scott and JT Ripton in Medical Economics, with its ability to “reduce appointment cancellations, improve patient flow, monetize after-hour consultations, attract new patients and help retain existing patients.”  

Yet, for all this potential to revolutionize care, telehealth is still widely misunderstood by many — and not just patients, but also doctors and healthcare professionals. A 2017 study published in the International Journal of Pharmacy Practice found that awareness of telehealth among primary care practitioners was low, which in turn was actively impeding its widespread adoption. 

But just what is telehealth, from a technological and operational standpoint? Let’s take a closer look at the definition of telehealth — what it means, and what types of technology combine to make it such a powerful force for the improvement of the healthcare continuum as we know it.

Telehealth Definition: 4 Aspects of Healthcare Technology

First, the basics: According to the Center for Connected Health Policy (CCHP), telehealth is defined as a "collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies."

If that sounds like a fairly broad definition, it’s meant to be. In reality, telehealth is a catch-all term that includes a number of sub-categories, or more specific types of technology and delivery methods. Let’s break down the four most common of these telehealth categories. 

Live Video Conferencing. Also known as “virtual visits,” video teleconferencing is probably the best-known type of telehealth. When most people think of telehealth, this is what usually comes to mind — the live, interactive videoconferencing that takes place between a patient and clinician/caregiver using modern audiovisual telecommunications devices (like a camera-enabled computer). 

This form of telehealth is also called “synchronous,” because it requires syncing between two parties in real time. As such, virtual visits are often scheduled interactions, serving as consultative, diagnostic, and/or treatment services between patients and caregivers. However, they can also be utilized in case of emergency as, in the words of the CCHP, a “life-saving technology.” (The CCHP offers an example of this in their video, Telehealth Saves Lives.) 

Although live video can be similar to an informal conversation via Skype, the technology they utilize is anything but informal. Instead, these types of meetings must utilize special, secure communications platforms that are compliant with HIPAA and carefully assessed to ensure the safe and secure collection and delivery of sensitive PHI. 

Store and Forward. Also called asynchronous telehealth, store-and-forward telehealth services do not require that the patient and clinician be online at the same time. Instead, under this model, specific medical data (like images, biosignals, and voice recordings) are collected and then transmitted for later assessment using secure electronic communications (as opposed to during a live patient visit). 

Store-and-forward telehealth services are useful in gathering data when a live visit (be it virtual or physical) is not necessary. “Because these consultations do not require the specialist, the primary care provider and the patient to be available simultaneously, the need for coordinating schedules is removed, and the efficiency of the health care services is increased,” as the CCHP notes

This type of telehealth delivery is also helpful for specialized diagnostics related to physical therapy, such as range-of-motion tests and sit-to-stand tests, which can be recorded by patients at home — where they’re most comfortable — and then assessed off-site by a clinical expert. A good example of how this technology can take clinical assessment to new levels is Reflexion Health’s use of full-body pose tracking, which combines depth cameras with human post estimation to identify and assess a patient’s primary joint locations. Read more here.

Remote Care. This type of telehealth uses technology to enable clinicians to monitor the progress of patients in their own homes, thereby reducing the cost (and inconvenience) of regular (and often unnecessary) in-office visits. Studies also indicate that effective remote care programs can cut down on expensive re-admissions and hospitalizations. 

Also known as remote patient management and/or monitoring (RPM), remote care involves the collection of a patient’s personal health information (PHI) via electronic communication technologies. That info is then transmitted to a facility or specific provider in a different location for use in care, diagnostic and treatment. Unlike virtual visits, interactive meetings aren’t involved. And unlike store-and-forward models, remote care involves not just a single assessment but ongoing monitoring that’s usually part of a long-term care plan.

Often seen as a method of helping people “stay healthy in their home and community, without having to physically go to the providers’ office,” according to the CCHP, remote care “allows a provider to continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates.” 

Mobile Health (mHealth). The term mHealth is sometimes confused with telehealth itself, but in reality, it speaks to a specific subset of telehealth — i.e., the use of mobile phones and personal communications devices to facilitate education and networking among patients, healthcare professionals, health IT workers, and many other groups. 

General applications widely available on mobile devices like tablets and smartphones, mHealth services are usually educational in nature, but not always — in fact, the entire range of mHealth apps include those designed for disease surveillance and management among high-risk patents; treatment support among those with chronic conditions; and epidemic outbreak tracking in third-world countries. More often, though, mHealth applications take the form of educational and/or monitoring apps used by consumers to help improve their day-to-day health. 

mHealth are helpful ways to extend telehealth beyond the immediate care applications represented by video conferencing and store-and-forward assessments. Telehealth providers are increasingly leveraging mHealth apps to help set patient expectations for their specific program, providing post-operative education and guidance, and similar services. 

Leveraging the Different Aspects of Telehealth for Improved Care & Outcomes

At Reflexion Health, we’re proud to be pioneers in the use of each of these different aspects of telehealth, with the goal of delivering a virtual physical therapy solution that improves the lives of patients while delivering operational benefits to facilities. 

For instance, our FDA-cleared Virtual Exercise Rehabilitation Assistant — or VERA, as she’s better known — utilizes all of the elements of telehealth, including:

  • Remote monitoring to collect biometric data from patients throughout the day
  • Store-and-forward technology to allow clinicians to review video of patient exercises
  • Virtual visits to enable patients to meet with their therapists off-site, but still in real time
  • mHealth to engage members with educational apps to help keep them educated and engaged

The result is premium physical therapy that lets patients recover in the comfort of their own homes, and which also gives healthcare providers the opportunity to expand post-op service offerings with a low-risk, easy-to-assess program that integrates seamlessly into existing workflows. 

Engaging and intuitive, VERA has shown high adherence metrics among patients recovering from joint or knee surgery, as compared to traditional PT. It also allows for more effective and efficient utilization of visits, and an increase in the number of exercises completed by patients. 

For more information on how our groundbreaking Vera service can help you improve your care plan, or for other insights into the possibilities of virtual physical therapy, we invite you to contact us here to schedule a complimentary consultation with a Reflexion Health virtual PT expert.