What is Telehealth
It's All About the 'Tele'
Clearly defining telehealth and telemedicine is no easier than defining health and medicine, neither is distinguishing between them. In a broad sense, as the prefix tele implies, they refer to the use of information or communication technology to deliver health or medical care from a distance. They describe ways of delivering services, rather than being services themselves.
In practice, telemedicine is often the term used to refer to activities relating to patient care, such as outpatient clinics conducted by videoconference. Telehealth is used more broadly to include activities not directly relating to patients, but nevertheless targeted at improving healthcare. Examples include education or training sessions and administration meetings.
Telehealth in the New Zealand Context
Three key areas to the development of telehealth in New Zealand are telemedicine, telemonitoring and mHealth, each of which is covered in detail in its respective section found on the left of this page. As your telehealth expertise develops you will notice that the three topics are not separate entities, but fluid in their definitions and applications. You will also notice that as telehealth is fundamentally tied to technology, the field develops very quickly as does its potential uses and services.
The intricacies of telehealth services can appear rather convoluted and daunting at first glance, as along with the intended uses there are myriad technical and administrative aspects that need to be understood and considered. The NZ Telehealth Resource Centre is here to consult, explain and offer assistance with understanding these issues and help you to establish a telehealth service. A selection of these important aspects are outlined as follows.
Key Elements of Telehealth
- The Type of data involved: The type of data can be standalone video or audio, combined video and audio, text (e.g. blood pressure, weight and symptoms), continuous monitoring streams, alarm signals or specialised recordings (e.g ECG and EEG).
- When Data Transfer Takes Place: Data transfer can be synchronous (real time), where the patient is usually present, or asynchronous (often called store and forward), where the patient is not usually present.
- Who is Involved: The parties at each end of a telehealth consultation include clinicians (the healthcare workers responsible for the patient), patients and patients' families and supporters. Any combination of these can occur, and in the case of video consultations it is possible for a number of people to be present at each end and still participate in the consultation. An example is a consultant seated with a medical student at one site and a patient, their family member and their rural nurse specialist at the remote site.
- The Type of Consultation: A range of consultations can be conducted including initial specialist assessments, follow up visits, discharge planning meetings, multidisciplinary team meetings, acute assessments, ward round and triage assessments. Some are more suited to telehealth than others, and this is in part determined by the intended outcome of the consultation as well as the resources at either end. As an example it is not usually a good idea to conduct an initial specialist assessment via telehealth, though it may be possible if a clinician is alongside the patient and available to examine them.
- How The Consultation is Scheduled: Consultations can be scheduled, where both parties, their locations and equipment are booked ahead of time, or unscheduled, where there is little warning – if any – that the consultation needs to take place. Scheduled consultations can be for example outpatients visits. Examples of unscheduled consulatations include assessments of emergency department presentations, and prior to retrieval to another location.