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Frequently Asked Questions about Telemedicine

What is telemedicine?

Telemedicine is the use of technology to electronically exchange medical information and provide medical services to patients from a distance.

How is telemedicine different from telehealth?

Telehealth often encompasses a broader definition of remote health care that doesn't always involve clinical services. Telemedicine can involve many different methods for providing health care remotely.

While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services, the American Telemedicine Association (ATA) uses the terms in the same way one would refer to 'medicine' or 'health' in the common vernacular.

Telemedicine is closely allied with the term health information technology (HIT); however, HIT more commonly refers to electronic medical records and related information systems while telemedicine refers to the actual delivery of remote clinical services using technology.

Why telehealth?

By removing barriers of time, distance, and provider scarcities, telehealth can deliver important medical and other health and education services where they are needed most; in remote, rural areas and medically underserved urban communities. As states across the country and employers, private payers and consumers prepare for the implementation of the Affordable Care Act, telehealth becomes an increasingly important tool for increasing access to care, improving the quality of care that lead to better patient outcomes, and ultimately reducing the per capita cost of care.

Who benefits from telemedicine?

Both patients and health care providers located far from large cities or in rural areas can benefit greatly from telemedicine.

Patient benefits
Provider benefits
  • Timely treatment close to home
  • Reduced travel time
  • Access to world-class treatment
  • Improved quality of care
  • Convenience and flexibility of care
  • Specialty consults to help make decisions about care
  • Input from world-class specialists without travel
  • Educational opportunities and mentoring
  • Increased efficiency
  • Improved patient outcomes
  • Reduced health care costs

Does Medicare or Medicaid pay for telemedicine services?

Medicare: Yes. CMS requires that reported telemedicine services include both an originating site and a distant site. The originating site is the location of the patient at the time the service is being furnished. The distant site is the site where the physician or other licensed practitioner delivering the service is located. There are geographic designations and limitations to where this is can be provided- must generally be rural areas like Northern New England. Many "telehealth" services, such as remote radiology, pathology and some cardiology, are covered simply as "physician services." For traditional fee-for-service beneficiaries living in rural areas, Medicare covers physician services using videoconferencing. The ~14 million beneficiaries in Medicare Advantage (managed care) plans, have complete flexibility in using telehealth, as long as their provider offers the service. Many groups like the American Telemedicine Association are pushing the Centers for Medicare and Medicaid, and Congress to removing the arbitrary restrictions that limit telehealth coverage, so that all beneficiaries can get this great benefit.

Medicaid: Almost every state Medicaid plan specifically covers at least some telehealth services; however, states vary greatly in their coverage. State-specific information is available on www.atawiki.org. ATA has challenged each state to fully cover telemedicine to increase coverage while simultaneously reducing service costs

Do private insurance plans usually cover telemedicine services?

20 states, (including NH, VT, and ME) and the District of Columbia require that private insurers cover telehealth the same as they cover in-person services. Many other insurers cover at least some telehealth service—and many more have expressed interest in expanding their telehealth coverage.

*Verification of insurance eligibility for telemedicine services is recommended when appointments are scheduled.

What about licensing?

Physicians who deliver telemedicine services, outside of consultation exceptions, are required by many state medical boards to hold a medical license in the state where the patients will present for treatment.

What equipment is needed for telemedicine?

This depends on the specialty and the method of telemedicine transmission. Virtual visits can be conducted using only a video connection- patients and providers can establish connection using smartphones/tablets or personal computers.

A more in-depth visit at a clinic location, like telemedicine specialty consults, will often involve use of a telemedicine practitioner’s cart for videoconferencing, a sophisticated ‘all-in-one” unit that includes the:

  • Monitor
  • Computer
  • Camera
  • Peripheral devices

There are many peripheral instruments which can be attached to the practitioner's cart that can assist in an interactive examination, such as:

  • Digital stethoscope
  • Otoscope
  • Ophthalmoscope
  • Total exam camera
  • Store and forward technology—for obtaining and transmitting images to a remote site for review and consultation—requires a software application on a personal computer, tablet, or smartphone.

Many hospitals throughout the region already have store and forward image transfer capabilities and real-time videoconferencing systems that allow them to collaborate with DHMC specialists.

Will patients still need to see a specialist in person?

Possibly, but the ultimate goal of telemedicine is to allow patients to receive care close to home, rather than care that requires long-distance travel.

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