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Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status. Closely associated with telemedicine is another term, telehealth, which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth.
Telemedicine and AV
Telemedicine might be based on three kinds of videoconferencing systems:
- Standard Videoconferencing systems, for use in the doctor’s office or for medical education,
- Purpose-built telemedicine carts equipped with videoconferencing capabilities, and
- Unmanned robotic systems or any number of medical devices such as a stethoscope or blood pressure monitor.
Videoconference enables a single doctor to extend their outreach and cover multiple hospitals at once. The traditional practice of having a local medical specialist onsite is inefficient and unaffordable for most facilities. A doctor using videoconferencing can achieve twice the number of consults in a 12-hour period than a specialist onsite. Videoconferencing is the key component; but it is estimated that that less than 10% of the total videoconferencing user base is telemedicine and telehealth, but that figure is expected to grow especially given the recent CMS announcement.
Centers for Medicare and Medicaid Services (CMS) issued a final rule on telemedicine credentialing and privileging that aims to not only make the process less cumbersome for small hospitals and critical access hospitals (CAHs), but also to provide more timely care.
The new rule was published in the Federal Register on May 5 and will go into effect July 2, 2011. The new rule revises the conditions of participation (CoPs) for both hospitals and CAHs. It allows rural hospitals to rely on information provided by the “distant-site telemedicine entity” to base its credentialing and privileging decisions regarding physicians and practitioners who will provide the consult.