Telepractices, Telerehabilitation and Telemedicine

Newborn baby having hearing screening

What’s in a name? A variety of terms are used to describe providing consultation, resources and service delivery through ICT tools. Professional associations and the US government have defined terms to foster understanding of the range of practices associated with ‘telepractices, telehealth, telerehabilitation, and telemedicine’. Examples of these definitions that have evolved with the growth of telepractice programs provide clarification of the distinctions:

• Telepractice — the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation.

Telepractice may be used to overcome barriers of access to services caused by distance, unavailablity of specialists and/or subspecialists, and impaired mobility.

Telepractice offers the potential to extend clinical services to remote, rural, and underserved populations, and to culturally and linguistically diverse populations.

The use of telepractice does not remove any existing responsibilities in delivering services, including adherence to the Code of Ethics, Scope of Practice, state and federal laws (e.g., licensure, HIPAA, etc.), and ASHA policy documents on professional practices…the quality of services delivered via telepractice must be consistent with the quality of services delivered face-to-face.

(American Speech-Language-Hearing Association (ASHA), 2005)

• Telehealth— Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.

Technologies used in telehealth typically are: videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications. While new applications are increasingly found for using these technologies, significant barriers remain to making these technologies an integral part of daily health care practice.

http://www.hrsa.gov/telehealth

Telehealth is the removal of time and distance barriers for the delivery of health care services or related health care activities. Some of the technologies used in telehealth include: telephones, computers, interactive video transmissions, direct links to health care instruments, transmission of images and teleconferencing by telephone or video.American Nurses Association. (1997) Telehealth: A Tool for Nursing Practice.

In Nursing Trends & Issues, ANA Policy Series. Washington, DC: ANA.

Telehealth— The use of advanced telecommunication technologies to exchange health information and provide health care services across geographic, time, social and cultural barriers.

Reid, J. (1996) A Telemedicine Primer: Understanding the Issues. Billings, Montana: Artcraft Printers.

• Telemedicine—Telemedicine (also referred to as "telehealth" or "e-health") allows health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications technology. Telemedicine allows patients in remote locations to access medical expertise quickly, efficiently and without travel. Telemedicine provides more efficient use of limited expert resources who can "see" patients in multiple locations wherever they are needed without leaving their facility. In developed and developing countries telemedicine offers a reduced cost solution to delivering remote care when and where it is needed without the building and staffing added facilities. Telemedicine also reduces isolation that clinicians can experience in small medical facilities in distant locations. Telemedicine allows local practitioners to consult with their peers and with clinical experts when needed. Telemedicine further allows them to participate in grand rounds and education opportunities they would not normally have access to without travel and time away from their patients.

Telemedicine has become standard medical practice and is in daily use across dozens of countries. Over 10,000 peer review papers have been published over the past 20 years supporting the clinical effectiveness and cost savings of telemedicine.

http://www.amdtelemedicine.com/telemedicine-resources/telemedicine-defined.html

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 the 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.

American Telemedicine Association, 2010

• Telerehabilitation— Telerehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Most types of services fall into two categories: clinical assessment (the patient’s functional abilities in his or her environment), and clinical therapy. Some fields of rehabilitation practice that have explored telerehabilitation are: neuropsychology, speech-language pathology, audiology, occupational therapy, physical therapy, and robot-aided rehabilitation. Telerehabilitation can deliver therapy to people who cannot travel to a clinic because the patient has a disability or because of travel time. Telerehabilitation also allows experts in rehabilitation to engage in a clinical consultation at a distance.

http://en.wikipedia.org/wiki/Telerehabilitation