The COVID-19 pandemic thrust connected care into the spotlight—and the use of connected care technology has grown exponentially in a matter of weeks and months. But the terminologies and definitions used in the U.S. by clinicians, market suppliers, policy makers, and patients vary widely. In an effort to gain understanding and clarity to the full range of connected care and telehealth definitions and terms, we offer this primer.
In some cases, connected care terms have specific regulatory or statutory definitions, while in other cases there are no official definitions—only a loose consensus of use. When using telehealth terms, we must take care to select appropriate terms for a specific audience, context, region and end-goal. The U.S. federal government's use of an array of terms—many of which differ across agencies, contributes significantly to definitional confusion.
For example, the U.S. federal government specifically describes telehealth services in the Medicare program as using an “interactive telecommunications system”, which is defined as: “Interactive telecommunications system means multimedia communications equipment that includes, at minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant-site physician or practitioner. Facsimile machines and electronic mail systems do not meet the definition of an interactive telecommunications system."
It’s important to note that Medicare does not include remote patient monitoring, virtual visits and communication-based technology services such as telehealth. Thus, when addressing anything related to the Medicare program or agencies responsible for its administration, we must select terms carefully to be clear about whether or not we are addressing their specific telehealth definition or technologies not subject to the restrictions placed upon telehealth.
Definitions written into policies and regulation vary by entity and drive coverage and reimbursement policy.
Telehealth is the most common term and often includes the full array of connected care modalities: video visits, phone calls, email-based consultations, and sometimes remote monitoring (excluding the U.S. Medicare program). Telemedicine more commonly involves consultation between providers on clinical cases, such as telestroke services, teleradiology and others.
The U.S. federal government uses an array of terms—many of which differ across agencies, contributing significantly to definitional confusion.