Question:

What is Telemedicine or Telehealth?

Answer:

• Telemedicine or Telehealth is the use of electronic communication and information technologies to provide healthcare when distance separates medical professionals from the patient. It also includes administrative and educational uses of the technology in supporting healthcare such as distance education.  The terms Telemedicine & Telehealth are used synonymously.

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Question:

What technologies are used in TeleHealth?

Answer:

• There are two kinds of technology that comprise Telehealth technologies.

“Store-and-Forward” technology is used to transfer digital images such as dermatological images from one location to another.

“Two-way-interactive TV” (IA23 TV) utilizes cameras and TV technology to transmit images and sound interactively between two or more locations.

Question:

Please explain the difference between a point-to-point and a bridged connection.

Answer:

• A point-to-point connection is when two sites link up directly.  One site calls another much like a normal telephone call.

• A bridge is a multi-point connection (more than two sites).  Since one site cannot typically call more than one other site, a conferencing bridge or MCU is used to perform a “conferencing” function bringing all sites together at once.   The bridge usually dials all sites at a specified time and ends at a specified time.

Question:

What is a T1 circuit?

Answer:

• A T1 circuit is a digital telephone circuit which connects one site to another comprising the basics of a Telemedicine or Telehealth network.  The circuit consists of (24) 64K channels which comprise a 1.544MB connection.

Question:

What is a “Codec?”

Answer:

• A codec is a “coder/decoder” and is the basic hardware component used to “code” analog audio and video signals into digital signals which can be transmitted across a network connection and be “decoded” back into analog images and sound at the receiving end.

Question:

What is a “Private Network?”

Answer:

• A network that is comprised of a collection of point-to-point circuits or is “closed” to users outside the network is referred to as a “Private Network.”  Video calls made to sites outside the private network are typically called “Off-net” calls and incur a per-minute connection charge.

Question:

What do H.320 and H.323 protocols refer to?

Answer:

• H.320 refers to a video call using Integrated Services Digital Network (ISDN) typically used outside of private networks.  H.323 refers to Internet Protocol (IP) and is used for the transmission of voice and video calls or traffic across networks.

Question:

What does the term  “QOS” refer to?

Answer:

• QOS or Quality of Service is an IP protocol used across networks to assure that IP-voice and video packets arrive on-time and in-sequence thereby minimizing tiling and jittering which degrades video images and sound.

Question:

What are the most common applications of Telehealth?

Answer:

• The most common applications used in Telehealth are teleradiology, mental health, dermatology and cardiology.

Question:

What does Universal Services Funding refer to?

Answer:

• Universal Services Funding refers to the subsidy provided by the federal government and administered by the Rural Healthcare Corporation for the costs of circuits used to connect Telehealth sites on a network.

Question:

Does insurance pay for telehealth?

Answer:

• Many insurance carriers in Washington State are now reimbursing for Telehealth clinical consultations.  Carriers are now realizing the potential for Telehealth to achieve considerable cost savings, improved turnaround time and greater access to medical care.  As of October of 2001, Medicare reimburses for most types of Telehealth consultations.  Medicaid reimbursement is not as consistent throughout the country and varies greatly between states.

Question:

Where can I find information about privacy issues?

Answer:

Check these web sites:

• Internet Healthcare Coalition
• Internet Privacy Coalition
• Telemedicine Information Exchange

Question:

Can providers practice Telehealth across state lines?

Answer:

• Most states currently require a physician to be licensed in the state where the patient is located.  Some states have special arrangements or limited licensure for “occasional” consultations while others have broad definitions not limited to opinions or consultations.  Individual state requirements should be investigated to verify restrictions before practicing Telehealth across state lines.

Question:

What can administrators do to decrease staff resistance to technology?

Answer:

    There are two elements of resistance to the incorporation of telehealth technologies.

• The first is a fear of change which is common to most everyone.  This can be addressed only by increasing familiarity with the technology and systems of operation.  That’s where training materials, personal training sessions, site visits, etc. come in.

• The second (and more important) however, is fear of personal consequences.  It’s hard to imagine that staff resistance would be substantial if staff expected introduction of the technology to make their jobs more secure, more lucrative, or more enjoyable.  Since resistance is so high, they must therefore believe that the opposite will be the case.  Thus, administrators need to realistically ask themselves whether this really is a good deal for health care staff when compared with their current non-telemedicine circumstances.  If so, then it’s a relatively straightforward communication problem.  If not, then you can: (a) sweeten the deal for them so that they’re at least not worse off; (b) secure new staff who don’t have the same frame of reference for comparison; or (c) live with the resistance and hope that it eventually fades away.  There aren’t many othere alternatives.

Question:

Where is Telehealth going in the future?

Answer:

• Telemedicine is part of the larger world of Telehealth: the use of communications technology in health care.  There is growing interest in using Telehealthcare for disease management and prevention.  Home healthcare and long-term care are both shaping up as areas which benefit from telemedicine.  Emergency telemedicine is starting to be used on airline flights and cruises, and it is part of many military operations.

• The future of Telehealth depends less on technology than on politics.  Funding of health care is tied to such areas as government programs, telecommunications law and insurance reimbursement.  The consumer is a key player in the future of Telehealth.  If people understand what telemedicine is, see it as having value, and insist that they have access to it, governments, employers, and insurance companies will make it feasible.  Public awareness is essential.

• RSS (which, in its latest format, stands for "Really Simple Syndication") is a family of web feed formats used to publish frequently updated content such as blog entries, news headlines or podcasts. An RSS document, which is called a "feed", "web feed", or "channel", contains either a summary of content from an associated web site or the full text. RSS makes it possible for people to keep up with their favorite web sites in an automated manner that's easier than checking them manually.
  
  "RSS." Wikipedia, the Free Encyclopedia. 19 July 2007, 19:23 UTC. Wikimedia Foundation. 23 July 2007 <http://en.wikipedia.org/wiki/Rss_feed>.

• The web browsers that have the ability to read RSS feeds are Safari, Mozilla Firefox, and Internet Explorer 7 or by desktop software programs known as RSS readers or aggregators. Examples of RSS readers are Amphetadesk, FeedReader, and NewsGator.
  
  


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