What’s the Difference between Telehealth, Telemedicine, and Home Health?: How COVID-19 is Forcing Healthcare to Evolve in 2020
Telemedicine and telehealth are expanding areas of home healthcare that allow doctors to harness the power of the internet to provide medical care without seeing a patient in person: video conference calls and other remote evaluation tools allow for communication between a patient and a medical team or practitioner at a remote site.
Home health care has traditionally required an in-person visit from a skilled health care worker, but expanded telemedicine applications will allow healthcare providers to extend care to patients’ homes from a distant location.As home health continues to become more sophisticated and widely used, in-home health providers will likely interface more frequently with specialist clinicians such as cardiologists, wound care physicians and the like.
Telehealth is a more general term than telemedicine, and covers a variety of interactions performed remotely and electronically. This includes such things as remote patient monitoring for blood pressure. Telecare is a less common term, but it is used interchangeably with telemedicine and telehealth.
Covid-19 infection control has been a catalyst for radical change to the current healthcare system. Medicare has made headlines with its recent expansion of telemedicine, prompted by a need to make doctor visits more efficient.
Telemedicine also allows vulnerable patients to have less exposure to dangerous viruses that they might encounter in a hospital or doctor’s office. Until recently, telemedicine mostly helped to provide healthcare to people who live in designated rural areas. In the current healthcare climate, it is on track to become a more regular part of patient care.
Telehealth is an umbrella term that covers a broad range of healthcare applications that can be performed remotely, using audio, text messaging, or audio and video conferencing. Telehealth technology has been increasing patient access to medical advice, including through patient-initiated questions submitted through an online portal.
What is an Example of Telehealth?
One example of telehealth is the ability for nurses to complete a wound care certification online. With this increased expertise, nurses can offer patients advanced wound care treatment whether via home health or bedside within a skilled nursing facility or assisted living facility.
Hospitals that employ wound care certified nurses lower the risk of their patients suffering from hospital acquired pressure injuries (HAPI) by over 30%.
The ability for health practitioners to earn credentials online, for patients to virtually interface with clinicians, and to perform digital health administration are all examples of telehealth.
Telemedicine consists of diagnosis, consultation, or any other type of care provided by a doctor from a remote location.
Who invented telemedicine?
It is impossible to point to one single inventor of telemedicine, and it has developed right alongside technological advancement. Doctors have used phones to consult with their patients since not long after their invention in the 19th century, and radios have proved a useful aid in medical treatment since the 1920s. Today, The American Medical Association has formal guidelines around telemedicine services.
Remote patient monitoring
Telemedicine might involve any HIPAA-compliant method of communication. Telemedicine technology can offer remote patient monitoring, which allows a medical team to review a patient’s vitals and organ functioning from afar. Remote patient monitoring is a useful tool for patients and doctors alike, especially for patients with conditions like chronic obstructive pulmonary disease (COPD), which is a condition that often necessitates hospitalization multiple times per year.
Studies have shown that remote monitoring of patients with COPD reduces healthcare costs by as much as 14%. Doctors can often see the signs of a worsening condition before a patient notices symptoms. By catching it early, remote monitoring reduces the number of times a patient needs to visit the hospital, thereby reducing the cost.
When it comes to patients that are extremely vulnerable to contracting coronavirus that should be adhering to the CDC’s recommendations regarding coronavirus droplet precautions, patients with COPD are just one of many populations that would benefit from increased access to home health and telemedicine.
A physician might offer continuing care for patients with wounds via interactive audio and video, a mobile app, or by monitoring a wearable device. These are just a few examples, and this field is set to expand in many new directions. In February 2020, Singapore introduced a telemedicine chatbot, which is a software program that provides answers to a pre-programmed list of commonly asked questions, in this case, to provide employers with up-to-date information on Covid-19.
In the U.S., telemedicine developed in part because of the need to provide healthcare to patients who live in remote parts of the country, where it might take hours for a patient to reach a clinic or hospital. For example, Project Echo provides chronic disease management to patients with hepatitis C in rural New Mexico.
Vohra Wound Physicians also offers wound care via telemedicine for continuity of care, and has done so for over ten years. A specialized wound care physician is able to evaluate, diagnose, monitor and direct treatment for new and existing wounds via routine telemedicine visits.
Who can use telemedicine?
There are no limits to who can use telemedicine, although many healthcare providers are only now starting to explore its applications since medical resources have been stretched especially thin during the Covid-19 pandemic.
Home Health Providers
Of course, telemedicine has its limits. Sometimes patients require the attention of an in-person home health provider. Home health agencies specialize in providing skilled home health care. Skilled health providers collect and relay information about a patient’s condition to their primary care provider. At least one physician and one nurse oversees a home health provider, which might be a public, nonprofit, or proprietary agency. It could also be a subdivision of an agency or organization.
Vohra Wound Care recently launched the Vohra@Home platform, a solution that provides home health providers the ability to interface with a wound care doctor using an audiovisual platform, enabling continuity of wound care treatment.
What is Skilled Home Health Care?
Skilled, in-home health care services are typically provided by nurses. Patients who are unable to leave their homes would typically be eligible for skilled home healthcare. Primary care physicians can evaluate whether a patient qualifies for home health care under Medicare or Medicaid.
Home Health Sector
The home health sector refers to the services that healthcare providers offer patients in their homes.
Who Pays for Home Health Care?
Research suggests that public health insurance leads to better health outcomes. Public insurance like Medicare and Medicaid may cover the cost of home health care, including telemedicine, for qualifying patients.
Patients who qualify for Medicaid may also qualify for long-term care. Some private insurance plans also cover home health care and telemedicine, although plans typically have strict limits on these types of health care. Patients and employers can also purchase insurance plans that include long-term care plans.
What types of care and services are provided by home health agencies?
Home health care is often approved to treat acute conditions, as in the case of a patient recovering from a wound that requires regular dressing changes, or a patient recovering from a heart attack who needs regular assessments. Some other examples of in-home healthcare include physical therapy, speech-language pathology services, and end-stage renal disease treatment. This is not an exhaustive list, and Medicare can always expand the types of care covered in the home health sector.
Health Care Costs
The cost of healthcare is rising, due in part to the U.S.’s aging population. Telemedicine lowers total healthcare costs by removing some of the burden placed on hospitals. With fewer patients in hospital beds, patients are able to handle their illnesses and injuries in a more cost effective manner.
The government defines affordable health care as health care that costs 9.78% or less of the employee’s household income. So for an individual who makes $49,000 per year, an affordable plan would be any plan that costs $399 per month or less. There is no income limit for affordable healthcare – there is simply a definition of what the government considers affordable. The monthly cost of family healthcare depends on several factors, including the size of the family and the age of the family members.
Health Care Organization
Some health care organizations are devoted to finding ways to lessen the burden of health care expenses on the taxpayer. In a Medicare Shared Savings Program—an Accountable Care Organization (ACO) made up of doctors and other health care providers—coordinates care of Medicare patients, and when they are able to save money, they share those savings with Medicare.
There are two different basic types of insurance provided through employers: HMOs and PPOs. Health Maintenance Organization (HMO) plans lower costs by only offering treatment from providers in their network, except in the case of an emergency. Preferred provider organizations (PPOs) offer care at a typically higher rate, but they also offer more flexible coverage, and cover costs incurred by an out-of-network provider – although patients who choose in-network providers often pay less.
How patients experience healthcare depends largely on how primary care providers define their needs. Access to medical care often depends on insurance, whether through a private provider, Medicare, or Medicaid.
Telehealth and telemedicine are increasingly essential components of home health care. Healthcare is playing catch up with technology, and the current system has only begun to tap into the potential afforded by virtual care. In the future, patients can look forward to making fewer visits to see their health care providers in person, and getting more of the guidance they need from the comfort of their homes.