Given the funding that has recently been pouring into healthcare technology due to COVID-19 in the first quarter of 2020, the behavioral health community can expect that many current innovations will be more visible in the market soon. Healthcare has been changed permanently in most of the countries of the world, and telehealth adoption has moved beyond the tipping point. Understanding the four basic types of telehealth technology can help the wise professional make informed choices about telehealth purchases. This article summarizes the four basic types as they apply to both general, as well as behavioral health care.
Four Types of Telehealth
Four basic types of telehealth exist, and some platforms combine two or more types to provide more comprehensive services. Given that funding for telehealth is expanding and more expansion is likely to continue, practitioners will benefit by knowing about these four types of telehealth.
Synchronous interaction is the most well-known type of technology-based healthcare service referred to in telehealth or telemedicine. It includes any video call or live chat software that allows a healthcare provider to communicate with a client/patient in real-time, or live. Consultation is conducted across distance using two-way, interactive software housed in desktop computers, laptops, tablets or other mobile devices such as smartphones.
Zoom, VSEE, Vidyo or Doxy.me are examples of software that can be used for real-time, live, interactive telehealth or telemedicine interactions. They can often be found wrapped with additional, feature-rich software to enable yet more clinical functionality for healthcare specialty areas, and sold separately for specific clinical areas of focus. In behavioral health, for example, such well-known platforms include PsyBooks for behavioral practitioners with its patient portal and EHR, or Thera-Link with other therapy-specific features.
Remote Patient Monitoring or RPM
Remote Patient Monitoring (RPM) enables providers to record and monitor a patient’s health data remotely. It uses technological devices to get vital signs needed to monitor a patient’s condition. RPM is usually recommended for patients with chronic diseases like diabetes, asthma, and cardiovascular illnesses. An important advantage of RPM is that it provides frequent monitoring at less cost. State regulations exist for telehealth reimbursement and remote patient monitoring. Go here for more details.
Also known as asynchronous telehealth, store-and-forward telehealth involves specialized technology that allows a client’s or patient’s data to be collected, stored in a secure cloud-based platform, and later retrieved by another treating professional or staff, often in a different location. Appropriate releases are signed, experts vetted, and specific protocols developed. Collected data can include video-recorded intake interviews, biosignals, medical images from x-rays or ultrasound scans, health history, or any other health parameter that can be measured. This type of telehealth is particularly advantageous in rural settings where access to specialists is limited. Providers in these areas electronically send patients’ data to specialists in other geographic areas for consultation.
For example, an addictions counselor in a remote town conducts an intake with a drug or alcohol user, utilizing a structured interview format and records the event to the cloud. A specialist/ prescribing professional renders a diagnosis and suggests a treatment plan/medication. The treatment plan is then returned to the counselor (and typically their agency) for further processing by a local prescriber who is appropriately licensed to prescribe medication in the client’s or patient’s jurisdiction. In this way, professionals using store-and-forward technology can consult over state lines with a full range of specialists who are not licensed in their state to deliver direct care, but who are readily available for such remote consultation. Store-and -forward technology can allow the client or patient to get the care they need in a timely, cost-effective manner rather than having to rely on a local professional’s limited expertise.
The fourth type of telehealth is Mobile Health, otherwise known as mHealth. Smart devices can be now used for many specialized aspects of health care that benefit from continuous data collection about a person’s behavior or condition. Smartphones, tablets, smart wearables like iWatch can monitor a variety of factors such as pulse rate, heart rate, and with some, blood sugar levels or quality of expired air. Apps are now available to encourage healthier lifestyles and behaviors by providing heart-rate variability scores, sleep cycles, movement tracking, weight changes, dietary tracking and much more. Telehealth providers recommend such apps to patients/clients and integrate the findings into the patients’/ clients’ health records. This list of iPhone apps may be useful to clinicians wishing to suggest an app to help clients/patients manage psychological conditions.
All types of telehealth service delivery are best practiced when following guidelines such as those developed by the American Telemedicine Association (ATA). These guidelines ensure proper implementation and protection for both the provider and the patient, and are available in many practice areas such as telecardiology, teledermatology, teleoncology from the ATA. Beyond professional association standards and guidelines, professional training and certification in telehealth offer many hands-on, competency-based strategies to solve everyday clinical, legal and ethical challenges that can arise when delivering professional care.