Frequently Asked Questions
Telehealth and telemedicine, for the average citizen in this country, is relatively an unknown. The following are several questions that are often asked about telemedicine, telemedicine development, and telemedicine services.
What is telemedicine?
Telemedicine is the term used for the process where medical services are provided when the patient and health care provider are separated by physical distance. The practitioner (health aid, physician’s assistant, nurse practitioner, physician) assisting the patient can obtain patient data – narrative, EKG, various images and sounds – and store it in a digitized format for immediate transmittal to a specialist in a different location, or for archival for later transmittal. It is a very unique melding of interactive medical equipment, computer technology, and telecommunications technology.
I have often heard the terms telemedicine and telehealth used interchangeably. Are they the same thing?
No. The term telemedicine refers specifically to patient and health care provider encounters for diagnosis and treatment. The term telehealth is a broader term to include telemedicine, but also includes using the technology for preventative, educational, and health-related administrative activities.
What does telemedicine mean to me and my family?
Telemedicine is designed for one thing: to bring quality primary health care and specialty services to remote areas of Alaska, where it might not otherwise be economical to do. It can bring more timely services to when your need is urgent and severe in nature, and the follow-up care can be done right in your home town in many instances. Potentially, telemedicine can save you and your family the inconvenience of traveling to referral centers such as Anchorage or Seattle.
Is telemedicine available in all communities in Alaska?
Not at this point. However, it is the goal of the Alaska Telehealth Advisory Council to support efforts to bring telemedicine to all communities in Alaska. Through collaboration with various agencies, communities, health facilities, and individuals, telemedicine can benefit all communities. The AFHCAN is currently the largest telemedicine project in Alaska serving much of remote Alaska.
What is an Electronic Health Record?
An Electronic Health Record (EHR) is software that allows patient medical information to be stored, created, edited and retrieved on a computer. EHRs contain the same information as the traditional paper chart maintained by health care providers. EHRs allow patient information to be retrieved more quickly and analyzed more completely. EHRs improve patient safety, health care access, coordinated treatment between providers, health care practice efficiencies, and the ability for patients to conveniently access their medical records and communicate with their health care provider. EHRs are in compliance with HIPAA privacy and security rules.
What is AFHCAN?
AFHCAN stands for the Alaska Federal Health Care Access Network. As the name implies, this is a telemedicine network developed specifically to serve federal beneficiaries in Alaska. It uses a “store-and-forward technology. It was originally developed as an entity of the Alaska Federal Health Care Partnership (AFHCP), funded primarily through the Alaska Native Tribal Health Consortium (ANTHC); it is now managed and organizationally part of ANTHC. The member organizations for AFHCAN include: ANTHC, Indian Health Service, Department of Defense, Coast Guard, Veteran’s Administration, and State of Alaska (through the Section of Public Health Nursing). Click here to visit: afhcan.org
What does store-and-forward mean?
In contrast to live-interactive telemedicine encounters, store-and-forward means the health provider where the patient is at stores the data from the encounter in a digital format, and then forwards them at the time of the encounter, or at a selected later time. The advantage is, the receiver of the information (usually a specialist at a tertiary care center in the same telemedicine network) typically can receive that information at anytime during the day. The specialist can then review the data when he next logs on to his computer, and review the encounters based on level of urgency, and makes the treatment and follow-up recommendations to the primary care provider at the local level. Those recommendations are usually transmitted using the same store-and-forward technology.
What is Health Information Exchange?
Health Information Exchange is the coordination of appropriate electronic records for the health needs of patients and providers. HIE organizes, integrates and retrieves data from existing sources of multiple electronic health records associated with a single patient using secure data transfer. Health record exchange security is governed by patient and facility permission levels.
What is the American Health Information Community?
The American Health Information Community (The Community) is a group of stakeholders who will provide input and recommendations to the Department of Health and Human Services (HHS) on how to make health records digital and interoperable, and provide assurance that the privacy and security of those records are protected.
What is the National Health Information Network (NHIN)?
A Nationwide Health Information Network (NHIN) would link disparate health care information systems together to allow patients, physicians, hospitals, public health agencies and other authorized users across the nation to share clinical information in real-time under stringent security, privacy and other protections. The NHIN is described in greater detail in the Framework for Strategic Action: "The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care" which is available at: http://www.hhs.gov/onchit/framework /.
What is a Regional Health Information Organization (RHIO)?
A Regional Health Information Organization (RHIO) is a regional version of a National Health Information Network. A region is defined by a service area which could be a state, group of states or a significant portion of a state. A RHIO would link disparate health care information systems together to allow patients, physicians, hospitals, public health agencies and other authorized users across the nation to share clinical information in real-time under stringent security, privacy and other protections.
How does live-interactive differ from store-and-forward? And what are the benefits?
As the term implies, live-interactive refers to telemedicine encounters where the patient, primary care provider physically with the patient, and the specialist in a different location are on-line at the same time (typically through a videoconferencing format). Both clinicians and patient are interacting real-time, not delayed. Live-interactive telemedicine has the benefit of the specialist have direct interaction with the patient for questions and patient education, and the patient and primary care provider get immediate feedback from the specialist.
It doesn’t seem like patients could receive the same level of quality of care as they would receive in and in-person encounter.
This issue has been debated and studied at the National level by physicians, hospitals, and telemedicine providers for several years. After much debate and studies, it has been determined that telemedicine delivers virtually the same quality of care as the in-person encounters. Patient and provider satisfaction has been very high. The studies conducted by AFHCAN show very high patient and provider satisfaction levels when they use telemedicine for the health care services in Alaska. Third-party payers (Medicaid, Medicare, private insurance) have deemed telemedicine services to be of sufficiently high quality to be reimbursable just as the in-person visit is.
How can I learn more about telemedicine?
This website will provide updated information on telemedicine developments and events in Alaska. It will maintain current links to key resources for planning, development, deployment, and funding of telemedicine programs. This site, along with most of the linked sites have contact information for individuals you can call or email directly to ask questions regarding telemedicine and related issues. See contacts and related links.
I’ve heard the word sustainability used a lot in telemedicine discussions; what does it mean?
Sustainability refers to the telemedicine’s program ability to survive beyond the original seed money or grant that originally created it.
What is the Universal Service Fund?
This fund was created by the Telecommunications Act of 1996 to provide public and nonprofit rural health care providers with access to advanced communications services at rates equivalent to those in urban areas. Universal Services, a function of the Federal Communications Commission, has earmarked $400 million annually for this purpose. www.rhc.universalservice.org