TELEMEDICINE

Telemedicine is a means of providing clinical healthcare at a distance by the use of telecommunications and information technology. It helps eliminates distance barrier, and make for improved medical services to areas that will ordinarily not be reached.

Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by healthcare institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services.

Telemedicine technologies permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging and health informatics data from one site to another.

What Services Can Be Provided By Telemedicine?

  • Primary care and specialist referral services.
  • Patients’ Remote Consultations. 
  • Remote Patient’s Monitoring.
  • Medical Education. 
  • Medical Health Records and Information Databank. 

What Are the Benefits of Telemedicine?

  • Improved Access 
  • Cost Efficiencies 
  • Improved Quality
  • Patient Demand

 

 

PATIENT PROGRAMS

Patient programs connects psychiatrists and other mental health providers with their patients via online video sessions. With telepsychiatry, there is no need for either patient or physician to travel to an office. With CloudVisit's telepsychiatry platform, HIPAA-compliant video sessions can be done from anywhere – all you need is a broadband internet connection, computer or laptop, and a webcam. This convenience expands your availability and outreach

Telepsychiatry connects psychiatrists and other mental health providers with their patients via online video sessions. With telepsychiatry, there is no need for either patient or physician to travel to an office

SECURITY

Medical privacy and confidentiality issues extend to the telehealth industry. Under HIPAA, telemedicine clinicians have the same responsibility to protect patients’ medical records and keep information regarding their treatments confidential. Electronic files, such as images or audio/video recordings, must be stored with the same precaution and care as paper documents.

Telemedicine networks require technical teams to run the systems, independent of medical staff. This presents privacy and security challenges by increasing the number of people with potential access to patient records. Also, electronic transmission of information is always susceptible to hackers and other breaches of security. The standards and guidelines defined by HIPAA must be strictly followed to ensure that patient privacy and confidentiality are maintained at all times.

Patients may be wary of video conferencing and the possibility of “unseen persons” viewing their examinations. Uncertainty regarding the reliability of the technology may also make some hesitant to use telemedicine. However, these concerns can be alleviated through legal, technical and administrative security measures and through proper patient education.

Telemedicine security includes problems such as authorization, authentication, and accounting8 that are common with other information technology applications such as banking and manufacturing support. There are, however, many new challenges as well. Telemedicine requires information security and privacy as well as physical safety. Physical safety, for example, detection of falls in older adults, has to be evaluated remotely. The patient should be able to trust the system and not feel that human contact in terms of an onsite caregiver is needed. Thus reliability is an important concern. Fischhoff and colleagues noted, “Acceptable risk for a new technology is defined as that level of safety associated with ongoing activities having similar benefits to society.” Thus telemedicine systems should also be evaluated for perceptions of both patients and caregivers since they may be perceived as intrusive and ineffective.

According to Broens and associates,7 both patient physical safety and patient information security are crucial to support the trust relationship between health care providers and patients and for acceptance of telemedicine implementations. Savastano and coworkers10 note that lack of patient trust means that patients would not reveal accurate and complete information, which lowers the quality of care. This is a critical consideration because a big part of the treatment of diabetes patients is in the accurate self-reporting of blood glucose levels. Poor quality of care would further reduce the confidence of both providers and consumers of telemedicine services. Lack of confidence would make it less likely for these services to be deployed widely.

Earlier research suggests that security is not the primary focus of the telemedicine research community. But this needs to change if telemedicine is to become widely acceptable.7 Several articles10,12 have suggested that poor security may lead to lesser quality of care and lack of confidence in the services for both providers and consumers and cause legal liability. These are unique challenges, separate from other forms of health-care-technology-related initiatives such as electronic medical record systems that need to be identified. Not addressing these issues in telemedicine services not only lowers the quality of care but may also have fatal consequences.

As innovations in technology become more and more prominent, the face of the healthcare world begins to change. Health information exchanges (HIEs) allow patient information to be shared with ease, and bring your own device (BYOD) policies enable healthcare staff to record and share information from almost anywhere. Among the more recent technology trends is telemedicine, which provides access to care where it might not otherwise be available. Physicians and mental health providers are able to use technology to consult and treat patients from a distance, and often from the convenience of their own homes. More and more telehealth companies are receiving large investments, like MDLive, which just received an $8.15 million investment from Sutter Health. But with advanced technology also come advanced concerns. As the industry expands and options boom, there are more challenges being presented to secure protected heath information (PHI) and comply with HIPAA. Here are four telehealth privacy considerations for healthcare organizations.

Individual device security

Not all devices being used in the “appointment” may be adequately protected. A provider may have a secure device, but does the patient? Ideally, personal computers and other devices would be safe from an intrusion, but without proper monitoring services, they may not be. And should a hacker gain access to a patient’s computer, the provider’s device and data may be accessed through the patient’s device. Health organizations may take great pains to secure devices being used in telemedicine and BYOD scenarios through the use of technical safeguards such as firewalls and intrusion detection systems (IDS), but patients have a vested interest in their own data security as well.

Patient identification

While not usually a common cause of a data breach, patient misidentification does indeed happen. Providers may send the right information to the wrong entity, or the wrong information to the right entity. Issues may also arise if the telemedicine provide is not the patient’s regular physician or care provider. Difficulties may arise when requesting patients records from other providers. As Micky Tripathi, CEO of the Massachusetts eHealth Collaborative (MAeHC), pointed out in an October 2013 interview with HealthITSecurity.com, saying, “The issue is more about organizations each keeping their medical records in their own silos and the challenge of exactly what information is put in and how accurate is that information? From there, the question is on what basis can you make patient matches with the accuracy that the technologies promise?” While nothing is perfect, the goal should be for technology to function to its capabilities and for human error be avoided as much as possible.

Access security

Verifying the entity on the other end of the data exchange or telehealth appointment is of great concern. Is the provider truly a provider, and is the patient—especially when receiving or accessing information—the correct patient? Either could lead to inadvertent breaches. While standard healthcare practice is to confirm a patient’s name, date of birth, and other information multiple times, a person who has inappropriately accessed the patient’s information would be able to answer these questions. While this should not be a problem for patients and regular providers, it may be for doctors seeing new patients, since they would be unable to recognize the incorrect patient in a video-based session, as can be said for patients seeing a new provider.

And what happens if a patient discloses PHI to a person who is not a provider? Unlicensed professionals posing as registered providers or offering services they are not qualified to perform is not unheard of. Providing secure logins for both patient and provider may alleviate the risks of inappropriate access. Multi-factor authentication, though seen as burdensome by some providers, may be a good solution to this concern. Requiring information beyond PHI, even trivial security questions, make gaining access to health information more difficult, and adds further insurance that both parties involved in the appointment are genuine..

BAAs and PHI use

Some services, such as Google Helpouts, may require any practitioners using their product in conjunction with PHI to sign a business associate agreement (BAA). In the case of Google Helpouts, which boasts itself as being HIPAA compliant, doctors offering their consultation services without patient disclosure of PHI are free to forgo a BAA, but those who require such information must sign an agreement with Google.

In its Health services & HIPAA terms, Google states:
Helpouts providers can enter into a BAA with Google when they create a listing on Helpouts.  The BAA must be entered into before those individuals identifying themselves as covered entities can provide services over Helpouts. Helpouts providers are responsible for determining whether they are subject to HIPAA requirements and whether they use or intend to use Helpouts in connection with PHI. Users who have not entered into a BAA with Google must not use Helpouts or other Google services in connection with PHI.

TELEPSYCHIATRY

Telepsychiatry connects psychiatrists and other mental health providers with their patients via online video sessions. With telepsychiatry, there is no need for either patient or physician to travel to an office. With CloudVisit's telepsychiatry platform, HIPAA-compliant video sessions can be done from anywhere – all you need is a broadband internet connection, computer or laptop, and a webcam. This convenience expands your availability and outreach

An  application of telemedicine to the specialty field of psychiatry. The term typically describes the delivery of psychiatric assessment and care through telecommunications technology, usually videoconferencing.[1] Telepsychiatry services can be offered through intermediary companies that partner with facilities to increase care capacities, or by individual providers or provider groups. Most commonly, telepsychiatry encounters take place at medical facilities under the supervision of onsite staff, though at-home models are becoming accepted as long as they are in compliance with HIPAA standards.

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