Telehealth Providers of the Future

International, peer-reviewed, open access online journal publishing original research, reviews, editorials and commentaries on the application of technology to support people and patients at home and in assisted living centers to optimize healthcare and management resources.

The American Telemedicine Association (ATA), with members from the United States and throughout the world, is the principal organization bringing together telemedicine providers, healthcare institutions, vendors, and others involved in providing remote healthcare using telecommunications. ATA is a nonprofit organization that seeks to bring together diverse groups from traditional medicine, academia, technology and telecommunications companies, e-health, allied professional and nursing associations, medical societies, government, and others to overcome barriers to the advancement of telemedicine through professional, ethical, and equitable improvement in healthcare delivery. ATA has embarked on an effort to provide practice guidance and technical recommendations for telemedicine. The goal of this effort is to advance the science of telemedicine and promote the delivery of quality medical services.

The Medical University of South Carolina has plans to double the number of school-based telehealth programs, from 45 to 90, by the end of next year. But they'll need the school nurse on their side to make that happen.

Today, telehealth is experiencing exponential growth in utilization. Paralleling this trend is the growth in the telehealth industry, with sharp increases in the number of platforms, functionalities, and levels of integrations within both the electronic health record and other technical systems supporting health care. When a telehealth network is intended to be used across independent health care systems, an additional layer of complexity emerges. In the context of regionalized telehealth networks that are not within the same health care system, not only are technical interoperability challenges a practical barrier, but administrative, clinical, and competitive elements also quickly emerge, resulting in fragmented, siloed technologies. The study aimed to describe a statewide approach to deploying an interoperable open access telehealth network across multiple health systems. The four stages of an OAN are defined according to operational maturity, ranging from feasibility to demonstration of implementation. Each stage is associated with infrastructure and resource requirements and technical and clinical activities. In stage 1, technical standards are agreed upon, and the clinical programs are designed to utilize compliant technologies. In stage 2, collaboration is demonstrated through technical teams working together to address barriers, whereas clinical and administrative teams share best practices. In stage 3, a functional interoperable network is demonstrated with different institutions providing service through common telehealth end points at different patient care sites. In stage 4, clinical workflows are streamlined and standardized across institutions, and economies of scale are achieved through technical and administrative innovations.

School-based telehealth is an efficient and effective way to overcome barriers to care and improve health equity for children in rural and underserved communities. Empowering health care providers, such as nurse practitioners, to develop successful, sustainable programs may contribute to improved access to care and improved health outcomes for the children served. Using a structured framework for program development is essential to successful implementation when connecting school-age children to care through a school-based telehealth program. The Telehealth Service Implementation Model provides a robust structure with requisite components to develop and implement a successful school-based telehealth program.

One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation.

South Carolina Dental Association members were surveyed on telehealth knowledge, need, and interest in using it for access to care improvements.

To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations.

We describe our approach in using health information technology to provide a continuum of services during the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 challenges and needs required health systems to rapidly redesign the delivery of care. Our health system deployed 4 COVID-19 telehealth programs and 4 biomedical informatics innovations to screen and care for COVID-19 patients. Using programmatic and electronic health record data, we describe the implementation and initial utilization. Through collaboration across multidisciplinary teams and strategic planning, 4 telehealth program initiatives have been deployed in response to COVID-19: virtual urgent care screening, remote patient monitoring for COVID-19–positive patients, continuous virtual monitoring to reduce workforce risk and utilization of personal protective equipment, and the transition of outpatient care to telehealth. Biomedical informatics was integral to our institutional response in supporting clinical care through new and reconfigured technologies. Through linking the telehealth systems and the electronic health record, we have the ability to monitor and track patients through a continuum of COVID-19 services. COVID-19 has facilitated the rapid expansion and utilization of telehealth and health informatics services. We anticipate that patients and providers will view enhanced telehealth services as an essential aspect of the healthcare system. Continuation of telehealth payment models at the federal and private levels will be a key factor in whether this new uptake is sustained. There are substantial benefits in utilizing telehealth during the COVID-19, including the ability to rapidly scale the number of patients being screened and providing continuity of care.

The American Telemedicine Association (ATA), with members from throughout the United States and the world, is the principal organization bringing together telemedicine providers, healthcare institutions, vendors, and others involved in providing remote healthcare using telecommunications. ATA is a nonprofit organization that seeks to bring together diverse groups from traditional medicine and healthcare, academia, technology and telecommunication companies, e-health, allied professional and nursing associations, medical societies, government, and others to overcome barriers to the advancement of telemedicine through professional, ethical, and equitable improvement in healthcare delivery. ATA has embarked on an effort to establish practice guidelines and technical requirements for telemedicine to help advance the science and to assure uniform quality of service to patients. These guidelines, based on clinical and empirical experience, are developed by work groups that include experts from the field and other strategic stakeholders and designed to serve as both an operational reference and an educational tool to aid in providing appropriate care for patients. The practice guidelines and requirements generated by ATA undergo a thorough consensus and rigorous review, with final approval by the ATA Board of Directors. Existing products are reviewed and updated periodically as time and resources permit. Board-approved practice guidelines will be considered for affirmation, update, or sunset at least every 4 years. Practice guidelines that have been sunset may continue to have educational value but may not represent the most current knowledge and information about the subject matter.

There are high rates of maternal and newborn morbidity and mortality associated with opioid use disorder (OUD). Integrating OUD treatment in obstetric practices for pregnant and postpartum women via telemedicine can increase access to care and reduce the consequences of OUD. Evaluation of this care delivery model, however, is needed before widespread adoption.