The Telehealth Jargon Funnel
We are going to be at the Connected Health Conference 2019 next month in Boston, from October 16 to October 18th. The HIMSS (Healthcare Information Systems and Management Society) spinoff is the largest conference of its kind on everything related to digital health coordination. Just by the way I phrased that sentence, you can tell that one has to be meticulous when using healthcare jargon. Different terms are used to capture varying swathes of the vast of world of health information systems. For all things health IT in general, there is the HIMSS conference, which has established itself as the “one size fits all” premier go to conference to talk about everything health IT. The Connected Health Conference is not as big as HIMMS. By using the very term Connected Health, they are segmenting the market.
Over the years, Connected Health has become the latest term to describe the virtual advances of healthcare connectivity, which has always been grounded on a basis of remotely connecting various stakeholders in healthcare. Chief among which are: Physicians, specialists, nurses, therapists, patients, executives, payers, academia, industry and the government. There is a possibility you are more familiar with the term telehealth, instead of Connected Health. Current Google search results show that the monthly traffic in USA for telehealth is at 9,900, and 880 for Connected Health. But practically speaking, telehealth’s aim is to connect, and the word tele means at a distance. No one would find fault if the two terms were used interchangeably. In fact, you are an avid consumer of telehealth news, you have seen all of the following terms used interchangeably to describe the digital aspect of healthcare coordination and delivery: Telemedicine, eHealth, mHealth, Connected Health, Remote Care, etc.
I am someone who likes to organize things for peace of mind. Yes, there exists many overlapping components of each of these terms’ definitions. But it’s usually the case of one of these terms completely encompassing another one, plus having some characteristic of its own to justify using a different term. It’s possible then, to organize all of these terms in an upside-down pyramid, where the top layer covers the most ground definition wise, followed by the layer below it which covers most but not all of the layer above it, and thus proceeding downwards. If the terms become specific enough at one point to exist side by side, and not have one engulf the other, then the layer of the pyramid where this happens will be split. I thought it would be interesting to depict this. See below where each term is explained. For a pictorial representation, refer to the Telehealth Jargon Funnel at the beginning of this post. Follow our Social Media pages for the complete diagram. Our pages are linked at the end of this post.
*It should be noted that different sites do have differing opinions on these very same terms. But as someone who routinely peruses through all this information and comes across all the usual suspects when it comes to jargon, this is what I have found to be true. If you look at the reference section of this article, all the resources listed have their own views on the matter. But it is possible to consolidate them all and present one current narrative.
Digital Health is the grandest term available to define anything that has to do with information technology and healthcare. It applies to both pop culture and the healthcare industry. It’s so popular, that it is the term first used by people who are interested in networking with like-minded people. For e.g., meet ups. They may specify later what they are all about, but Digital Health will be used as a feeler, to qualify interest among the general population.
All other terms below are a part of Digital Health.
eHealth, like Digital Health, captures everything at the intersection of IT and health. But it is more particularly suited to hospitals. By using this term, one makes it clear that provider organizations will be one of the stakeholders that will be discussed in the spectrum of digital healthcare delivery. And it only makes sense, as it is difficult to imagine healthcare scenario without the inclusion of the actual care providers. eHealth also conjures up images of the different IT systems inside hospitals to conduct operations such as EHR (Electronic Health Records) and Clinical Decision Support.
All other terms below are a part of eHealth.
Virtual care refers to the remote provision of healthcare across the entire patient journey. It shifts the focus from organizations to the people in those organizations. It drops an anchor on the care aspect of health, where there must be communication from healthcare practitioners to the patient. The word virtual is not used to strictly refer to long distance, but it could mean any replication of a real-life situation in healthcare or using a screen to do an activity without any human interaction. For e.g., the concept of Digital Twins, where a digital version of yourself is made with as many data points, and the accessing of patient records through an e-portal respectively.
All other terms below are a part of Virtual Care.
Connected Health takes on a definition which is the sum of many parts. Basically, it is coordination of knowledge between multiple stakeholders to provide healthcare. The main stakeholders are the patient, physician, nurses, specialists, executives, payers, government and academia. Like virtual care, the focus is also care centric, but it especially applies to connectivity aspect of health, where two parties have to collaborate, coordinate and cooperate to achieve better outcomes. For e.g., the use of evidence-based studies from academia, or the lobbying for more value-based laws to congress.
All other terms below are a part of Connected Health.
With Telehealth, one is zooming in on care providers and the patient. Other parties are privy to the term as well, but not as much as the dyadic relationship between care providers and the patient. It is the provision of remote care via telecommunications, which include three main mediums currently. Virtual visits, store and forward and remote patient monitoring. These three mediums are recognized by CMS and reimbursed differently from state to state. Telehealth captures them all, plus nonclinical services as well which have spilled into popular culture. Wearables that track vital signs, sleep and connectivity are part of this as well.
The three terms below, namely: Telemedicine, Remote Care and mHealth, are all under Telehealth.
Telemedicine strictly refers to virtual visits and store and forward technology. It addresses the diagnosis and treatment of a condition in a patient’s continuum of care, not the whole spectrum of a patient’s journey as virtual care does. Or if one is feeling generous, it could more broadly mean the administration of relationship between a patient and physician using telecommunications. Its application is solely clinical.
Remote Care refers to Remote Patient Monitoring (RPM). Even though RPM is a term that has become more popular than remote care, it forms the bedrock of what remote care does, which is remotely monitor the biodata of the patient. It starts with monitoring the vital signs, with some vendors monitoring more complicated ECG data. Remote Care gets its distinction as being separate from the other two main mediums of telehealth, I.e., virtual visits and store and forward.
mHealth refers to the use of cellular devices to deliver healthcare. Mobile apps and mobile technology are a big part of it as well. Its application is not restricted to clinical use only, the wearables and personal wellness apps are also captured by this term. Remembering its definition is easy, as long as a mobile wireless device is involved, it is said to be mHealth.
I hope you were able to get some clarity on all these different healthcare terms that are floating about. Do you have any insight that could help me better define these terms? Email me at firstname.lastname@example.org. Or let us know on our media channels.
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