The Telehealth Dictionary

The growth of telehealth

It is no secret that telehealth adoption has increased significantly since the start of the COVID-19 pandemic. Faced with an unprecedented global shutdown, the medical industry had to find a way to deliver quality care to patients with minimal face-to-face interaction across all reaches of the world.

The answer? To deliver it virtually. Long before the pandemic, telehealth did exist but it was far from widely used. Today, it is viewed as a close equal to in-person care by many patients and physicians, especially when applied to the right use cases (eg. chronic care management, high risk or bed ridden patients, prescription or lab test reviews, non-emergency visits and specialized support for rural communities).

In fact, the global telehealth market is projected to reach a whopping $266.8 billion by 2026, compared to its $49.8 billion valuation in 2018. That’s a lot of momentum in less than a decade with no signs of slowing. With the rising popularity of telehealth, comes new medical terminology applied to our advancements in virtual care and the range of options available to treat patients through technology. If this sounds like a lot to stay current on, you’re in luck. As experts in this space, we have compiled a complete list of vocabulary to familiarize yourself with in the exciting times ahead for telehealth delivery.

The terminology

You are probably familiar with the common healthcare terms that come along with traditional face-to-face medicine, whether you’ve been treating chronic issues or performing regular check-ups. However, there are several new terms tied to in-person care’s virtual counterpart that will be beneficial to know in the coming weeks, months and years. So, let’s get started.

Telehealth vs. telemedicine

At this point, you have probably heard the words ‘telehealth’ and ‘telemedicine’ more times than you can recall. Often, these terms are used interchangeably but there is a technical difference. As defined by the American Academy of Family Physicians (AAFP):

• Telehealth “refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance.”

• Telemedicine “the practice of medicine using technology to deliver care at a distance.”

Still a little confused? Essentially, telemedicine is a subset of telehealth that refers specifically to delivering remote clinical services. Whereas telehealth encompasses a broader scope of remote health care, including the non-clinical aspects.

Types of telehealth delivery

Synchronous telehealth

Within the realm of telehealth, there are several different ways to perform visits. The most well known delivery method is synchronous. This includes any video call, phone call or live chat that allows the healthcare provider to communicate with a patient in real-time. This method is extremely popular for primary care, follow-up visits and chronic illness management. It is no surprise that synchronous visits are the most common type given their familiar flow for patients and clinicians. They also bring some undeniable benefits:

• Provides immediate attention for the patient, catering to emergencies or urgent situations

• Maintains the provider-patient relationship through face-to-face interaction like a traditional office visit

• Allows the provider to quickly seek any additional information needed from the patient without delay

Asynchronous telehealth

Asynchronous, or store-and-forward, is another common delivery method for telehealth services. This interaction does not occur live and usually has a time delay in messages between the provider and the patient. It is ideal for evidence-based care, because it allows providers to share lab reports, medical images and data with other physicians or specialists. It is also ideal for patients who prioritize immediate access, ease and convenience over relationship building or in-depth conversations with their clinician.

A type of asynchronous care that is becoming increasingly popular is Remote Patient Monitoring (RPM), sometimes referred to as Remote Patient Management. This method of healthcare delivery uses information technology to gather patient data outside the standard healthcare setting and transmits it to the provider(s). It can be captured through everyday devices like an Apple Watch or Fitbit, or through implanted patient devices like pacemakers.

The technology that actually gathers the patient data is called a Remote Patient Monitoring Device. These devices can capture everything from blood pressure and heart rate, to blood oxygen levels and vital signs. By collecting this information 24/7 and analyzing it, we are seeing major advances in the ability to:

• Provide proactive care

• Increase quality of life

• Reduce hospitalizations

• Shorten hospital stays

Now that we have covered the technology that powers virtual patient visits, let’s cover the lingo frequently used during them.

Virtual etiquette

As you know, good bedside manner is one of the most important traits that physicians should have when interacting with patients. Body language, tone and actions all have a major impact on patient experience, comfort and understanding. On the telehealth side of patient care, the term ‘webside manner’ is often used to describe the proper etiquette for maintaining the same quality of care, relationship nurturing and trust virtually as physicians would in-person.

In general, webside manner is the way the healthcare provider interacts with the patient in a virtual setting. It is extremely important to build that same patient-physician connection through compassion and empathy virtually as you would in-person to combat any feelings of isolation or uncertainty the pandemic may have sparked. Here are some helpful tips for delivering top-notch care to patients remotely:

• Over communicate with your patient. When starting the telehealth visit, address the fact that this is going to feel different than sitting in an exam room and that’s okay. If you’re taking notes, let them know if you’re taking them in a notebook or on your computer so they are aware you may be looking down or typing. This reassures the patient that your sole focus is on them.

• Double-check your environment. Make sure you are in a private space, preferably in an office or in a room that is interruption-free. If possible, a room with solid, neutral colors. This will create a relaxing environment for your patient and avoid having a distracting background.

• Focus on the camera. Looking into your computer’s camera during your visit with the patient will give the feeling that you are making eye contact. This will take some practice and will feel unnatural for a while, but this will help achieve that connection with the patient and help them feel more comfortable.

• Watch your body language. Virtually, patients will be solely focused on you which means they will notice every little movement. It is important to make sure you are mindful of your hand motions when talking - too much hand motion can be distracting. Avoid clicking a pen, tapping your foot on the floor or drumming your fingers on the desk. Many microphones on computer’s can pick up even the slightest sound. Now, you should nod your head while the patient is speaking to acknowledge you are listening and understanding what they are saying. Remember, you are in the center of the screen, so be mindful of that while conducting a telehealth visit.

Practicing these tips and zoning in on what the patient is saying will ensure the patient feels heard, understood and in good hands at the end of the call.

Less common terms

Now that we have covered some of the more common terms in telehealth delivery, let's move on to a few others that may be less widely known but are equally as important.

• The ATA, otherwise known as the American Telemedicine Association, is one of the sole non-profit organizations focused on accelerating the growth of telehealth through adoption, education and policy.

• ePrescribing is the ability for physicians to fill medical prescriptions based on a remote visit. You may also hear this referred to as tele-pharmacy or ePharmacy.

• HIPAA, short for the Health Insurance Portability and Accountability Act, is a national standard designed to protect sensitive health information from being shared without the patient's consent.

• mHealth is a shortened version of the term Mobile Health, and it refers to the use of mobile devices (phones, tablets, etc.) to deliver medical care.

• Value-Based Care, also referred to as pay for performance, is a healthcare delivery model that pays providers based on patient outcomes and it is gaining serious traction.

• The CMS, which stands for Centers for Medicare and Medicaid Services, is the federal agency responsible for developing the Medicare and Medicaid reimbursement policies for telehealth and defining HIPAA standards.

• A compact state is a state that has joined the Interstate Medical Licensure Compact, formed by the Federation of State and Medical Boards (FSMB) in 2017. This collection of states have agreed to a streamlined process for providers to get licensed in more states, more efficiently. This is a good way for telehealth providers to secure multi-state medical licenses and provide care for patients in many states.

The technology behind it all

Let’s move onto some of the technologies that are powering telehealth behind the scenes.

• Interoperability refers to the ability of different devices or systems to exchange information easily. It is essential for healthcare companies to have this functionality built into any products they use, especially for ensuring a seamless user experience on the patient side regardless of the device.

• Bandwidth refers to the amount of data that can be transmitted from one network to another in a specific amount of time. Most often, it is the speed of your internet measured over seconds. Sufficient bandwidth is essential for a positive telehealth experience for all parties. That’s why there is such a large focus on solving low bandwidth challenges in many rural communities to continue bridging that care gap.

• Latency refers to the delay in transmission of picture or audio during a telehealth visit. It can create those awkward pauses or the feeling of talking over each other that can be avoided with high bandwidth.

• API, also known as Application Programming Interface, is a software middle man that allows two applications to communicate with each other. APIs are used in the telehealth industry to connect the technology to things like an online scheduling tool, remote patient monitoring, or ePrescribing. So, as you can imagine, they are very important!

• SaaS, or Software as a Service, is when an outside vendor allows an organization (in this case a telehealth company) to conduct part of their business. This puts the task of maintenance of the software on the vendor which reduces time and cost for the organization.

Speaking of SaaS, we need to spotlight how many companies offering telehealth services tap into providers, like OpenLoop, for staffing the clinicians that will support their patients virtually. How exactly does this work, you ask? Let’s explain through a few final terms to learn…

• Locum Tenens or Moonlighting describes the way many physicians, specialists and nurses pick up temporary medical shifts outside of their normal job. We’re seeing a rising trend in this area due to burnout, lifestyle changes and financial demands. Grabbing locum work is a great way for clinicians to set their own schedules, tap into competitive pay, achieve a better work-life balance and gain valuable exposure in their areas of expertise across a variety of patients and geographies.

• Credentialing is the process of obtaining, verifying, and assessing a clinician’s qualifications (e.g. licensure, education, experience and any red flags) in order for them to provide medical care to patients. From there, each clinician needs to be credentialed with an in-network insurance payer per state at about $24,000 a pop. In OpenLoop’s case, we have a 24x7 credentialing team dedicated to streamlining this process for our telehealth clients.

• Medical licensing is an occupational license that permits a clinician to practice medicine. Every clinician must possess a license per state they support patients in at about $1,000 each with 3-6 months dedicated to obtaining each one. If a telehealth company is supporting patients nationwide, that’s a lot of licenses their certified clinicians must hold. This is another area that OpenLoop assists with for rapid multi-state licensing that will scale with your demand.

Let us introduce OpenLoop

At OpenLoop, we like to think of ourselves as a telehealth company that empowers fellow telehealth companies. By servicing all 42,000 zip codes nationwide, we accelerate the delivery of patient care by connecting our trusted community of certified clinicians and insurance partners with telehealth companies across the US. We take the heavy lifting off your plate by ensuring smooth clinician matching aligned to your culture, rapid shift placement in your desired specialities and geographies and convenient, live support that scales with you.

Pretty cool, right? Check out our website and get in touch. We’d love to connect on the ways we could empower YOUR telehealth offerings too. And there you have it! Those are some of the most common words and phrases used in the telehealth industry today. With the rapidly changing world of healthcare delivery, it’s important to talk the talk and educate your patients and peers along the way. Hopefully this added some valuable tools to your belt.