Week 11: Remote Delivery of Healthcare Services, Telehealth, and Telepharmacy Flashcards
(24 cards)
What is telehealth?
broad term encompassing use of electronic information to support long-distance clinical healthcare
What is telemedicine?
specific to use of medical information being transmitted between two sites electronically
What is telepharmacy?
specific to appropriate dispensing of medications when a pharmacist is in a different site
What is mobile health (mHealth)?
healthcare delivered via mobile device such as phones, tablets, watches
- included in remote healthcare delivery
What are 4 examples of how telehealth can be utilized in almost all areas of care delivery?
- direct patient care (ie. virtual visits)
- product dispensing
- communication among team and patient (ie. emails, chats)
- link to mobile apps, resources, patient portals
What are some reasons that are driving the growth of telehealth? (7)
telehealth benefits all of the following (except cost savings is still unclear/mixed evidence):
- (pandemics)
- rising costs to provide healthcare services
- shortage of clinicians
- stresses on current system
- patient expectations for technology-enabled services
- improve access in remote areas
- business model (?)
What are the 3 modes of healthcare data transmission?
- store-and-forward
- real-time
- remote monitoring
What is store-and-forward healthcare data transmission?
images/videos are saved and sent to be viewed when time permits
- asynchronous
- ie. commonly used in dermatology/radiology, patient sends updated pictures of wound to nurse
What is real-time healthcare data transmission?
images/videos captured and sent in real-time as they are viewed by remote clinician
- two-way communication allows for more sophisticated assessments
- ie. electronic stethoscopes or otoscopes
What is remote monitoring healthcare data transmission?
monitoring patient status for disease management
- estimated only 1% of Canadians using this
What are the 4 categories of remote patient monitoring?
- enabling information – providing patient disease-specific information and care plans
- self-monitoring systems – patient’s report data, triggering pre-programmed interventions (ie. take additional dose of drug)
- assisted monitoring – regular check-ins with clinician
- environmental monitoring – sophisticated devices that capture patient status and reports it
What are the 3 different communication modes?
- patient-portal secure messaging – ie. Medinet Mail
- telephone
- audio-video – ie. Telus, WELL Health, Teladoc
What are the pros of patient-portal secure messaging? (3)
- asynchronous
- can attach documents/photos
- creates paper trail
What are the cons of patient-portal secure messaging? (2)
- no personal interaction
- requires internet access
What are the pros of telephone communication? (3)
- widely available
- cheap
- real-time
What are the cons of telephone communication? (3)
- unstructured
- no paper trail
- only real-time
What are the pros of audio-video communication? (3)
- most robust data available to clinician
- ‘best of both worlds’
- real-time
What are the cons of audio-video communication? (2)
- expensive hardware/software that is secure
- requires relatively fast network
What are the 4 primary provincial telehealth networks?
- enterprise network gateway (eNG)
- physician’s private network (PPN)
- UBC private network through UBC MedIT
- First Nations Health Authority
What does the enterprise network gateway (eNG) do?
connects health authorities together
What does the physician’s private network (PPN) do?
connects physician offices to eNG and allows remote access of EMRs
What may be required to connect sites from different provincial telehealth networks?
‘bridges’ may be required to connect sites from networks together via authorization from IT support
Describe point-to-point and multi-point telehealth calls for both direct and bridged connections.
audio-video communication calls can be:
- point to point (direct):
- point to point (bridged):
- multi-point (direct):
- multi-point (bridged):
What are 6 possible barriers to the use of telehealth?
- lack of reimbursement models
- high cost of implementing hardware
- limited availability of capable networks and bandwidth
- lack of standards – ie. patient devices used to access telehealth
- potential for increased cost in consumer-driven system
- patient attitudes and preferences
