Getting started with telehealth
Telehealth has become more common since the start of the COVID-19 public health emergency due to several policy changes that relaxed regulations and expanded reimbursement.
Types of telehealth
Telehealth allows you to provide health care for a patient when you are not in the same location. There are two main categories of telehealth:
Synchronous care is a live interaction between a provider and a patient. Visits may also include a caregiver, as appropriate. Examples include:
- Video calls between a patient and a health care provider
- Audio only calls when a video visit is not an option
- Secure text messaging to answer patient questions
Asynchronous telehealth, also called “store and forward”, is communication or information shared between providers, patients, and caregivers that occur at different points in time. Examples include:
- Messaging with follow-up instructions or confirmations
- Images sent for evaluation
- Lab results or vital statistics
There are other forms of asynchronous telehealth that patients and providers can use.
Mobile Health (mHealth). The use of a digital device such as a smartphone or something worn by the patient, commonly called a wearable, that is used to support patient health. Examples include:
- Fitness tracker
- Phone applications that record a patient’s exercise
- Automatic reminders such as when to take medicine
- Storing information or educational materials such as discharge instructions
Remote patient monitoring (RPM). The transmission of patient data and clinical information to the provider either through in-home devices or information entered and transmitted electronically by the patient.
Examples of remote patient monitoring devices include:
- Blood pressure monitors
- Glucose meters
- Wireless scales
- Heart rate monitors
Leveraging Remote Patient Monitoring in Your Practice (PDF) — from the Health Resources and Services Administration (HRSA)
Telehealth for Providers: What You Need to Know (PDF) — from the Centers for Medicare & Medicaid Services (CMS)
COVID-19 & Telehealth Implementation: Stories from the Field — from the Centers for Disease Control and Prevention (CDC)
Integrating telehealth practices
There are several guides to help you start providing telehealth services — or enhance your use of telehealth.
- Translating Research into Practice (PDF) — from the Health Resources and Services Administration (HRSA)
- Telehealth Partner Toolkit – from the Health Resources and Services Administration (HRSA)
- Telehealth Implementation Playbook — from the American Medical Association
- COVID-19 Telehealth Toolkit — from the National Consortium of Telehealth Resource Centers
- Telehealth Resources for COVID-19 Toolkit — from the Mid-Atlantic Telehealth Resource Center
- Revving Up Your Telemedicine Practice In The Time Of COVID (video) — from the Southwest Telehealth Resource Center
2022 National Telehealth Conference
Telehealth experts gathered for the National Telehealth Conference to discuss best practices and lessons learned during the COVID-19 pandemic.
Watch the session recordings and read the summary report (PDF).
Understanding telehealth technology options
Health care providers should always use private locations to deliver telehealth and implement reasonable Health Insurance Portability and Accountability Act (HIPAA) safeguards for protected health information (PHI), or known as identifiable personal health information.
The telehealth platform you use should meet HIPAA requirements.
- COVID-19 public health emergency exception: Until the public health emergency ends, health care providers may use any non-public facing application to communicate with patients without risking any federal penalties — even if the application isn’t in compliance with HIPAA. Read more about this in FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency.
After the public health emergency ends: Health care providers will be required to provide telehealth services through technology vendors that are HIPAA compliant and must enter into HIPAA business associate agreements. Read more about policy changes after the COVID-19 public health emergency.
The Department of Health and Human Services has produced additional resources on telehealth compliance with HIPAA.
The Health Resources and Services Administration (HRSA) funds telehealth centers of excellence which have cultivated resources to help providers in their journey from adoption to optimized use of telehealth. HRSA-funded regional telehealth resource centers offer providers and organizations individualized assistance, education, and information about telehealth.
Finding a telehealth vendor
Telemedicine & Telehealth Service Provider Directory — from the Arizona Telemedicine Program and Southwest Telehealth Resource Center, funded by HRSA. This directory lists companies providing telehealth for medical specialty services (such as radiology, rheumatology, neurology, psychiatry) and ancillary services (such as patient education and language interpretation).
You may already have access to some telehealth services, such as a patient portal with telehealth functionality built-in or you may already use a specific telehealth platform.
Once you’ve identified what technology you already have or are considering, here are some questions to assist in researching additional options:
- Is the product HIPAA compliant?
- Is a contract required?
- Does it integrate into my electronic health record?
- Will it be easy for my patients to use?
- Is there a waiting room feature?
- Can staff or patients schedule visits through the platform?
- Can patients provide consent to receive telehealth on the platform itself?
- Will my patients need to download an application to have a telehealth visit?
- Does it support on-demand visits?
- What are the costs, and are they per visit or a single charge?
- Is there a limit to the number of individuals who can use the technology?
- Does it allow more than two participants in a telehealth session (for example, if you would like to bring in a specialty consult)?
Resources for selecting a telehealth vendor:
- Digital Health Implementation Playbook Step 4: Evaluating the Vendor (PDF) — from the American Medical Association
- Selecting a Vendor Guide (PDF) — from the American Medical Association
- Vendor Intake Form (PDF) — from the American Medical Association
- Clinician’s Guide to Video Platforms — from the National Telehealth Technology Assessment Resource Center