Medicaid Handbook - Medical Assistance and Telehealth: An Evolving Partnership

June 2006  | American Telemedicine Association

Executive Summary
Telehealth/Telemedicine probably is not what you think it is. Forget Starship Voyager and its holographic physician and technology that suddenly push old-fashioned medicine into oblivion.

Proponents will tell you that telemedicine is not about technology at all. It is about using technology – anything from an ordinary telephone to an ingestible biosensor – to extend the reach of medical practitioners and to support new applications of standard medical procedures (“Reinventing Government”, Jan 12, 2001). The financial, performance, and management challenges facing Medicaid programs are greater than ever before. Incorporating telemedicine into state programs can provide an important step toward improving access, quality, and cost-effectiveness of Medicaid services. This report provides a  background on the current use of telehealth/telemedicine and its link to Medicaid.

Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status. Closely associated with telemedicine is the word telehealth, which is often used to encompass a broader definition of remote healthcare that does not always involve interactive clinical services, provided by physicians or clinical services at all. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth.

Telehealth/Telemedicine is not a separate medical specialty. Products and services related to telehealth/telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telehealth/telemedicine; often no separate coding is required for billing of remote services.

Telemedicine customarily uses two methods to transmit images, data and sound – either live, real-time transmission where the consulting professional participates in the examination of the patient while diagnostic information is collected and transmitted, or ‘store and forward’ transmission, where the consulting professional reviews data asynchronous with its collection. Many programs employ both transmission capabilities, to maximize efficient use of resources appropriate to the medical services being provided.

Full report is available here.