In this post we’ll cover some of the telemedicine
terminology which might be new to the reader, and provide resources for
learning more about the telemedicine terminology.
I know I said I’d include technology in this post, but I’ve
decided to save the technology portion until next week. There’s a lot to cover and I try to keep my
posts short so it’s a quick read.
The terms I’m listing here are ones which I think might not
be so obvious to a physician or practice manager. For a more comprehensive terminology listing,
particularly very technical terminology, two excellent sources are CMS LINK and
the American Telehealth Association LINK.
I’m attempting to list terms in a relational order, keeping
related terms near each other, for example synchronous is followed by asynchronous.
Telemedicine and
telehealth
Telemedicine is the provision of medicine service by a
provider in one location to a patient in a distant location, and their
communication is via some electronic means.
Telehealth is generally considered the same as telemedicine, though
sometimes it is thought of in a broader context. For example, telemedicine might mean a direct
patient/doctor interaction, whereas telehealth might refer to a patient
interacting with a pharmacy tech regarding a prescription, or with a dietitian
on a meal plan.
Originating/Spoke
site
The originating or “spoke” site is the location of the
patient at the time of service.
Distant/Hub site
The distant or “hub” site is the location of the provider at
the time of service.
Presenter/Patient
presenter
The presenter or “patient” presenter is a person, typically
with a clinical background, who is with the patient and assists in the
encounter. They assist the patient with
the communication aspects of the encounter, and may collect and transmit
diagnostic data to the provider.
Synchronous
communication
This means there is real time, two-way interactive
communication between the provider and the patient, or the spoke and the hub. We typically think of this as audio/video
communications.
Asynchronous
communication
This mean communications are one directional, as contrasted
with synchronous communication. For
example, a provider may electronically receive an MRI, then later send back an
opinion. See Store and Forward below for
more information.
Store and Forward (S&F)
A store and forward
(S&) encounter refers to an encounter where a provider electronically receives
some diagnostic information (patient picture, MRI, ECG, blood glucose level) then provides an opinion or diagnosis. It utilizes asynchronous communications.
Bandwidth
In simple terms, bandwidth is a measure of the information
carrying capacity of your communications channel (Internet connection, office
network). Video and large pictures
(think radiology) take more bandwidth.
Simple voice communication takes less.
Picture bandwidth as a highway. The more
data trucks that travel it, the more lanes you’ll need to keep traffic moving
freely.
CODEC
Short for coder-decoder, this is simply the
videoconferencing device which converts audio/video at both ends of your
connection (both spoke and hub sites). Device
manufacture names you may be familiar with include Polycom and Cisco
Telepresence. More on this in the
technology section.
The reason we use a CODEC is that audio/video information
must be compressed in order to more quickly and orderly transmit it over the
internet or phone line. Also, the
audio/video information must be converted from analog to digital, and digital to
analog.
Encryption
Encryption is process of scrambling a digital stream of
data, then unscrambling it when it reaches its intended user. The way this works is the source (sending)
computing device scrambles the data. The
receiving computing device has a special “key” which can put the pieces back
together again. Without the key, the
data is a useless string of zeros and ones.
This explanation is greatly simplified, but you get the idea. While not a new word for most of us, I include
it because we’ll revisit this in the technology section.
In the next post, we’ll look at telemedicine
technology. I’m a techno geek, so I’m
really excited about this next post.
Sources:
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