This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. This information is not intended as legal or consulting advice. Please utilize resources provided within this article for more information.
Telehealth refers to a collection of methods to enhance health care delivery and education — it’s not a specific service.
Synchronous telehealth is a virtual interaction between a patient and a provider that takes place in real time, like a video call, audio call, or secure text messaging. It usually results in a provider giving a patient a diagnosis, treatment plan, or prescription, according to Health & Human Services. Synchronous telehealth has been shown to reduce the number of no-show patients, shorten the wait time for patients to see their provider, and increase efficiency in a physician’s practice. Asynchronous telehealth, on the other hand, is a virtual interaction between a patient and a provider that doesn’t take place in real time.
Telehealth spans four distinct applications:
- Live Video;
- Store-and-Forward;
- Mobile Health (mHealth); and
- Remote Patient Monitoring (RPM).
Store-and-Forward
Asynchronous telehealth is generally used for patient intake purposes or follow-up care. Store-and-Forward is considered “asynchronous telehealth, a communication between parties that is not live.” It is a service rendered outside of a real-time or live interaction with a patient.
Within asynchronous telehealth is also called “Store-and-Forward”. There are two subcategories:
- Mobile health (also called mHealth); and
- Remote patient monitoring, or RPM.
Mobile health involves using a device such as a smartphone or a wearable device (like an Apple Watch) to support a patient’s health and transmit health data between a patient and their provider.
Remote patient monitoring involves transferring patient data from a medical device, like a blood pressure monitor or a pacemaker, to a provider.
According to https://telehealth.hhs.gov asynchronous direct-to-patient telehealth can streamline patient workflows by standardizing patient data for later use, flexibility because no scheduling is involved and efficiency through automated patient intake. Examples include:
- Messaging or texting between patient and provider with follow-up instructions or confirmations;
- Patient report sharing;
- Symptom survey questionnaires;
- Wound imaging;
- Images sent for evaluation, X-ray or MRI sharing;
- Lab results or vital statistics;
Store-and-forward technologies are most commonly used in radiology, pathology, dermatology, ophthalmology and for electronic consultations (eConsults). eConsult is a web-based system that allows a primary care physician (PCP) and a specialist to securely share health information and discuss patient care.
Although store-and-forward services can increase efficiency, these services are not always reimbursable by private insurers. Medicaid policies on this issue vary from state to state.
Address HIPAA and Privacy Concerns
Technology considerations
The telehealth platform you use should meet HIPAA requirements. All telehealth services provided by covered health care providers and health plans must comply with the HIPAA Rules. This means only using technology vendors that comply with the HIPAA Rules and will enter into HIPAA business associate agreements in connection with the provision of their video communication products or other remote communication technologies for telehealth.
HIPAA Telehealth Compliance Resources
- Guidance on HIPAA and Audio-Only Telehealth (OCR)
- HIPAA and Telehealth – Privacy & Security (OCR)
- Telehealth Privacy Tips for Providers (HRSA)
- HIPAA Privacy & Security Online Course (AIHC)
- HIPAA Privacy Officer Training Online (AIHC)
Other Telehealth Resources
American Telemedicine Association
Artificial Intelligence -Article posted in the National Library of Medicine
Center for Connected Health Policy (CCHP) and the National Consortium of Telehealth Resource Centers has finalized a Telehealth Definition Framework to help clarify how to accurately use “telehealth” and its key components.
- Download the 1-Page “A Framework for Defining Telehealth” Fact Sheet.
Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF:
- “Telehealth for Providers: What You Need to Know”. It covers billing, Federal Medicare policies and State Medicaid policies.
Center for Connected Health Policy (CCHP) - Medicare and each Medicaid program are different in how they approach and reimburse telehealth delivered services.
- CCPH provides a Telehealth policy finder which includes all telehealth policies and FQHC policies.
E-consults - Telehealth for Emergency Departments -E-consults are communications between providers only. Providers can interact with each other by using phone, video, or a HIPAA-compliant platform that allows two-way communication and can securely share patient records.
E-Consults and Their Outcomes: a Systematic Review
This article is written by members of the AIHC Volunteer Education Committee. AIHC is a non-profit organization. We value our members, credentialed professionals and greatly appreciate the talents offered by our member volunteers!
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