Telemedicine and Telehealth

What are telemedicine and telehealth?

Telemedicine is the use of technology that lets a patient have medical appointments (or visits) with their doctor or another member of their health care team. It can be used when the patient and their doctor are not in the same location.

Telemedicine uses technology to help the doctor “see” you when you have a medical problem that needs to be managed. For example, telemedicine might be used if you have diabetes or high blood pressure, or if you’re getting a medicine or treatment that could cause side effects. Telemedicine can be helpful because you might not need to leave your home to be checked or might not have to travel if you’re far from a doctor. Your doctor might refer to telemedicine as having a virtual visit with you.

Telemedicine is just one part of telehealth services. Although telemedicine is focused on medical care (often provided by a doctor or nurse practitioner), telehealth uses the same technology to provide a wider range of health services from a wider range of providers. Telehealth may include other health services such as:

• Teaching sessions for patients and caregivers about a new diagnosis or new medicine
• Nutrition counseling for eating or weight problems
• Mental health counseling for anxiety, depression, or other problems
• Offering help and tips for staying healthy and well

In the past, telehealth and telemedicine were mostly used for patients who lived in rural areas, didn’t have easy access to doctors, and would otherwise have to travel a long distance for a medical appointment. More recently, they are being used for patients who live anywhere.

Types of technologies used in telehealth and telemedicine

Different technologies can be used depending on what’s being done or what problems you might have, such as if you’re due for a check-up or if your doctor needs certain kinds of information to help manage your care from a distance. Keep in mind that some doctors' offices or health care facilities may not have any technology available, but those that do might use things like:

• Video chat or video calls using computers or smart phones to let you and your doctor or nurse see and talk to each other in real time.
• Devices that can connect over the internet to monitor blood levels or blood pressure. These are also called remote patient monitoring (RPM).
• Web-based patient portals that let you and your health care provider send messages back and forth. You might also be able to see test results, current prescriptions, upcoming appointments, and educational information shared by your health care team.

How does telehealth and telemedicine work?

If technology is available, it can be used to do a virtual visit when you’re at home. Or, it can be used when you’re in a doctor’s office or health care facility and you need to meet with a doctor, specialist, or other health care professional who is in another location. For example, if you’re at a rural health clinic; a skilled nursing facility or nursing home; a mental health center; or another hospital, doctor’s office, or health center.

Here are some examples of how you might be able to use telemedicine or telehealth, if it’s available to you:

• Your doctor can evaluate your medical problems o give you a diagnosis or decide if you need to have tests done.
• You can have a referral appointment or consultation with a specialist.
• You can learn and talk about treatment options.
• You can ask for a new prescription or have current prescriptions refilled.
• You and your family or caregiver can have a teaching session about a health problem, diagnosis, or medicine.
• You can have certain problems monitored without having to go in for a face-to-face visit.

It’s important to know that a face-to-face visit may still be required even though you are using telemedicine or telehealth for certain things.

How are telemedicine and telehealth used in cancer care?

For cancer patients and survivors, here are some examples of how telemedicine and telehealth technologies can be used. Technology might be available and helpful if you need:

• Help managing your medicines
• Hints to help with nutrition
• A teaching session about a new medicine or treatment
• A consult with a palliative care specialist or other professional who can help manage symptoms and side effects (for example, nausea and vomiting or pain)
• A check-up between treatments or after treatment ends
• Help making lifestyle changes like diet and exercise, or help quitting smoking
• A referral with a genetic counselor

Talk to your cancer care team to find out if any technologies are available to help with these or other concerns you, your family, or caregiver might have.

Will telemedicine and telehealth be covered by my insurance?

If telehealth services are available to you, check with your health care team to find out which types of technologies they have and if there is a cost for you. If there are costs for certain types of telehealth services, it may be covered by your insurance. In the US, this depends on which state you are in.

Each state has the choice to decide whether or not telehealth is covered, what types of telehealth are covered, which types of care or services to cover, and where in the state telehealth can be made available.

Each state also has its own way of describing the technologies used in telehealth. Some might call all of these technologies telehealth or telemedicine and some might have very specific names for each type of technology. It is important to learn and be familiar with the rules in your own state.

Check with your insurance company to see if and what telehealth services are covered, and what your out-of-pocket costs might be. For patients who have Medicare, a list of services covered for telehealth can be found at https://www.medicare.gov/coverage/telehealth.