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What is Telehealth?

The terms telehealth and telemedicine are often used interchangeably by the public, even though they describe distinct processes. In the most generic sense, telehealth and telemedicine involve conducting health care services remotely. The difference between the two terms arises when one examines the medical portion of telemedicine. The nuance isn’t just a lexicological typo, it ties a specific clinical component to the provided services. 

Telehealth, on the other hand, is more inclusive. Non-clinical activities related to education, staff training, healthcare administration, professional conferences, or patient-provider clinical services all fall under the telehealth label. Three of the main telehealth modalities are live patient-provider video sessions, the store-and-forward technique—which collects clinical data and sends it to a separate location for evaluation—and off-site patient monitoring that studies clinical data as it elapses in real-time.

History of Telehealth Services

The telehealth revolution found its footing in a 1925 science fiction premise, which questioned the possibility of remote-based medical procedures. Matt Novak of Smithsonian Magazine pointed to entrepreneur and author, Hugo Gernsback, who imagined a world where doctors could interact with patients using radio waves—an insight that has helped clinicians grow their virtual presence and deliver patient-centered care over the internet. 

Kane and Gillis (2018) found that 15.4% of physicians employed telehealth services as part of their healthcare delivery model in 2016, noting that larger practices—typically greater than 50 employees—substantially raised the buy-in for telemedicine. The American Academy of Family Physicians have said that telehealth services not only expand choice for patients, but they increase provider efficiency as well. The evolution of telehealth practice has many iterations ahead of it, but research suggests it already offers distinct advantages over brick-and-mortar services. 

Benefits of Telehealth and Telemedicine

 For patients who lack the means to reach medical facilities for treatment, telemedicine visits help them stay in touch with their medical team. Patient portals equip users with an on-the-go method for checking provider reports, lab results, or asking pertinent follow-up questions. Distance communication gives the gift of freedom, comforting patients who are undergoing stressful medical interventions. With telehealth platforms, providers customize their delivery system to meet patient and business-related parameters. 

Limitations of Telehealth Practice

The financial burden of acquiring, mastering, and implementing telehealth services can be great for individual practitioners. Economic uncertainty has been one of the biggest hesitations for clinicians interested in using a telehealth modality in their practice. Another economic concern is the lack of smart phone holders or internet connectivity in vulnerable communities across a provider's client load. With over 30% of rural residents in 2019 lacking access to a smartphone, emerging technology is not the only focal point for success.

State licensure requirements are another area of consideration for providers, as failure to obtain licensure—or in some cases, an out-of-state agreement—can upend a prospective telemedicine practice. Nine states currently offer special assistance for out-of-state telemedicine practice through their respective medical or osteopathic licensing boards. Twenty-four states, and the District of Columbia, follow the Federation of State Medical Board’s Medical Licensure Compact (IMLC) to expedite out-of-state license approvals. 

Tips for a Smooth Experience

If providers commit to a little legwork upfront, they can rest assured that their telehealth and telemedicine practices will be set up for success. There is no lifetime guarantee in the telecommunications field, but the American Academy of Allergy, Asthma, and Immunology have recommended prerequisites to take before connecting online. Reliable broadband internet, a video platform, reachable IT support contacts, and access to medical devices used in a patient’s care plan, are essential steps.  

Reimbursement policies are another grey area affecting the success of a telehealth or telemedicine practice. Avoiding common mistakes can save providers ethical, legal, or financial headaches in the long run. Participating in educational coursework, such as the THTC certificate program through the Telehealth Certification Institute, protects clinicians while they integrate best practices into their care plans.

 

Sources

American Academy of Allergy, Asthma, & Immunology. Technology requirements in telemedicine. (Discusses recommendations for using telehealth and telemedicine services).  https://www.aaaai.org/practice-resources/running-your-practice/practice-management-resources/Telemedicine/technology

Kane, K. C., & Gillis, K. (2018). The use of telemedicine by physicians: Still the exception rather than the rule. (Looks at the popularity, efficiency, and split of telemedicine services between medical professions). https://doi.org/10.1377/hlthaff.2018.05077.

Novak, M. (2012). Telemedicine predicted in 1925. Smithsonian Magazine. (An article that highlights an unlikely visionary in the telehealth movement). https://www.smithsonianmag.com/history/telemedicine-predicted-in-1925-124140942/

Rural Health Information Hub. (n.d.). Barriers to telehealth in rural areas. (Examines how rural and underserved populations face limitations when accessing telehealth services via computer or smart phone devices). https://www.ruralhealthinfo.org/toolkits/telehealth/1/barriers

The National Telehealth Policy Resource Center. (2018). State telehealth laws & reimbursement policies. (An overview of state telehealth guidelines with a focus on insurance reimbursements and licensure restrictions). https://www.telehealthpolicy.us/sites/default/files/2018-10/CCHP_50_State_Report_Fall_2018.pdf#page=10

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Course was very informative!
David Hopkins
MS, LPC / Thriveworks Woodstock
Informative and brief
Tracy Gilbert
Well designed. informative, comprehensive program broken down into manageable segments.
Dawn M. Miskus
Licensed Clinical Professional Counselor (LCPC) / Conscious Counseling & Coaching, Ltd.
This course offered a great overview of TeleMental Health and the important considerations that should be addressed when establishing an online practice.
Helen Geris
Registered Psychotherapist
Wonderful and approachable presenter, great information!
Sabrina Eads
I have completed the course requirements. Thank you a great program of videos and information.
Linda Lovisi-Dwyer
LCSW-R / Linda Lovisi-Dwyer, LCSW-R
Good introduction
Sylvia D. Jessup, MBA, MA
Owner / Sylvia Jessup Counseling Services PLLC
Very clear emergency planning laid out in this course, Helpful for many situation and settings.
Jane Schindler
The course was detailed.
Kelly Villarreal
MFT / Alan Behrman & Associates
EXCELLENT PRESENTATION
DAVID F. CIAMPI, Ph.D., LMHC.
Really chuck full of information and very helpful
Carolyn Spencer
social work
Great course!
Lashonda Jones
Ray's program is engaging and informative. I'm excited to extend my professional reach online.
Pamela Madsen
LAPC / Empower Counseling Center, LLC

Very informative session.

Valrey Richards-Lucas

Video was good, a little slow

Jessica Walraven

This is great material!

Erika T Johnson

Very Informative!!!!

DALAYNA MILLER

Really good training so far!

Erika T Johnson
LAC

Excellent information, extremely generous resources and so well paced. I am really grateful.

Carolyn Spencer
LCSW / Carolyn Spencer

Very thorough and informative

DALAYNA MILLER

This program is very informative and easy to use.

Gania Bruno Harrold
LCSW / IN THERAPY WE TRUST

Love the convenience and easy-to-understand information in this course.

Natalia Gourlay-Fernandez
LAMFT / Rock Springs Positive Coaching, Caring, and Counseling

Very informative. Help give an overview of tele therapy and starting an online practice.

Meg Maginn
L.C.S.W Private Practice / Eating Disorder Associates

The course was easy to follow and provided a lot of valuable insight into the benefits and limitations to teletherapy.

Katie-Ann Magnuson
Mental Heath Therapist / Kwenyan Professional Health Services

Wonderfully compact and rich in information, many areas i had not even considered!

VIRGINIA PROVENCHER
therapist / private practice
Very informative and guiding in educating all that you need to grasp to be properly compliant and aware.
Dena Damaskinos
A great overview for telehealth, including state to state
Susan Cortilet Jones
Integrative Lifeskills Coach

Great presentation!

Cristina Lazaro-Garcia
Mental Health Clinician, APC / CETPA, View Point Health
Oustanding presentation!!!
Michelle Collins

Helpful and inviting information to get started. Feel empowered to get this going and eager to start!

Dena Damaskinos

Well presented, easy to access and understand.

Sedonia Perrier
CEO / Steelhead LLC

This was very informative.

Wendy Pazdur
Substance Abuse Counselor / Transformation therapy
This course was full of detailed information, that I will utilize in my practice. I highly recommend this training to all interested in adding to their existing practice or transitioning to Telehealth Services.
Utopia Session
Class was informative.
Kimberly Horrell
This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

ZUNILDA CHAUDRY
Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara
LPC-S, LMFT

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist

Awesome

Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock
Therapist

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

TRUDY POST SPRUNK, LMFT-S LPC CPCS RPT-S CPT-S EMD
Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy