A New Era of Healthcare: Telehealth vs. Telemedicine Explained

Chatting with your doctor and easily refilling prescriptions with just a few taps on your smartphone is becoming the new healthcare norm. Telehealth and telemedicine are on everyone's radar. But defining the difference between the two may make you scratch your head. Telehealth isn't just about doctor-patient chats; it's a wide-reaching platform encompassing many services from medical consultations to mental health counseling sessions. Telemedicine, on the other hand, zooms in on the nitty-gritty of medical care — think diagnoses, treatments, and prescriptions — all delivered remotely. With the line between face-to-face and virtual care becoming increasingly blurry, grasping the nuances of telehealth and telemedicine may be key to ensuring patients receive the best care possible.

What is telehealth?

Telehealth is a broad term that encompasses using digital technologies to deliver healthcare services remotely (telemedicine is one of its subsets). It goes beyond traditional face-to-face appointments, allowing patients to access care virtually, anytime and anywhere. However, most of the time, a steady internet connection is required.

Services offered under telehealth

Under the umbrella of telehealth, patients have access to virtual consultations with doctors, specialists, and mental health professionals. They can receive medical advice and educational content, discuss symptoms, and even get prescriptions without ever stepping foot in a clinic and waiting for hours in urgent care. Additionally, telehealth extends to remote monitoring of patients with chronic conditions that allow for continuous care and timely interventions.

Telehealth is rooted in the innovative use of technology. Video conferencing platforms, secure messaging apps, and mobile health applications make communication between patients and healthcare providers possible. These platforms often integrate with electronic health records (EHRs), so that providers have access to medical histories and information during virtual consultations.

Benefits of telehealth

Telehealth doesn’t just make healthcare more convenient for patients, but such far-reaching accessibility is particularly beneficial for individuals in remote or underserved areas, so they can consult with providers they might not be able to visit in person. Telehealth also promotes early intervention and preventive care that may lead to improved health outcomes. For healthcare providers, telehealth offers greater flexibility in scheduling, increased efficiency, and the ability to reach a broader patient population.

One of the challenges telehealth addresses is healthcare accessibility. Patients who face barriers such as mobility issues, transportation limitations, or living in rural areas can connect with healthcare professionals. Telehealth may also help mitigate the burden on hospitals and clinics, reducing overcrowding and improving resource allocation. Plus, during public health crises like the COVID-19 pandemic, telehealth emerged as a useful tool for delivering care while minimizing the risk of virus transmission.

What is telemedicine?

While often used interchangeably, telemedicine is a subset of telehealth that focuses on providing clinical services remotely via a chat, voice, or video call. These services include regular check-ups for ongoing or recurring health conditions, making it convenient for patients to manage their health without frequent in-person visits.

For those seeking treatment for infections such as cold or flu, telemedicine provides a safe and efficient alternative to traditional clinics. Additionally, telemedicine is well-suited for addressing symptoms such as coughs, allergies, back pain, sprains, or strains, allowing patients to receive prompt care from the comfort of their home.

Mental health care services are also an option including therapy, medication management, and counseling. Moreover, telemedicine facilitates consultations with specialists, providing access to expert opinions and advice regardless of location.

Technologies powering telemedicine

Since telemedicine is part of telehealth, there is a parallel to what fuels these services from online patient portals and smartphone applications to a variety of wearable devices that make remote patient motoring possible.

Whether it’s smartwatches, blood pressure cuffs, or continuous glucose monitors, data from these devices provides a wealth of information to the healthcare provider about the patient and their health status. These technologies work in harmony to create a comprehensive and efficient remote healthcare experience that may lead to more efficient care and improved patient outcomes.

Benefits of telemedicine

Telemedicine benefits not only the patients and providers but also the healthcare economy at large. According to research conducted in Canada, after the initial COVID-19 pandemic surge, it was estimated that if the use of telemedicine continued to increase, it had the potential to reduce unnecessary emergency care visits and missed appointments, resulting in CAD 147 million saved annually in direct healthcare costs.

Additionally, it’s been shown to contribute to improving health outcomes and patient satisfaction. Patients who have regular access to telemedicine services are more likely to adhere to their treatment plans and follow-up appointments. This continuity of care leads to better management of chronic conditions, early detection of health issues, and timely interventions.

Technological and regulatory challenges

As technology and telemedicine continue to evolve, so are the challenges both patients, providers, and health systems face. The efficacy of telemedicine depends greatly on reliable internet and adequate equipment, which can be a barrier for some, particularly in rural or underserved regions. Moreover, there may be a disparity in digital proficiency, with certain demographics struggling to utilize telemedicine platforms and software.

Another issue is the security of patient data in a virtual setting. There’s constant transfer and retention of sensitive and personal medical data that requires strong cybersecurity protocols. Healthcare providers must comply with strict regulations to protect patient confidentiality and ensure data integrity. Addressing these concerns requires ongoing investment in secure telemedicine platforms, staff training, and adherence to privacy laws.

Telemedicine is also becoming increasingly regulated to ensure safety and privacy while providing efficient care. Providers offering telemedicine services may need to navigate varying state regulations, which can be cumbersome and time-consuming. Reimbursement policies also vary, with some insurance providers and healthcare systems still adjusting to the reimbursement models for telemedicine consultations. Cross-border practice raises additional challenges, as telemedicine allows for consultations across different countries, requiring clear guidelines and agreements between regions.

Comparing telehealth and telemedicine

Both telehealth and telemedicine focus on remote healthcare delivery. However, each has its distinct roles and functionalities that may help distinguish between the two services.

Major differences

Telehealth is the wider term that goes beyond clinical care. It includes services such as remote monitoring of vital signs, patient education, administrative meetings, and even virtual training for healthcare professionals.

Telemedicine, on the other hand, focuses on remote clinical services, such as consultations, diagnoses, treatments, and monitoring. It revolves around direct patient care, facilitating interactions between healthcare professionals and patients for medical purposes.

Overlapping areas

There is a wide overlap between both. They work synergistically to provide comprehensive remote healthcare solutions. Both rely on digital technologies to deliver care remotely, leveraging platforms such as video conferencing, secure messaging, and mobile health applications. Both modalities aim to improve access to care, patient satisfaction, and convenience and optimize healthcare delivery. Additionally, they both play a role in promoting preventive care, early intervention, and chronic disease management.

Technological innovations driving change

A New England Journal of Medicine commentary on what to expect in this decade noted that traditional healthcare will be undergoing a continued transformation powered by innovations in digital health. Artificial intelligence, machine learning, generative AI, and various diagnostic and health monitoring technologies will create a new paradigm in telehealth and telemedicine.

Authors of that NEJM commentary noted that as consumerism continues to grow, people will become more knowledgeable and active in their care. “The health industry will need to become more person-centered, personalized, and more transparent.”

Advanced AI technologies are becoming virtual assistants and chatbots to help improve patient care by providing advice on treatments, diagnoses, and medications. They answer patient queries, provide necessary information for informed decision-making, and interface with EHR systems for appointment scheduling. They also remind patients to take medications or exercise, effectively promoting patient compliance. For patients living alone or in remote areas, these virtual assistants can even provide companionship, enhancing their mental health.

The use of wearable technologies provides an opportunity for not only health monitoring but also for tailored health management, paving the way from a reactive to a proactive healthcare system.

Legal and regulatory considerations

Making healthcare more accessible, convenient, and patient-centric requires many laws and regulations to ensure patient safety. Regulatory frameworks set the standards for practice, establish criteria for licensing and certification, and provide guidance on ethical and legal issues. However, the regulatory landscape in telehealth is complex and can vary from one state or country to another.

Even within the U.S., while federal laws often set basic standards, state laws can impose additional requirements. Hence, providers must be licensed in the state where the patient resides. For instance, there may be differences in how the provider can prescribe medication via a tele-visit in any given state.

As such, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 added a new provision to better regulate controlled substance prescription via the internet, so that the “provider must perform at least one in-person medical evaluation of the patient.” However, to limit the potential for viral transmission, the COVID-19 pandemic pushed for more flexibility and accessibility. Hence, temporary regulations currently allow for providers to prescribe controlled substances as long as the visit is conducted via a real-time video call. This will remain in effect till the end of 2024.

Providers must also comply with the regulations of the institutions they are affiliated with concerning credentialing procedures for telehealth practitioners, or particular standards for protecting patient privacy and security.

Privacy and ethics

In the U.S., the Health Insurance Portability and Accountability Act (HIPAA) sets the standard for protecting sensitive patient data. Telehealth providers must ensure that they comply with HIPAA regulations, which may involve using encrypted communication, deidentified patient information and data storage systems, implementing strong password policies, and regularly updating software and operating systems to mitigate security risks.

Telehealth practitioners are also bound by the same ethical principles that govern traditional healthcare practice. These include respecting the patient's right to make informed decisions about their care, the duty to do good and act in the best interest of the patient, non-maleficence or to the duty to do no harm and the obligation to treat all patients fairly and equitably.

While these principles are universally applicable, they can manifest in unique ways in the context of telehealth. For instance, ensuring patient autonomy in telehealth may involve obtaining informed consent not just for the treatment plan, but also for the use of telehealth technologies. Similarly, justice in telehealth may involve addressing disparities in access to technology or internet connectivity.

Telehealth and telemedicine during the pandemic

As COVID-19 spread resulting in lockdowns and social-distancing measures, conventional healthcare systems were under great pressure. This led to an urgent need for alternative ways to care delivery. Patients and providers turned to digital platforms for a wide range of healthcare needs, from routine check-ups to managing chronic conditions and seeking urgent care.

With the option of telehealth and telemedicine, access and adoption saw a rapid increase during the pandemic. According to a national study that included 36 million adults with private insurance claims, telemedicine encounters increased 766% in the first three months of the pandemic. According to another analysis published in Connect Health, “data from the Centers for Medicare and Medicaid Services reported an increase in weekly telehealth visits from 13,000 pre-COVID to 1.7 million visits in the week of April 2020. Compared with data from 2019, telehealth visits in October 2020 increased by more than 3000%.”

And, according to a McKinsey report, telehealth use in 2021 “increased 38X from the pre-COVID-19 baseline.”

What did we learn?

It was a learning experience for both patients and providers. One key lesson was the importance of infrastructure readiness and scalability. Healthcare organizations that had invested in robust telehealth platforms and digital capabilities were better equipped to handle the surge in virtual visits.

In Q2 of 2022, global telehealth investments reached a record $5 billion, a 169% increase from the same time two years prior.

Several big companies set foot in telehealth to expand their services and take advantage of the growing demand. Walmart acquired virtual primary care provider MeMD which connects patients with licensed medical providers, psychiatrists and therapists. Amazon launched its national rollout of a virtual care marketplace. And, Accolade bought PlushCare for $450 million and that will give Accolade users access to virtual primary care and mental health consultations.

Emergency response protocols and telehealth guidelines were also rapidly developed or revised to facilitate the safe and effective use of telemedicine during the pandemic. Governments and regulatory bodies enacted temporary policy changes to expand telehealth coverage and reimbursements, allowing more patients to access virtual care without barriers.

The U.S. Department of Health and Human Services took administrative steps to expedite the adoption and awareness of telehealth. Some of these telehealth flexibilities have been made permanent while others are temporary until December 31, 2024.

Future trends and predictions

The current healthcare system is highly reactive and focuses on treatment as opposed to prevention, and many patients develop serious chronic health conditions before anyone notices or tries to intervene.

According to a forecast mentioned in the NEJM, “emerging systems must be designed around robust and accessible primary and community care, where multidisciplinary teams coordinate all health-related issues.”

Authors of the commentary say the focus needs to shift from transactional care to value-based care, where providers are incentivized based on the quality of care and patient outcome over the number of patients treated.

As telehealth and telemedicine continue to become an integral part of our daily lives, wide adoption of wearable technology, AI and advanced diagnostic, and health monitoring tools will become critical to reaching a more preventive and proactive approach to healthcare.