Page 12 - Part 1 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

The key term here is “electronic”. Ironically, this definition is

generally understood to exclude telephone conversations. The
reasons for this are historical rather than logical. Mirroring the

HIPAA Security Rule , many telemedicine regulations treat
4
3
telephonic communication as verbal, separately from other
electronic transmission media. Frankly, special treatment of

telephone calls makes less and less sense when the definition of
telephone is radically different from what it was in 1996; as

networked mobile devices serve multiple communications
functions (including voice) simultaneously, and distinctions

between real-time and stored data become fuzzy.

Regulatory Definitions

The practice of medicine in the U.S. is regulated by state and

federal laws administered by state medical boards and numerous

agencies. This potentially allows 50 different state standards, plus
definitions and standards from Federal agencies including AHRQ,

CDC, CMS, DEA, DOD, FDA, HRSA, IHS, NASA, NIST, OCR, VA, etc.
(as of 2014, there were at least seven different federal legal

definitions of telemedicine). Fortunately, vigorous efforts are

underway by governmental and quasi-governmental working
groups (such as the Federation of State Medical Boards) at several

levels—assisted by technology vendors and other experts—to
harmonize these.

At the federal level, probably the most widely accepted definition
comes from the Health Resources and Services Administration

(HRSA/DHHS). This agency uses the term “telehealth” and defines

3 Pub. L. No. 104-191, 110 Stat. 1936 (1996)
4 https://www.hhs.gov/hipaa/for-professionals/faq/2010/does-the-security-rule-apply-to-written-and-oral-
communications/index.html [7/16/18]

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