Page 13 - Telemedicine - Essentials of Virtual Care Delivery Part One

SVMIC Telemedicine: Essentials of Virtual Care Delivery

Technological Definitions

From a technological and functional standpoint, the American
Telemedicine Association (ATA) defines Telemedicine as, “[T]he

use of medical information exchanged from one site to another
via electronic communications to improve patients’ health status”.
4

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
6
5
telephonic communication as verbal, separately from other
electronic transmission media. However, during the coronavirus
pandemic, audio-only communications were widely adopted as

electronic communications by payors.

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.

4 https://www.americantelemed.org/resources/telehealth-nursing-foundations-for-
governance-2019/ [7/16/18]
5 Pub. L. No. 104-191, 110 Stat. 1936 (1996)
6 https://www.hhs.gov/hipaa/for-professionals/faq/2010/does-the-security-rule-apply-to-
written-and-oral-communications/index.html [7/16/18]

Page 13