Date Posted: Thursday, July 25, 2024

 

This article provides a basic overview of Artificial Intelligence (AI), telehealth, asynchronous services, and HIPAA privacy concerns. This information is not intended as legal or consulting advice. Please utilize the resources provided within this article for more information.

 

Telehealth refers to a collection of methods to enhance healthcare delivery and education—it's not a specific service. 

 

Synchronous telehealth is a virtual interaction between a patient and a provider that takes place in real time, like a video call, audio call, or secure text messaging. According to the U.S. Department of Health and Human Services (HHS), synchronous telehealth usually results in a provider giving a patient a diagnosis, treatment plan, or prescription. Synchronous telehealth has been shown to reduce the number of no-show patients, shorten the wait time for patients to see their provider, and increase efficiency in a physician's practice. Asynchronous telehealth, on the other hand, is a virtual interaction between a patient and a provider that does not take place in real time.

 

Telehealth spans four distinct applications:

 

• Live Video
• Store-and-Forward
• Mobile Health (mHealth)
• Remote Patient Monitoring (RPM)

 

Store-and-Forward

 

Store-and-Forward is considered “asynchronous telehealth, a communication between parties that is not live.”  Asynchronous telehealth is generally used for patient intake purposes or follow-up care. It is a service rendered outside of real-time or live interaction with a patient.

 

Within asynchronous telehealth, also known as store-and-forward, there are two subcategories:

 

• Mobile health  involves using a device such as a smartphone or a wearable device (like an Apple Watch) to support a patient's health and transmit health data between a patient and their provider.
• Remote patient monitoring  involves transferring patient data from a medical device, like a blood pressure monitor or a pacemaker, to a provider.

 

According to telehealth.hhs.gov, asynchronous direct-to-patient telehealth can streamline patient workflows by standardizing patient data for later use, offer flexibility since no scheduling is involved, and improve efficiency through automated patient intake.

Asynchronous telehealth examples include:

 

• Messaging or texting between patient and provider with follow-up instructions or confirmations
• Patient report sharing
• Symptom survey questionnaires
• Wound imaging
• Images sent for evaluation, X-ray, or MRI sharing
• Lab results or vital statistics

 

Store-and-forward technologies are most commonly used in radiology, pathology, dermatology, and ophthalmology, and for electronic consultations (eConsults). An eConsult is a web-based system that allows a primary care physician (PCP) and a specialist to securely share health information and discuss patient care.

 

Although store-and-forward services can increase efficiency, these services are not always reimbursable by private insurers. Medicaid policies on this issue vary from state to state.

 

HIPAA and Privacy Concerns

 

The telehealth platform you use should meet HIPAA requirements. In “HIPAA Rules for Telehealth Technology,” HHS states that “All telehealth services provided by covered healthcare providers and health plans must comply with the HIPAA Rules. Covered healthcare providers and health plans must use technology vendors that comply with the HIPAA Rules and will enter into HIPAA business associate agreements in connection with the provision of their video communication products or other remote communication technologies for telehealth” (2023).

 

Recommendation

 

Read additional free articles on asynchronous telehealth and patient privacy  posted to the American Institute of Healthcare Compliance Blog.

 

AIHC Volunteer Education Committee. AIHC is a non-profit organization. We value our members, credentialed professionals, and greatly appreciate the talents offered by our member volunteers!

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HIPAA Telehealth Compliance Resources:

•  Guidance on HIPAA and Audio-Only Telehealth (OCR)

•  HIPAA and Telehealth – Privacy & Security (OCR)

•  Telehealth Privacy Tips for Providers (HRSA)

•  HIPAA Privacy & Security Online Course (AIHC)

•  HIPAA Privacy Officer Training Online (AIHC)

 

Other Telehealth Resources:

 

•  American Telemedicine Association

Artificial Intelligence (AI) Principles

•  Artificial Intelligence - Article posted in the National Library of Medicine

Addressing the Challenges of AI-Based Telemedicine: Best Practices and Lessons Learned

•  Center for Connected Health Policy (CCHP) and the National Consortium of Telehealth Resource Centers  has finalized a Telehealth Definition Framework to help clarify how to accurately use “telehealth” and its key components. 

Download the 1-page fact sheet: A Framework for Defining Telehealth

•  Centers for Medicare & Medicaid Services (CMS)  offers a 17-page PDF that covers billing, Federal Medicare policies, and State Medicaid policies: Telehealth for Providers: What You Need to Know

•  Center for Connected Health Policy (CCHP)
Medicare and each Medicaid program are different in how they approach and reimburse telehealth delivered services. CCPH provides details on telehealth policies and FQHC policies: Telehealth Policy Finder  

•  E-Consults - Telehealth for Emergency Departments
E-consults are communications between providers only. Providers can interact with each other by using phone, video, or a HIPAA-compliant platform that allows two-way communication and can securely share patient records.

TeleHealth.gov offers advice on how to get your ED started

•  E-Consults and Their Outcomes: A Systematic Review

Article posted in the National Library of Medicine