Telehealth is the use of medical information shared through two-way audio and video and other forms of telecommunication technology, including mobile communication devices and remote monitoring devices, with the goal of improving a patient’s health status . The definition of telehealth is more expansive than that of telemedicine. Telehealth refers to the broader scope of health care services and includes non-clinical services, such as provider training, case management support, administrative meetings and continuing medical education. The term telehealth is used to synchronize the wide range of definitions that exist to describe this form of care delivery and encompasses telemedicine. Widespread adoption of telehealth can increase access to health care, reduce health disparities, and create efficiencies in health care delivery. However, before its full potential can be realized, a number of technology and policy challenges need to be resolved.
For more information, please visit the American Telemedicine Association: About Telemedicine? page.
Telehealth Implementation: Challenges and Considerations
There are several challenges impacting telehealth initiatives in the State. Challenges include ensuring physician licensing for practitioners providing services over state lines, credentialing for telehealth services, and adequate liability and malpractice coverage when providing telehealth services. In addition, limited information on return on investment for providing telehealth services make the financial decision to provide telehealth services difficult. Limited broadband access, and lack of defined standards for maintaining health care data confidentiality and integrity when providing telehealth services poses technology challenges for organizations. Current organizational processes are set up to support face-to-face encounters, and implementation of telehealth services would require organizations to shift how they operate and deliver care. For more information, visit the Challenges and Considerations page.
Telemedicine Task Force Overview
In 2010, the Maryland Health Quality and Cost Council (Council) created the Telemedicine Task Force (Task Force) to develop a plan for a comprehensive statewide telemedicine system of care. The Task Force submitted a report to the Council in September 2010. A Leadership Committee was subsequently established in 2010 and was tasked with developing recommendations to advance telemedicine in Maryland. The Leadership Committee established three advisory groups: Clinical; Finance and Business Model; and Technology Solutions and Standards. In December 2011, the Leadership Committee submitted a report to the Council with recommendations for the implementation of telemedicine in Maryland.
In 2013, the General Assembly enacted legislation requiring the Maryland Health Care Commission (MHCC), in conjunction with the Council, to reconvene the Task Force, including the three advisory groups. The Task Force used the term telehealth instead of telemedicine to encompass the non-clinical practices such as public health, education, and care coordination. The Task Force was required to identify opportunities for using telehealth to improve health status and care delivery in the State, assess factors related to telehealth, and identify strategies for telehealth deployment in rural areas. The Task Force developed recommendations for expanding telehealth adoption in the State and submitted an interim report in December 2013, and a final report in December 2014 to the Governor, the Senate Finance Committee, and the House Health and Government Operations Committee. For more information visit the Telemedicine Task Force page.
MHCC Telehealth Grants
The MHCC has awarded five rounds of telehealth grants to qualified organizations to implement innovative projects in the State that assess the effectiveness of telehealth in various care settings. Collectively, a total of $375,042 in grants has been awarded to ten organizations. Highlights from the grants are included below:
Round 1 - Three grants awarded in October for a 12-month period demonstrated the impact of telehealth in improving transitions of care between hospitals and long-term care (LTC) facilities. The Brief and Final Reports published in April of 2016 provide a summary of the findings from the telehealth projects.
Round 2 – Three grants were awarded in June 2015 for an 18-month period to demonstrate the impact of telehealth using remote patient monitoring devices to support chronic care management of high risk children, adults, and elderly patients. The Brief and Final Reports published in March of 2017 provide a summary of the findings from the projects.
Round 3 – Three grants were awarded in June 2016 for an 18-month period to demonstrate the impact of telehealth to improve the patient experience and overall health of patients with chronic conditions living in underserved rural and minority communities. These grants will test the effectiveness of telehealth with various technology, patients, providers and clinical protocols in a variety of settings.
Round 4 – Two grants were awarded in June 2016 for an 18-month period to demonstrate the impact of telehealth in supporting value-based care delivery in primary care settings through expanding access to health services and addressing the needs of different patient populations.
Round 5 - One grant was awarded in January 2017 for an 18-month period to demonstrate the impact of using telehealth to increase access to health care and improve population health in rural communities of the eastern shore (Caroline, Cecil, Dorchester, Kent, Queen Anne's, Somerset, Talbot, Wicomico, and Worcester). The grant will provide enhanced palliative care services through telelhealth,.
For more information on MHCC telehealth grants, visit the Telehealth Grants page.
The Telehealth Symposium: Remote Monitoring and Chronic Care Management of High Risk Patients was held on February 22, 2016 at Anne Arundel Medical Center. The Symposium showcased the work of the Round 2 grantees that include: Crisfield Clinic, LLC; Lorien Health Systems; and Union Hospital of Cecil County. The Symposium also featured guest speakers with expertise in telehealth for remote patient monitoring, including Lois Freeman, Doctor of Nursing Practice of the Veterans Affairs Maryland Health Care System and Gary Capistrant, Chief Policy Officer of the American Telehealth Association.
For presentation materials from the Symposium as well as more information on previous Symposiums, visit the Telehealth Symposium page.
Organizations and Initiatives
Arcticles and Publications
- U.S News & World Report, How Telemedicine is Changing Health Care, October 2014
- Association for Community Affiliated Plans, Safety Net Health Plans Deliver Better Care and Increase Access via Telemedicine, November 2014
- Ober/Kaler, A Guide for Telemedicine Service Vendor Contracting: Applying Traditional Contracting Considerations in a New Arena, October 15, 2015
- Ultra Risk Advisors, Top 5 Questions Teleradiology and Telemedicine Companies Should Ask About Their Professional Liability Insurance, August 2015
- RCM&D, Compliance in Telemedicine: Know Before You Video, November 2015
For more information, contact Angela Evatt by phone 410-764-3574 or email at firstname.lastname@example.org.
1. Maryland Telemedicine Task Force Final Report, October 2014
2. American Telemedicine Association. About Telemedicine? 2012.
3. HealthIT.gov. What is telehealth? How is telehealth different from telemedicine?
4. Maryland Telemedicine Task Force Final Report, October 2014
5. Information Technology and Innovation Foundation, Unlocking the Potential of Physician-to-Patient Telehealth Services, May 2014
6. Telemedicine Recommendations, December 2011
7. Maryland Telemedicine Task Force Final Report, October 2014
8. 2013 Md Laws, Chap. 319