Overview of Medical Telecommunication
Health care in the United States has employed telecommunications since at least the Civil War, when casualty lists and supply orders were transmitted by telegraph. Medical telecommunications expanded with the invention of the telephone and radio, and have grown in new directions with today’s internet, mobile devices and virtual meetings that allow real-time discussions between health-care providers and their patients. Voice and video discussions also allow collaboration among clinicians.
The COVID-19 pandemic brought an unprecedented surge in medical telecommunication as an alternative to traditional face-to-face medical care. One study found that family use of virtual health care during the pandemic jumped dramatically to 79 percent of families surveyed, compared with 35 percent before the pandemic (Nemours Children’s Health & Amwell, 2021).
The American Academy of Pediatrics (AAP) promotes the use of medical telecommunication to provide health care to children and youth. The AAP’s 2021 policy statement, “Telehealth: Improving Access to and Quality of Pediatric Health Care” covers the advantages of medical telecommunications while also noting drawbacks, such as health-care disparities and barriers to accessing digital resources.
All children and adolescents deserve access to quality health care regardless of their race/ethnicity, health conditions, financial resources, or geographic location. Despite improvements over the past decades, severe disparities in the availability and access to high-quality health care for children and adolescents continue to exist throughout the United States. Economic and racial factors, geographic maldistribution of primary care pediatricians, and limited availability of pediatric medical subspecialists and pediatric surgical specialists all contribute to inequitable access to pediatric care.
Robust, comprehensive telehealth coverage is critical to improving pediatric access and quality of care and services, particularly for under-resourced populations.
(AAP, 2021)
The AAP supports medical telecommunication for preventive care, management of acute illness as well as chronic diseases and disabilities (Ibid.).
Prevalence and Disparities of Medical Telecommunication for Pediatric Care
About 12.6 million U.S. children and adolescents—17.5 percent of children ages birth through 17 years—used medical telecommunication from July 2019-December 2020, a period before and during the coronavirus pandemic (Centers for Disease Control and Prevention [CDC], 2022). More than 10 million of those youth used medical telecommunication in 2020 because of COVID-19.
During the pandemic, the CDC (Ibid.) found that:
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Medical telecommunication was highest for children and adolescents with family incomes at or above 400 percent of the federal poverty level.
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Youth who had a parent with more than a high school education were more likely to use medical telecommunication than youth whose parent had a high school education, GED or less education.
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8 percent of children and adolescents living in large metropolitan areas used medical telecommunication compared with only 6.9 percent of youth in nonmetropolitan areas.
The American Academy of Pediatrics (AAP) 2022 technical report “Telehealth: Opportunity to Improve Access, Quality, and Cost in Pediatric Care,” states:
More than 17 million children live more than a 1-hour drive from a regional children’s hospital, and the maldistribution of pediatric health care is a contributing factor in the differential health outcomes observed among populations living in rural and other underresourced communities, particularly for children and youth with special health care needs.
Implementation of technology allowing for virtual visits can improve some geographic disparities by expanding the reach of general and specialty care into communities that otherwise would not have access but requires adequate broadband connectivity and access to equipment.
Note on nomenclature
While telemedicine and telehealth are sometimes used interchangeably, this course uses the words as separate terms with unique definitions (abridged) from the Texas Medicaid Provider Procedures Manual (TMPPM) and Texas Occupations Code Section §111.001. Find a link to the Occupations Code in this course’s Appendix of Resources.
Telemedicine:
Health-care services delivered by a licensed Texas physician or health professional under the delegation and supervision of a licensed Texas health professional to a patient at a different physical location using telecommunications or information technology.
Telehealth:
Health-care services such as behavioral health or physical therapies delivered by a licensed, non-physician Texas health professional to a patient at a different physical location using telecommunications or information technology.
When discussing both types of remotely provided health care, this course uses the umbrella term “medical telecommunications.” Keep in mind that you may see other terms such as telepractice, teleintervention and tele-enabled visit in literature as technology and health care evolve.
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