Page 12 - Delaware Medical Journal - July 2017
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Delaware’s Journey in Adopting Telehealth
Carolyn Morris, MHSA, CTPM; Ingrid Pretzer-Aboff, PhD, RN; Gerard Gallucci, MD, MHS
Introduction is generally credited to the
use of closed-circuit television in a Nebraska psychiatric hospital in 1959 for training medical students who observed patients at
a distance.1 sent 24 miles via telephone lines between two points in eastern Pennsylvania.2 And telehealth was envisioned much earlier.
The invention of the radio had led to a world of ideas for its use, including uses for health care. For instance, in 1925, German scientist Hugo Gernsback designed a theoretical device for telemedicine that would use radio waves to allow doctors to see their patients through a view screen and examine them from miles away using his radio-controlled “teledactyl;” he anticipated it would be in use by 1975. (See Figure 1).3
Due to geographic constraints in remote areas, like Antarctica and Alaska, and the need to bridge those distances to deliver health care, telehealth has been in use for more than 50 years. In the
early 1960s, space exploration made the transmission of health information of astronauts from space to physicians on earth a necessity.2 other corrections situations to reduce costs and improve safety
for staff as well as the public, with programs operational in the
US since the 1990s.2 performed at the South Pole4 with assistance from orthopedic surgeons at Massachusetts General Hospital in Boston. Today, telehealth has become an essential tool for providing health care
to individuals of all ages, especially in rural areas and areas of professional shortage. But with the silver tsunami upon us, there is a need to improve access to health care in all geographic locations.
5 According to the Health Resources and Services Administration and telecommunication technologies to support and promote long- distance clinical health care, patient and professional health-related education, public health, and health administration.”6 The many
of telehealth at federal and state levels. However, there are four general ways telehealth is used:
• Live, real time video conferencing (synchronous) between a person and a health care professional which may involve direct
evaluation and treatment or consultation between professionals;
• Store-and-forward (asynchronous) transmission of recorded health information, such as x-rays or other images, for evaluation and/or treatment that will take place sometime afterward;
• Remote patient monitoring (RPM) to collect and transmit data (telemetry) from a person at one location to a health professional at another location via electronic communication technologies;
• Mobile health (mHealth) using devices such as cell phones and tablets to provide health care, public health services, or education.
The distinction between telehealth and telemedicine is that, while telemedicine is usually thought of as the use of live, interactive videoconferencing between health professional and patient, telehealth includes all four of the above listed categories of applications, including telemedicine.5
BACKGROUND
Telehealth was not much more than a blip on Delaware’s radar screen until late 2010. A couple of little-known uses of technology to provide care were already in operation locally but, for the most part, few physicians or consumers were paying attention to the health care in the state. Two key events helped catalyze telehealth in the state:
•
•
A group of Delaware residents with Parkinson’s disease (PD)
and their caregivers who were struggling to keep up with the
trek to see specialists in urban locations, such as Baltimore7 and Philadelphia,8 learned about a specialist — known as a Movement Disorder Specialist (MDS) — who offered these specialty services via telemedicine;9
The United States Department of Justice (DOJ) legal proceedings against the State of Delaware10
in caring for individuals with serious and persistent mental
health issues prompted exploration into ways to reduce institutionalization while meeting the mental health care needs of these individuals in the community.
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