Friday, December 18, 2015

The Art of Terminology - Telemedicine or Telehealth?

Image courtesy of Chicago Tribune.

With the relentless pursuit of efficiency in the delivery of healthcare, combined with advances in technology and policy, two terms that are increasingly being used in the USA are telemedicine and telehealth.  Are they meaningfully distinct terms?  Do we need both?

It Depends On Who You Ask

In many cases, these terms are defined locally.  In the same vein as "analytics" and "cloud", it's important to verify everyone is operating under the same assumptions.  When you engage in a conversation on these topics, it is wise to explicitly state what you mean with your use of the term early on in the conversation.

Position 1 - Telemedicine is a Subset of Telehealth

Much like the use of "medicine" versus "healthcare", one term is naturally broader.  Healthcare can include not just the medical practice of a physician, but patient education, population health engagement, and a host of other services aimed at prevention and treatment.

In a similar vein, telemedicine has historically been used specifically to refer to the practice of medicine and clinical services remotely.  For the most part the things one would commonly associate with a physician, e.g., surgery by telepresence (aka "robotic surgery").  Telehealth, on the other hand, has been used more broadly, not only to refer to telemedicine, but also any remote services related to healthcare.

Position 2 - They Are Interchangeable

This is the position of the American Telemedicine Association.  Given that their name has "telemedicine" in it and "telehealth" is the more encompassing term, one can understand why they would like to see them used interchangeably.  I mean, heck, it's on all of their business cards.

Best Practices

"Best" can be a matter of opinion.  This is what I do.
  1. If in doubt, use "telehealth"
  2. If you are trying to distinguish clinical services from the rest of healthcare services, use "telemedicine"
  3. In writing or conversation, state clearly what you mean as soon as you use either term
As with any vague term, the key is agreeing with your audience on what it means.  Communicating clearly, after all, is the goal; not winning a semantic victory.

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