Telehealth and telemedicine are often used as synonyms. They both describe a slew of healthcare services that are delivered remotely. Websites, healthcare providers, and even some healthcare organizations use them interchangeably, without paying any mind to the subtle differences between the two terms.

What  Is the Difference Between Telehealth and Telemedicine?

From a patient’s perspective, it matters little how anyone chooses to refer to the remote medical care they receive. The only thing patients have to worry about is whether or not those services are covered by their insurance plans.

When it comes to healthcare providers, the story is a bit different. The main reason why medical professionals need to be able to make the distinction between telehealth and telemedicine are the different laws, rules, and regulations that apply to remote healthcare in their state. In some cases, all the laws and regulations apply to both terms, while in some states, specific limitations may apply to telemedicine and telehealth separately.

To help clear the confusion and provide you with a better understanding of the two terms, we have to closely examine various definitions of telemedicine and telehealth from several health organizations and state laws. 

How is Telemedicine Defined?

Telemedicine has a rich history, and the idea of “healing at a distance” dates back to the 19th century. Although the first use of the term “telemedicine” is difficult to pinpoint, an 1879 article in the Lancet discussed using the telephone to reduce unnecessary office visits. The article describes how a physician managed to determine if a baby had croup by listening to its cough through a telephone. 

Providing medical care to patients at a distance became a reality as technology advanced. Telemedicine took its modern form in the 1950s and 1960s when healthcare providers started utilizing the technology to transmit images, video, and medical data. 

As the practical uses of technology to transmit medical information and treat patients at a distance evolved, various healthcare professionals and organizations adopted different definitions of telemedicine.

What Do Over a Hundred Different Telemedicine Definitions Have in Common?

A 2007 study collected 104 different peer-reviewed definitions of telemedicine. The study reinforced the view that it’s difficult to provide a clear-cut definition of the term but simultaneously highlighted several aspects that the majority of the 104 views of telemedicine had in common.

The researchers found that these four areas were often referenced in nearly all 104 peer-reviewed definitions: 

1. Medical aspects—Unsurprisingly, all definitions included the providing of healthcare services
2. Technological aspects—To be considered telemedicine, the services have to be delivered through various telecommunication channels
3. Distance—Telemedicine implies a geographical separation between patients and healthcare providers
4. Benefits—A good number of definitions highlighted the fact that telemedicine includes providing medical care to patients who may otherwise have limited access to healthcare or experience difficulties receiving in-person medical care

The results of the 2007 study largely influenced the World Health Organization’s (WHO) definition of telemedicine, resulting in the WHO settling on a rather broad definition of the term. 

In their 2009 report—Telemedicine: Opportunities and Developments in Member States—the World Health Organization defines telemedicine as the delivery of healthcare services using telecommunication and information technology and highlights distance as the key factor. 

WHO states that the main purpose of telemedicine is the advancing of the health of individuals and their communities. According to WHO, telemedicine revolves around exchanging valid medical information through various communication channels, which enables: 

1. Diagnosis
2. Treatment and prevention of disease and injuries
3. Research and evaluation
4. Continuing education of healthcare professionals

One interesting thing to note is that the World Health Organization does acknowledge the presence of telehealth. The organization states that “some distinguish telehealth from telemedicine,” but still opts to use the two terms interchangeably. 

All in all, WHO’s definition of telemedicine doesn’t tell us much, if anything. Anyone encountering the term “telemedicine” for the first time would’ve guessed that it refers to healthcare services (medicine) that are provided remotely (tele). 

Same Term—Different Meanings

If we want to understand telemedicine and telehealth better, as well as uncover any differences between the two terms, who better to turn to than the American Telemedicine Association (ATA)?

Although ATA also uses the two terms to refer to any healthcare services delivered remotely, it does acknowledge that telehealth is a broader term that encompasses a range of non-clinical services. This gives us the first hint we need to solve this conundrum.

The Association also provides a formal definition of telemedicine, stating that the term involves exchanging medical information from one site to another, using electronic communications, for the purpose of improving a patient’s clinical health status. 

ATA also recognizes that the advancement of technology is largely impacting telemedicine and adds that telemedicine today includes a variety of applications and services, such as:

• Video conferencing
• Email
• Smartphones
• Wireless devices
• Various other forms of telecommunications technology

There are two things to pay attention to in the American Telemedicine Association’s definition of telemedicine. 

Firstly, it doesn’t explicitly state that the services need to be delivered to a patient. What this means is that ATA recognizes that, in order to provide treatment to patients, healthcare providers may need to rely on telecommunications technology to share information with other medical professionals or consult specialists.

Secondly, it states that the main goal of telemedicine is to improve the patient’s clinical status. This implies that telemedicine includes the examination, diagnosis, and treatment of the patient. 

Clinical vs. Non-clinical Activities

With ATA’s definition in mind, the main difference between telemedicine and telehealth would be the fact that telehealth encompasses a variety of other non-clinical activities, such as continuing medical education for providers. 

ATA also highlights the fact that telemedicine is not a separate medical specialty. Rather, telemedicine represents an effort by a healthcare organization to implement modern telecommunications and information technology to facilitate the clinical care of patients. 

Keep in mind that the Association uses telemedicine and telehealth interchangeably. In other words, both telemedicine and telehealth under ATA’s definition include not only video conferencing between a patient and a healthcare provider but also:

• Image transmission
• Remote Patient Monitoring (RPM)
• Educational eHealth portals
• Health-related applications
• Nursing call centers

Although the American Telemedicine Association does point us in the right direction when it comes to finding the differences between telemedicine and telehealth, we have to dig a bit deeper.

Clarification of the Two Terms

In 2014, the Department of Health and Human Services (HHS) provided clarification of the two terms and formally expressed the differences between telemedicine and telehealth. 

HHS defines telemedicine as the utilization of telecommunications technologies and electronic information to support:

1. Remote clinical care
2. Healthcare provider education
3. Patient health-related education
4. Public health
5. Health administration

This definition alone doesn’t tell us much regarding the differences between telemedicine and telehealth, but the Department did address the issue. In a post on HealthIT.gov, HHS explicitly stated that telehealth is different from telemedicine. 

Their view of the matter is such that telehealth encompasses a wider range of remote healthcare services than telemedicine. With that in mind, HHS emphasizes the fact that telemedicine pertains to remote clinical services. Telehealth is a more encompassing term and may refer to a variety of non-clinical remote services, like provider training and continuing medical education.

With this post, HHS revised its earlier definition of telemedicine and put the emphasis on distinguishing clinical and non-clinical services. 

That said, the situation still seems convoluted. We need to take a look at different state laws, regulations, and policies in order to understand the practical implications of the difference between the two terms. 

Legal Differences Between Telemedicine and Telehealth

The fact of the matter is that subtle differences in definitions of telemedicine and telehealth by various organizations don’t actually matter. What healthcare providers looking to embrace telemedicine need to pay attention to are the state laws and other applicable rules, regulations, and policies that apply to remote healthcare services in their state.

Lawmakers in different states have different takes on telemedicine and telehealth. While some states don’t recognize any differences between the two terms, others have separate policies for telemedicine and telehealth and even specify the type of equipment that can be used to deliver remote healthcare services. 

Let’s go over telemedicine and telehealth definitions in a few states quickly to show you exactly what you need to pay attention to if you’re planning on providing remote healthcare services to your patients. 

Telemedicine and Telehealth in Texas

In Texas state law, telemedicine and telehealth are two clearly separate terms. The statutory definition of telemedicine in the State of Texas states that physicians licensed to practice medicine in the state may provide healthcare services to patients at a distance by leveraging telecommunications or information technologies. 

What this means is that telemedicine in Texas only comes down to remote healthcare services provided by physicians or healthcare professionals under their delegations, where said services include clinical assessment, diagnosis, and treatment. 

Telehealth in Texas is defined as remote medical services other than telemedicine, delivered by a healthcare professional licensed in the state. This distinction has several practical implications, the most notable one being that only Texas-licensed physicians can issue online prescriptions to patients in the state. 

Read more about telemedicine in Texas. 

Telemedicine and Telehealth in Michigan

The State of Michigan not only fails to recognize the difference between the two terms, but it replaced telemedicine entirely with telehealth as a more comprehensive term. 

The initial definition of telemedicine highlighted the connection between a physician and a patient at different locations. Keeping pace with the technological advancements, Michigan’s lawmakers amended the definition to include patient and provider health education, public health, and health administration.

In Michigan, telemedicine is just one area of telehealth, which pertains to remote clinical care. Unlike Texas, Michigan allows various medical professionals apart from physicians to issue online prescriptions as a result of a telemedicine encounter:

1. Dentists
2. Doctors of osteopathic medicine and surgery
3. Podiatrists
4. Optometrists

Read more about telehealth and telemedicine in Michigan. 

Telemedicine and Telehealth in Georgia

Although Georgia state law views telemedicine and telehealth as similar terms, it does acknowledge the subtle differences between the two. The State of Georgia distinguishes the two terms by looking at the intent behind the remote healthcare services and the way in which they are delivered.

Telemedicine in Georgia refers to clinical services delivered through two-way audio and video communication. The important thing to note here is that Georgia state law excludes phone consultations and facsimile transmission from the definition of telemedicine. What this means is that delivering remote healthcare services to patients via phone isn’t billable. 

Several other states impose similar limitations to telemedicine. The reason for this is that telemedicine services need to be held to the same standard of care as medical services that are delivered in-person. To that end, Georgia and several other states require providers to establish a real-time, two-way connection with the patient in order to arrive at an accurate diagnosis.

Telehealth in Georgia refers to the use of electronic and telecommunication, including phone consultations and remote patient monitoring, to facilitate clinical healthcare, health consultations, health-related education, and health administration.

The key thing to note here is that telemedicine requires a live audio-video communication channel and implies diagnosis and treatment, while telehealth pertains to a variety of remote healthcare services that aid in-person medical care. 

Read more about telemedicine and telehealth in Georgia.

Telemedicine and Telehealth Laws by State 

If you want to start practicing telemedicine and telehealth, we strongly advise you to familiarize yourself with all applicable laws in your state. Here’s a table with quick links to our comprehensive articles that provide a detailed overview of telemedicine and telehealth laws by state:

If there isn’t a link for your state, please note that we will cover telemedicine and telehealth laws by state for all 50 states, so make sure to check out our blog regularly! You can also read our article on telemedicine reimbursement by state to see what types of remote healthcare services are eligible for reimbursement in your state. 

Telemedicine and Telehealth Modalities

To surmise, it’s difficult to draw the line between telemedicine and telehealth, as different organizations and states have varying outlooks on the two terms.  

In general, telemedicine is often limited to remote clinical services—examination, diagnosis, and treatment of patients at a distance, for a variety of medical conditions. Telehealth is often viewed as a broader term that includes a wide range of non-clinical services that promote health education of both providers and patients, facilitate health administration, and otherwise aid in-person medical care.

That said, the Center for Connected Health Policy (CCHP) points out that, in recent years, telehealth has been used more often, given the fact that the term takes into consideration new capabilities of providing remote healthcare, made possible by technological advancements. 

CCHP stresses the fact that telehealth has a broader scope and includes various other medical fields, aside from clinical care. This expands remote healthcare services to other areas, such as:

• Counseling 
• Physical and occupational therapy
• Home health 
• Dentistry 
• Chronic disease monitoring and management 
• Disaster management 
• Patient and provider education

The Center also defines the four telehealth modalities:

• Live video conferencing
• Store-and-forward technology
• Remote Patient Monitoring (RPM)
• Mobile health

Live Video Conferencing

CCHP defines live video conferencing as the use of audio-visual telecommunications technologies to connect a healthcare provider with a patient, caregiver, or another medical professional. The accent is on the real-time connection and the ability to provide the same level of services that the patient would receive in an in-person setting. 

Store-and-Forward Technology

Store-and-forward technology refers to the storage and transmission of medical information, such as lab results, digital images, videos, and other medical documents. The technology is primarily used to share information between two healthcare providers, or a healthcare provider and a medical facility, to aid in patient treatment—whether said treatment is provided remotely or in-person. 

Remote Patient Monitoring

Remote patient monitoring (RPM) refers to leveraging digital technologies and wireless devices to collect and transmit medical data from the patient’s location to the provider’s office or a medical facility. This gives healthcare providers valuable insights into their patients’ conditions, allowing them to adjust treatment when necessary. 

Mobile Health

Mobile health refers to the provisioning of healthcare services and the monitoring of personal health data through a variety of health applications on mobile devices.

Have a Successful Telemedicine Start with Curogram

Regardless of how different organizations define them or what subtle differences there may be in your state’s telemedicine and telehealth laws—Curogram has you covered on all fronts! 

Our robust telemedicine and telehealth platform allows you to set up your virtual clinic in less than 48 hours, start seeing patients online, share protected health information (PHI) in a secure environment, and more! 

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