Virtual Care Terminology: Telemedicine, Telehealth, and Hybrid Care Defined

As healthcare consumers gravitate away from exclusively in-person care, providers need to keep up with the terminology their patients are using when seeking care.

Even veteran healthcare providers and hospital staff can get confused by the rapidly evolving collection of terms used to describe virtual and hybrid care. So, here's a short guide designed to refine your understanding of several terms associated with technology-enabled care delivery.

The 4 Most Common Terms

Telehealth is a broad, catch-all term, referring to electronic and telecommunications technologies used to provide remote care and services.

Telemedicine, at the intersection of healthcare and technology, is frequently used for primary and urgent care, monitoring and evaluating conditions, medication management, mental health services, and an expanding array of specialty care types. It is a subset of telehealth, referring to the specific delivery of care at a distance. Telemedicine is a handy tool for those with limited transportation or mobility challenges.

Virtual Care is a broad term, encompassing all the different ways healthcare providers remotely interact with their patients. Especially beneficial for underserved patients, it can refer to any high-quality, cost-effective clinical care delivered at a distance via live video, audio, and instant messaging. Virtual care solutions enable delivery of care when the clinician is not in the same physical location as the patient and are often end-to-end platforms that virtualize the many steps and activities of the in-clinic process.

Hybrid Care, is the strategic application of all available modalities of care delivery, including in-person care, to suit the patient's current needs. This often involves a digital front door that efficiently triages patients to the most appropriate care given both their preferences and the provider's capacity. 

Some Other Common Terms (A-Z)

Artificial intelligence (AI) in healthcare includes chatbots and virtual health assistants to facilitate digital interactions between a clinician and a patient. As virtual care becomes a more prominent choice, AI will be an important differentiator in clinical outcomes and continued efficiency.

Application Programming Interface (API) is software that sets the rules for two applications to send data between each other. It is like a messenger that takes your request of the software to a database and returns with a response back to you. In the medical field, an API can be used to connect virtual care technology to electronic health records (EHR) systems, reducing the need for duplicate data entry and leveraging the EHR data as the “single source of the truth.”

AR (Augmented Reality) is the use of displays, cameras, and sensors to overlay digital information onto the real world. Providers and clinicians interact with AR applications often to improve patient education and outcomes.

Asynchronous Virtual Care refers to telemedicine delivered at a different time from when the patient or healthcare provider requests it, and can take the form of text-based (SMS) interactions or a specialist reviewing labs or records at a different time from when the real-time visit took place. It uses store-and-forward technology and not real-time technology such as video.

Audio-Teleconferencing is a phone call between two or more parties. Visits using audio-teleconferencing without a video component are not usually covered by insurance.

Chatbots are conversational interfaces that simulate a dialogue with a user through messaging, website, mobile apps or over the phone. Varying in sophistication and either text-based or voice-based or a combination of both, a chatbot can be used to extract patient information using simple questions about name, symptoms, current doctor, and insurance details.

Digital Clinical Encounters involve the automation of all or a component of a clinical encounter. Examples include surveys, forms, chatbots, a virtual health assistant or clinical decision support.

Electronic Health Records (EHR) are a digital version of a patient’s paper-based chart, and these records can be shared across different healthcare settings. As they relate to virtual care delivery models, it's important to identify where in a clinical workflow the EHR will be engaged. For example, it will nearly always include clinical documentation and patient record storage, but should never be to engage directly with patients. Understanding this flow will inform where integration points lie, and where logistical bottlenecks may need to be addressed. Because EHRs aren't built for patient interactions, using them as a stop gap when no other option is available should be as short lived as possible.

HealthTech, or Health Technology, is the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of care.

mHealth, or Mobile Health, refers to healthcare apps and services delivered via smartphones, tablets, and other forms of mobile technology with the aim of achieving improved health goals. mHealth often doesn’t involve a clinician at all.

Native Virtual Care vendors provide solutions that have been developed to meet specific healthcare uses cases, such as tele-stroke, e-ICU, on-demand virtual visits and asynchronous ambulatory visits.

Picture-in-Picture is a telemedicine video feature where a smaller window appears showing a live image of a video caller within a larger image of the opposite video caller. This helps ensure telemedicine providers stay within the camera’s view and monitor what the patient is seeing during a visit.

Remote Care is when a physician delivers care from a different physical location from the patient. It provides for a strong line of communication between clinical care teams, including clinicians, caregivers, patients, and their families.

RPM (Remote Patient Monitoring) is a method of healthcare delivery that uses the latest advances in information technology to gather patient data outside of conventional healthcare settings. Health systems have rapidly adopted RPM technology because of the COVID-19 pandemic. RPM involves clinician-to-patient interaction.

Real-Time Communication involves the capture, processing, and presentation of data at the time the data is originated. A telephone call or live video conference involves real-time communication.

SaaS (Software as a Service), also referred to as cloud-based or internet-based software, is a method of delivering software in which the software resides on hardware controlled by the vendor. The customer accesses the software via a web browser or mobile application, and the onus is on the vendor, rather than the customer, to ensure it is working as intended.

Synchronous Telemedicine is virtual care delivered in real-time. Examples include video, phone, or live chat.

Telecare is a term for offering remote care for the elderly and people with disabilities. It delivers health services, while allowing patients to remain living in their own homes. Social and lifestyle monitoring are also included under telecare, and it encompasses a broader category than telemedicine.

Telemonitoring is defined as the use of information technology to monitor patients at a distance. In-the-home applications cover chronic illnesses such as cardiopulmonary disease, asthma, and heart failure.

Video Visits provide an alternative to the traditional in-person and in-clinic interaction between a clinician and a patient conducted using two-way video conferencing solutions. It's important to point out that while two-way video is rather common (especially in the wake of the pandemic), most applications lack the configurability and workflow integrations that make them viable long-term solutions. 

Virtual Health Assistants (VHA), like chatbots, can be used as a productive means of communication between remote patients, providers, and payers. They use advanced AI capabilities.

VPN (Virtual Private Network) is a secure and private way to connect to the internet over public wireless connections. VPNs are common among digital nomads and those accessing the internet in foreign countries where networks may be vulnerable to restrictions and interference.

VR (Virtual Reality) is computer-generated simulation in which a person can interact within an artificial three-dimensional environment using electronic devices, such as special goggles with a screen or gloves fitted with sensors. In healthcare it can allow the physicians to be transported inside the human body virtually stepping into a patient-specific reconstruction of its anatomy and pathology. Not only useful for physicians, VR also allows patients to be taken through their surgical plans. VR applications in healthcare are evolving at a strong rate.

Webside Manner is the virtual equivalent of a clinician’s bedside manner. Proper webside manner fundamentals include putting yourself in the center of the video frame, while speaking to a patient over a HIPAA-compliant video communications platform; ensuring you are HIPAA-compliant by confirming anyone else in the room is necessary for the visit and approved by the patient; and confirming the patient’s location. Good virtual etiquette has become increasingly critical as telehealth has become the norm.

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