_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
TeleHealthNews
Vol. 1 No. 1 August 5,1997
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Welcome to the first issue of TeleHealthNews, an Internet resource for health
professionals. Please feel free to pass this newsletter onto your
friends and colleagues. Subscribing/unsubscribing info is at the bottom.
If you would like more information than found here, check out our website
at: <http://cybertowers.com>
This issue is brought to you by Imagelink, a videoconferencing hardware
development company. For more information about how your organization can
benefit from videoconferencing tools, please contact Tom Fitsimmons at:
303-708-1280.
Table of Contents
1. Feature Article(s)
2. Politics and Policy
3. Terminology (Equipment and Jargon)
4. Active Telehealth Projects
5. Equipment and Internet Connection
6. Internet Resources
7. Telehealth Articles, Books, Journals, Reports
8. Conference and Education
9. Organizations & Companies
10. Internet Lists
11. Telemedicine Opportunities
12. Subscribing and Unsubscribing
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
FEATURE ARTICLE: Behavioral Telehealth
Editorial by David Nickelson, Psy.D., J.D.
(Adapted from a post to the Telehealth Discussion List)
One of the challenges facing the development and implementation of
telemedicine is the delineation of a consistent set of terms to define
the services being used. The following article by David Nickelson, Psy.D,
J.D. suggest that the adoption of the names telehealth and behavioral
telehealth are sufficient to describe the myriad of practices involved
under telemedicine, while providing a consistent language that will facilitate
comprehensive development of the field as a whole -Joseph M. Rudolph,
M.A.
~~
Telehealth and behavioral telehealth are the only new terms we need;
they define the medium in which the traditional profession, whatever it is,
is practiced. All other "tele-" terms work against acceptance of this new
method of practice, and do not accurately reflect that we are simply
practicing our named professions much as we always have, only with the
addition of technology that overcomes distance.
One of the more fundamental problems facing the development of
telehealth is defining just what telehealth is. Telehealth is the use of
telecommunications and information technology to provide access to health
assessment, diagnosis, intervention, consultation, supervision, education,
and information to under served populations, isolated practitioners, and
individuals separated by distance. Behavioral telehealth is simply the
application of telecommunications and information technology to provide the
behavioral health aspects of these services to the very same populations.
They are blanket terms that apply any technological effort to supply
information or care, from email and Internet searches at 2400 baud, to
real-time, full-color video and stereo audio teleconference hookups via
mobile satellite. Telehealth, and the definition provided, is both more
inclusive and more accurate than a number of the somewhat problematic
definitions recently proposed. The National Institute of Medicine (IOM)
has defined telemedicine as "the use of electronic information and
communication technologies to provide and support health care when distance
separates the participants." The federal Joint Working Group on
Telemedicine (JWGT), operating under the direction of the Office of Rural
Health Policy (ORHP), in the recent Department of Commerce report
"Telemedicine: Report to Congress," defined telemedicine as "the use of
electronic and information technologies to provide clinical care." That
same JWGT report defines telehealth as "a diverse group of health related
activities, such as professional education, community health education,
public health, and administration of health services."
These definitions pose a number of concerns. The IOM definition of
telemedicine is extremely broad, and a reasonable interpretation of the
functional scope of the definition seems to include any type of support or
provision of health care services, including non-medical services such as
behavioral assessment and intervention, or similar services delivered by
non-medically trained providers. Therefore, the broad term telehealth a
actually provides a better fit with the range of technology and applications
that the IOM definition encompasses.
The JWGT definitions are also non-inclusive. While the JWGT definition
of telehealth squares functionally with the IOM definition of telemedicine,
the JWGT definition of telemedicine is troubling. The JWGT defines
telemedicine as "providing clinical care." Functionally, the JWGT
therefore defines "clinical services" as "clinical medical services"
--inaccurate for two significant reasons. First, the broad range of
clinical services provided in the evolving health care system are not
solely focused on medically-based or disease -based theory, models, or
interventions. Second, the term as defined does a great disservice to the
bulk of the providers who currently supply most of the services on these
systems, particularly in rural areas -- advanced practice nurses, social
workers and other non-physician providers. Perhaps Senator Kent Conrad
(D-ND), the leading congressional supporter of the development of
telehealth networks, said it best in his introductory remarks to a special
telehealth edition of the North Dakota Law Review (Conrad, in press):
"I have become increasingly convinced that the term "telehealth" is
the more accurate description of this field than "telemedicine." Survey
after survey shows health care entities all over the country use a vast
array of telecommunications technology to supply a full range of health
services. In many rural communities these systems are operated by a wide
range of health care professionals, including nurses, psychologists, social
workers, and other non-physician providers. The term telehealth
encompasses this broad range of technology, services, and providers without
drawing artificial and potentially harmful distinctions that will only slow
the development of integrated, multi-use systems. It is in that spirit
that I have adopted and use the term telehealth."
Telehealth technology is just another tool to practice what we already
know how to do: undertake our professions within our scope of practice and
the dictates of our ethics. If in our judgment we are outside of those
boundaries when providing a telehealth service, then we have a professional
duty (not a "tele-duty") to decline to provide those services. In a
nutshell, telehealth is doing what we already know how to do (e.g.
psychological services, social work, psychiatric services, counseling,
etc.), but through a new means.
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
POLITICS & POLICY
Summary by David Nickelson, Psy.D., J.D.
As the application of telecommunication grows so do the legal, financial,
and political issues involved with managing such a field. This is
increasingly difficult when the application of such technology is being
used to provide something as important as health care. The growth of the
telecommunications industry and the growing use of telehealth applications
make it increasingly important to stay abreast of the changes in federal
funding for projects, changes in legal statues affecting such things as
interstate licensure, and who is working for and against these projects.
On May 7, 1997, the FCC ruled on the Universal Service recommendations of
the Advisory Committee on Telecommunications and Health Care regarding
rural health care providers. The FCC released a 900+ page order including
sections on distance learning and education. The FCC recently also put up
a "Health" section of its website, dedicated to telehealth
telecommunications. This is a great example of how interconnected health
and communications are going to become in the evolving health care
marketplace and the variety of organizations involved in the provision of
telehealth.
The FCC provided that all public and private not-for-profit health care
providers located in rural areas would be eligible to receive universal
service support, not to exceed a total cap on expenditures from the
Universal Services fund of $400 million. This bill will provide funds to
help rectify cost disparities in internet access between rural and urban
providers. For example, rural providers may be funded for
telecommunications capacity up to and including a T-1 line, at rates
comparable to those paid for similar services in a the nearest urban area,
(more than 50,000 residents). Other examples are the provision for
distance-based charges and toll-free connection to an Internet service
provider or reimbursement for providers that lack toll-free access to an
Internet service provider. The latter clause allows the lesser of $180 or
30 hours of Internet access at local calling rates per month.
Editors Note: As of June 27, Southwestern Bell and a small cellular
provider each filed requests for temporary restraining order on
implementation of the FCC Order, pending a review of filed claims for
preliminary injunctions on the Order, in separate federal circuit courts.
These restraining orders have likely been granted pending a meeting to
combine the requests into a single circuit court, which will then rule on
the merit of the preliminary injunction claims. It is not thought that
these claims will harm the substance of the Order, but will certainly slow
implementation.
For more information the complete FCC Order is available on-line at:
http://www.fcc.gov/ccb/universal_service/fcc97157/
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Terminology (Equipment and Jargon)
As the world of telecommunication technology develops so does the equipment
and the language. This section will be used to help health and mental
health care providers better understand the equipment and the terminology
surrounding this exciting field. If you have definitions or questions
about definitions please e-mail us at <[log in to unmask]>
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Active Telehealth Projects
This section will provide both a listing of active telehealth projects as
well as reviews of such projects. It is hoped this will facilitate the
collaboration of researchers and practitioners as the field develops. If
you have a project you would like included or reviewed in the next issue
please e-mail us as [log in to unmask]
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Equipment and Internet Connection
CyberTowers Professional Center, Telehealth Office
http://cybertowers.com/
Comparative Reviews: In depth comparisons of Hardware, Software and
Internet Tools http://cnet.com/Content/Reviews/Compare/
New Technology Registry for Mental Health - Free on
http://cybertowers.com/cgibin/prof.cgi
TopClass, free demo, adopted by the State University of New York Server
software for Web Based Training http://www.wbtsystems.com/
WebCT, University of British Columbia, Software to Develop Web Based
Training/Courses http://homebrew1.cs.ubc.ca/webct/
WINNOV Video and Audio Boards: http://www.winnov.com/
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Internet Resources
Ethics Survey for Online Psychotherapists
http://cybertowers.com/cgibin/health_survey.cgi
Psychotherapy Finances & Managed Care Strategies http://www.psyfin.com
US Federal Policy Issues http://www.policy.com
Psychological Tests: http://www.thesite.com/0697w1/life/life585_060597.html
More Psychological Tests: http://www.queendom.com
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
CONFERENCES & EDUCATION
Promoting Standards in Telehealth Conference
July 17, 1997, Washington, D.C. sponsored by Healthcare Open Systems and
Trials (HOST) & the Federal Communications Commission in collaboration with
Department of Health and Human Services Office of Women's Health, Food and
Drug Administration, Federal Interagency Joint Working Group on
Telemedicine. For more information Contact HOST @ 202-434-4771]
The Information Connection: Implementing Effective Technologies in
Healthcare, University of Vermont http://uvmce.uvm.edu:443/infoconn/info
con.htm
University of Vermont Continuing Education
http://uvmce.uvm.edu:443/profprog.htm
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
TELEHEALTH ARTICLES, BOOKS, JOURNAL, REPORTS
A Searchable index of nearly 3000 Telemedicine abstracts is available on :
http://tie.telemedicine.com
Forbes "I Got My Degree Through E-Mail."
http://www.forbes.com/forbes/97/0616/5912084a.htm
_Telemedicine: A Guide to Assessing Telemedicine in Healthcare_
National Academy Press 1-800-624-6242 or http://www.nap.edu
"Telephone Triage-Products, Services and Successful U.S. trends and
forecasts from 1996-2002", 1-800-927-8071 or http://www.feed-back.com.
"Telemedicine Report to Congress "by the JWGT
http://www.ntia.doc.gov/reports/telemed/cover.htm
Senate Bill. 385 "Comprehensive Telehealth Act of 1997," House Bill 966
"Increased Access Telehealth Act of 1997." The full text of the bill, and
Sen. Conrad's floor statement supporting it's introduction, can be found
on: http://www.arentfox.com/telemedicine.html
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
ORGANIZATION & COMPANIES
Arent Fox Telemedicine & Law home page at
http://www.arentfox.com/telemedicine.html
British Health Care Internet Association http://www.bhia.org
DoD-Weekly Telemed, grants, policy meetings, and new technology
http://www.matmo.org/news/newspage.html
FCC: http://www.fcc.gov/
Federal Interagency Council on Statistical Policy- Reports from 70 US
agencies: http://www.fedstats.gov
Federal Telemedicine Gateway: http://www.tmgateway.org/
Georgia's Rural Health Information Clearinghouse (RHIC)
http://gain.mercer.edu/www/rhic/rhic.html
John Mitchell & Associates http://www.jma.com.au
NIH: http://www.nih.gov
NIMH: http://www.nimh.nih.gov
Rural Utility Service Distance Learning Loan & Grant program, RFP
http://www.usda.gov/rus/dlt/dlml.htm
Telemedicine Information Exchange: http://tie.telemed.org
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
EMAIL DISCUSSION LISTS
One source of information are internet discussion lists. These lists
provide forums for discussion on a specific topic or interest area. All
list names are in quotations followed by the subscription address and
subscription commands for the body of the messages
"TELEHEALTH" Discussion List To subscribe send email:
TO: [log in to unmask]
BODY: SUBSCRIBE TELEHEALTH <YourName>
"NETPSY" Psychological Services on the net To subscribe send email:
TO: [log in to unmask]
BODY: SUBSCRIBE NETPSY <YourName>
"INTA" discussion list for the International Telehealth Nurses
Association, for Nurses and others interested in all aspects of
telemedicine.
To subscribe send email:
TO: [log in to unmask]
BODY: Subscribe itna <First Name> <Lastname>
"Mental-Health-Worker" Psych Techs with Bachelors and Below
To subscribe send email:
TO: [log in to unmask] with this in
BODY: SUBSCRIBE Mental-Health-worker <Your Full Name>
"Poli-Psy" Political Science of Psychology/Psychiatric To subscribe send:
TO: [log in to unmask]
BODY: SUBSCRIBE poli-psy <Your Full Name>
"Hospital-Downsize" closures and downsizing of psych facilities
To subscribe send email:
TO: [log in to unmask]
BODY: SUBSCRIBE hospital-downsize <Your Full Name>
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
TELEMEDICINE OPPORTUNITIES
Do you have a job opening? Do you need a job in telemedicine? Did you
hear about some Grant funding for telemedicine? This section is designed
for the various opportunities for individuals or organizations in the field
of Telehealth. Please send all information or requests or openings to us
at: [log in to unmask]
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
SPONSORSHIPS
TelehealthNews is proud to be sponsored by companies offering telehealth
communication tools. To learn more about how you can become a sponsor for
this newsletter, please write to Marlene Maheu at <[log in to unmask]>
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
SUBSCRIBING & UNSUBSCRIBING
You can be assured that our mailing list is not sold to any third party.
If you have received this via a friend or colleague and would like to
subscribe to the TeleHealthNews, send a message to
TO: [log in to unmask]
BODY: SUBSCRIBE TeleHealthNews <Your Full Name>
If you are wondering why you are receiving this e-mail, it is because you
subscribed to our mailing list. This mailing list is very low volume--only
one message every two months. We do not send out unsolicited junk e-mail
nor do we want to send you e-mail if you don't want to get it. To
unsubscribe, send a message:
TO: [log in to unmask]
BODY: SIGNOFF TELEHEALTHNEWS
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
Marlene M. Maheu, Ph.D. <[log in to unmask]> (PSY 11921)
TeleHealthNews Editor/Writer
CyberTowers, Professional Center <http://cybertowers.com/>
Joseph M. Rudolph, M.A. <[log in to unmask]> or
<[log in to unmask]>
TeleHealthNews Editorial Assistant
TeleHealthNews Review Board
B. Hudnall Stamm, Ph.D. <[log in to unmask]>
David Nickelson, Psy.D., J.D. <[log in to unmask]>
Deborah Burton, M.A. <[log in to unmask]>
_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@_@
|
