What is telehealth?

Telehealth, telemedicine and related terms generally refer to the exchange of medical information from one site to another through electronic communication. The Centers for Medicare and Medicaid Services (CMS) defines telehealth as a two-way, real-time interactive communication between a patient and a physician or practitioner at a distant site through telecommunications equipment that includes, at a minimum, audio and visual equipment. 

Telehealth is not interchangeable with the term “telemedicine.” According to the Health Resources Services Administration, telehealth refers to a broader scope of remote health care services than telemedicine. While telemedicine has historically referred to remote clinical services, telehealth can refer to broader services including synchronous and asynchronous communications.

The AMA STEPS Forward® toolkit “Telehealth Integration and Optimization” outlines various ways to improve patient care through virtual health care delivery, including:

• Reducing the burden of travel to access care
• Enhancing timely delivery of health care services
• Increasing compliance with treatment plans
• Improving communication with health care practitioners
• Lowering the cost of care

During the COVID-19 pandemic, telehealth facilitated safer access to care that is quick, efficient and, most of all, remote–for people all over the world. Although telehealth use has since declined, AMA research shows that 74% of physicians work in practices that offer telehealth and nearly 70% of physicians say they want to keep providing telehealth services. AMA Immediate Past President Jesse Ehrenfeld, MD, MPH, outlined why permanently expanding telehealth access will improve public health. Find out more about how the AMA supports telehealth.

In the Jan. 27, 2021, edition of the “AMA COVID-19 Update,” (now the AMA Update) Brian Garibaldi, MD, associate professor of medicine at Johns Hopkins University School of Medicine, talked about going beyond video and audio for telemedicine. 

“The other thing I would love to see is us taking advantage, not just in the video and the audio, but beginning to use other technologies that we're already using in the hospital, point-of-care devices that can tell you your pulse oximetry, that can tell you your heart rate ... maybe even digital stethoscopes that we can deploy in the home or even ultrasound machines that can guide the patients actually get additional information. I think there's a whole host of untapped resources that we can apply to telehealth.”

Telehealth in practice

In the March 18, 2021, edition of the “AMA COVID-19 Update,” physicians discussed “The Telehealth Initiative,” a collaboration between the AMA, The Physicians Foundation, and several state medical associations, which supports physician practices in adopting and adapting to telehealth.

“If you're not sure, or you need a quick jumpstart, use The Telehealth Implementation Playbook, that'll really help you get started,” said Corey Howard, MD, founder and director of Physicians Life Centers. “Understanding how to integrate it, how to select a vendor, how to code properly and give you the confidence to explore what telehealth can really do for your practice.”

Telehealth has evolved and grown over the past years, and it is crucial to stay on top of the latest telehealth trends such as data sharing, patient participation and remote diagnoses. The AMA STEPS Forward Innovation Academy's Future of Health webinar series offers physicians and health systems proven approaches on how to implement digital health solutions and reduce technology-associated administrative burdens. 

Challenges presented by telemedicine & ethical practice

Despite the benefits telehealth may bring, in its May 2014 issue the AMA Journal of Ethics says it is also important to anticipate and address four possible pitfalls:

1. Erosion of the patient-doctor relationship
2. Threats to patient privacy
3. Forcing one-size-fits-all implementations
4. Temptation to assume that new technology must be effective

To realize telehealth’s full potential, the AMA brief “Equity in Telehealth: Taking Key Steps Forward” (PDF) asks that those developing and implementing telehealth solutions prioritize partnerships with historically marginalized and minoritized populations to ensure that solutions are designed to be accessible and work well for all. The AMA also urges that health plans be required to cover telemedicine-provided services on the same basis as in-person services, and not limit coverage only to services provided by select corporate telemedicine providers.

What the Code says about physicians & telehealth

The AMA Code of Medical Ethics Opinion 1.2.12 states that physicians “must assure themselves that telemedicine services have appropriate protocols to prevent unauthorized access and to protect the security and integrity of patient information at the patient end of the electronic encounter, during transmission, and among all health care professionals and other personnel who participate in the telehealth/telemedicine service consistent with their individual roles.”

In addition, the Code says that physicians “who participate in telehealth/telemedicine have an ethical responsibility to uphold fundamental fiduciary obligations by disclosing any financial or other interests the physician has in the telehealth/telemedicine application or service.”

• Telehealth Implementation Playbook
• Advancing the Appropriate Use of Telehealth within Medical Specialties (PDF)
• Commercial Payer Coverage for Digital Medicine Codes
• Closing the Digital Health Disconnect: A Blueprint for Optimizing Digitally Enabled Care (PDF)
• Telehealth Quick Guide
• AMA policies on telehealth
• AMA Ed Hub™: Telemedicine: Providing Safe Remote Health Care
• AMA STEPS Forward®: Telehealth Integration and Optimization toolkit
• AMA Journal of Ethics: Telemedicine's Challenges for the Medical Profession

Reviewed by: Stacy Lloyd, director, digital health & operations, AMA

Reviewed and updated on: June 12, 2024