telehealth telehealth telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. it allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. when rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult. telehealth telehealth versus telemedicine telehealth is sometimes discussed interchangeably with telemedicine, the latter being more common than the former. the health resources and services administration distinguishes telehealth from telemedicine in its scope, defining telemedicine only as describing remote clinical services, such as diagnosis and monitoring, while telehealth includes preventative, promotive, and curative care delivery. this includes the above-mentioned non-clinical applications, like administration and provider education. the united states department of health and human services states that the term telehealth includes "non-clinical services, such as provider training, administrative meetings, and continuing medical education", and that the term telemedicine means "remote clinical services". the world health organization uses telemedicine to describe all aspects of health care including preventive care. the american telemedicine association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments. ehealth is another related term, used particularly in the u.k. and europe, as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology. methods and modalities telehealth requires good internet access by participants, usually in the form of a strong, reliable broadband connection, and broadband mobile communication technology of at least the fourth generation (4g) or long-term evolution (lte) standard to overcome issues with video stability and bandwidth restrictions. as broadband infrastructure has improved, telehealth usage has become more widely feasible. healthcare providers often begin telehealth with a needs assessment which assesses hardships which can be improved by telehealth such as travel time, costs or time off work. collaborators, such as technology companies can ease the transition. delivery can come within four distinct domains: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. store and forward store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. it does not require the presence of both parties at the same time. dermatology (cf: teledermatology), radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. a properly structured medical record preferably in electronic form should be a component of this transfer. the 'store-and-forward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination. remote monitoring a blood pressure monitor remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. this method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. these services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective. examples include home-based nocturnal dialysis and improved joint management. real-time interactive electronic consultations are possible through interactive telemedicine services which provide real-time interactions between patient and provider. videoconferencing has been used in a wide range of clinical disciplines and settings for various purposes including management, diagnosis, counseling and monitoring of patients. videotelephony videotelephony comprises the technologies for the reception and transmission of audio-video signals by users at different locations, for communication between people in real-time. at the dawn of the technology, videotelephony also included image phones which would exchange still images between units every few seconds over conventional pots-type telephone lines, essentially the same as slow scan tv systems. currently, videotelephony is particularly useful to the deaf and speech-impaired who can use them with sign language and also with a video relay service, and well as to those with mobility issues or those who are located in distant places and are in need of telemedical or tele-educational services. categories emergency care u.s. navy medical staff being trained in the use of handheld telemedical devices (2006). common daily emergency telemedicine is performed by samu regulator physicians in france, spain, chile and brazil. aircraft and maritime emergencies are also handled by samu centres in paris, lisbon and toulouse. a recent study identified three major barriers to adoption of telemedicine in emergency and critical care units. they include: regulatory challenges: related to the difficulty and cost of obtaining licensure across multiple states, malpractice protection and privileges at multiple facilities financial barrier: lack of acceptance and reimbursement by government payers and some commercial insurance carriers, which places the investment burden squarely upon the hospital or healthcare system. cultural barriers: occurring from the lack of desire, or unwillingness, of some physicians to adapt clinical paradigms for telemedicine applications. telemedicine system. federal center of neurosurgery in tyumen, 2013 emergency telehealth is also gaining acceptance in the united states. there are several modalities currently being practiced that include but are not limited to teletriage, telemse and eppe. an example of telehealth in the field is when ems arrives on scene of an incident and is able to take an ekg that is then sent directly to a physician at the hospital to be read. therefore, allowing instant care and management. telenursing main article: telenursing telenursing refers to the use of telecommunications and information technology in order to provide nursing services in health care whenever a large physical distance exists between patient and nurse, or between any number of nurses. as a field it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc. telenursing is achieving significant growth rates in many countries due to several factors: the preoccupation in reducing the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. among its benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. a greater degree of job satisfaction has been registered among telenurses. in australia, during january 2014, melbourne tech startup small world social collaborated with the australian breastfeeding association to create the first hands-free breastfeeding google glass application for new mothers. the application, named google glass breastfeeding app trial, allows mothers to nurse their baby while viewing instructions about common breastfeeding issues (latching on, posture etc.) or call a lactation consultant via a secure google hangout, who can view the issue through the mother's google glass camera. the trial was successfully concluded in melbourne in april 2014, and 100% of participants were breastfeeding confidently. telepalliative care palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. in the past, palliative care was a disease specific approach, but today the world health organization (who) takes a broader approach suggesting that palliative care should be applied as early as possible to any chronic and fatal illness. as in many aspects of healthcare, telehealth is increasingly being used in palliative care and is often referred to as telepalliative care. the types of technology applied in telepalliative care are typically telecommunication technologies, such as video conferencing or messaging for follow-up, or digital symptom assessments through digital questionnaires generating alerts to health care professionals. telepalliative care has been shown to be a feasible approach to deliver palliative care among patients, caregivers and health care professionals. telepalliative care can provide an added support system that enable patients to remain at home through self-reporting of symptoms and tailoring care to specific patients. studies have shown that the use of telehealth in palliative care is mostly well received by patients, and that telepalliative care may improve access to health care professionals at home and enhance feelings of security and safety among patients receiving palliative care. further, telepalliative care may enable more efficient utilization of healthcare resources, promotes collaboration between different levels of healthcare and makes healthcare professionals more responsive to changes in patients' condition. challenging aspects of the use of telehealth in palliative care have also been described. generally, palliative care is a diverse medical specialty, involving interdisciplinary professionals from different professional traditions and cultures, delivering care to a heterogenous cohort of patients with diverse diseases, conditions and symptoms. this makes it a challenge to develop telehealth that is suitable for all patients and in all contexts of palliative care. some of the barriers to telepalliative care relate to inflexible reporting of complex and fluctuating symptoms and circumstances using electronic questionnaires. further, palliative care emphasizes a holistic approach that should address existential, spiritual and mental distress related to serious illness. however, few studies have included the self-reporting of existential or spiritual concerns, emotions, and well-being. healthcare professionals may also be uncomfortable providing emotional or psychological care remotely. palliative care has been characterized as high-touch rather than high-tech, limiting the interest in applying technological advancements when developing interventions. to optimize the advantages and minimize the challenges with the use of telehealth in home-based palliative care, future research should include users in the design and development process. understanding the potential of telehealth to support therapeutic relationships between patients and health care professionals and being aware of the possible difficulties and tensions it may create are critical to its successful and acceptable use. telepharmacy pharmacy personnel deliver medical prescriptions electronically. remote delivery of pharmaceutical care is an example of telemedicine. main article: telepharmacy telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. it is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities. health outcomes appear similar when pharmacy services are delivered by telepharmacy compared to traditional service delivery. the term can also refer to the use of videoconferencing in pharmacy for other purposes, such as providing education, training, and management services to pharmacists and pharmacy staff remotely. telepsychiatry this section is an excerpt from telepsychiatry. telemental health session telepsychiatry or telemental health refers to the use of telecommunications technology (mostly videoconferencing and phone calls) to deliver psychiatric care remotely for people with mental health conditions. it is a branch of telemedicine. telepsychiatry can be effective in treating people with mental health conditions. in the short-term it can be as acceptable and effective as face-to-face care. it can improve access to mental health services for some but might also represent a barrier for those lacking access to a suitable device, the internet or the necessary digital skills. factors such as poverty that are associated with lack of internet access are also associated with greater risk of mental health problems, making digital exclusion an important problem of telemental health services. during the covid-19 pandemic mental health services were adapted to telemental health in high-income countries. it proved effective and acceptable for use in an emergency situation but there were concerns regarding its long-term implementation. teledentistry main article: teledentistry teledentistry is the use of information technology and telecommunications for dental care, consultation,