From Telemedicine to Telehealth to eHealth: Where Does mHealth Fit?

The field of telemedicine, which emerged more than 40 years ago, has evolved from one-way transmission of information primarily for the purpose of diagnosis and treatment monitoring to robust telecommunications systems that enable virtual engagement between patients and providers. The technology evolution was made possible by the advent of high-speed processing and broadband transmission innovations. A forthcoming driver, changes in reimbursement practices associated with the Affordable Care Act, may impel the implementation of applications to a level more closely aligned with what we can and should do via remote health care, than what we have been financially motivated to do in past years. Research has shown telehealth programs to be both cost-effective and of good quality. And, patient acceptance of programs has been consistently good, due in large part to the convenience factor and the improved access to specialty services in remote or rural areas. Future research on program effectiveness should include the issue of scalability, whether programs that are deemed successful locally can translate effectively and profitably to a larger national or even international scale. To date, the most comprehensive users of telehealth options have been the military and the Veterans Administration. This phenomenon can be attributed largely to the single-payer system and the technology infrastructure. With growing user acceptance of mobile technology since the smart phone has become ubiquitous, and the availability of high-functioning computer and telecommunication products at acceptable costs, the remaining challenges of reimbursement and regulation may become national priorities for resolution.