From patient engagement to telehealth, what does it all mean?

Seeking to draw clarity from health IT ambiguity
By Michelle Ronan Noteboom
10:57 AM
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Several years ago some girlfriends and I were enjoying a happy hour and noticed a group of guys wearing matching shirts. We were a friendly bunch, so we asked what they did.

In response, one guy handed me his card which displayed a title of "Transportation Coordinator." Travel agent perhaps? Nope. Turned out that he and his comrades sold used cars.

More recently I met an individual who said he loved his job as a "Commercial Consultant." I know lots of consultants, but had never met a "commercial" consultant. I asked if he helped people create television commercials. Bad guess. Apparently his expertise is securing financing for companies when they acquire commercial vehicles.

[Learn more: Meet the speakers at the Patient Engagement Summit.] 

Today I quickly skimmed LinkedIn and discovered I'm connected to quite a few people with interesting titles, such as Futurist, Chief People Officer, Wicked Problem Solver, and Employee Engagement Game Changer. As fun as these titles are, I'm pretty sure I wouldn't want a title that leaves people wondering what I really do.

I prefer obvious titles like "salesperson" and "programmer." Unambiguous titles seem more appropriate for today's world where everyone is urging more transparency from the government, providers, and vendors.

Unfortunately our world is full of ambiguous titles and concepts. In health IT, the lingo is continuously evolving and stakeholders don't necessarily agree on a single definition for each term. Sometimes we create new terms that really aren't that much different from older, existing concepts (anyone want clarify the nuances between a CHIN, RHIO and HIE?)

Ambiguity, of course, can create all sorts of problems. If you are a provider in a need of a patient portal, you can't assume that the solution from vendor A includes secure messaging and EHR integration just because that's what is included in vendor B's patient portal.

With so many similar concepts, it's no wonder that providers are sometimes unsure what type of solution they really need. If, perhaps, you are running a small practice and need to exchange data with the hospital or other providers, do you need an EMR that is interoperable? Do you need an interface? Or, do you need an option for electronic information exchange?

Obviously, many of these concepts are relatively new and the definitions are still evolving. The definitions seem to get muddled even further when the concepts are tied to some sort of government incentive or penalty. For example:

Patient engagement. Broadly speaking, patient engagement is defined as getting patients involved in their own care. And then there are more specific definitions, such as this one from HIMSS Analytics:

"An organization's strategy to get patients involved in actively and knowledgeably managing their own health and wellness and that of family members and others for whom they have responsibility. This includes reviewing and managing care records, learning about conditions, adopting healthy behaviors, making informed healthcare purchases, and interacting with care providers as a partner."

Compare the HIMSS Analytics definition to the Stage 2 meaningful use objective for patient engagement which requires providers to give patients secure online access to their health information. To qualify for meaningful use, all a provider must do is prove that one single patient has the ability to view, download, and transmit their health information. What's "engaging" about that?

Telemedicine/telehealth. A Center for Connected Health Policy notes that some states use the terms telemedicine and telehealth interchangeably, while other states use telehealth to reflect a broader definition.  In addition, the CCHP found that "no two states are alike in how telehealth is defined or regulated."

Similarly, on the Medicaid.gov website, the telemedicine is defined as medical care that permits two-way real-time interactive communication between the patient and clinician at a distant site.

In comparison, The World Health Organization's telemedicine definition includes interactions between patients and providers, as well as the continuing education of healthcare providers. I doubt many Medicaid carriers are willing to reimburse providers for continuing education via telemedicine or any other method.

I prefer clarity over ambiguity, though I realize it's impossible to eliminate all of life's obscure titles and concepts, especially in a dynamic environment like health IT that must continually adjust to new payment models and emerging technologies.

Rather than just rant about all these abstruse terms, I wonder if I should also designate myself "Seeker of Lucidity?"