'E-care' not 'telehealth'…the FCC says so!

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This editor [Donna] hates to sound jaundiced and a touch choleric–again–but the Federal Communications Commission (FCC), which regulates all broadband and telephone in the US, in its now-published ‘National Broadband Plan’ gives us ‘e-care’ as their new, approved umbrella term for ‘The electronic exchange of information—data, images and video’. Telehealth is now kicked to the curb as ‘Often used as a synonym for e-care, but includes non-clinical practices such as continuing medical education and nursing call centers.’ Really? Perhaps in the commissioners’ minds, but those of us who’ve been in the field for the past 5 (or more) years don’t use the term ‘e-care’ (eHealth has its fans) and when speaking of telehealth, don’t toss in CMEs and whatever they mean by ‘nursing call centers’.  The industry also differentiates between telecare, telehealth and telemedicine (which didn’t even make the cut).  All those workshops, consultations with industry groups, uncounted pages (electronic and printed) of materials–and the FCC decides not to speak our language?  The VA (spending next year $163 million on telehealth) and Department of Defense (another major spender within its $31 billion budget) use ‘telehealth’ and ‘telemedicine’, but perhaps that is not good or original enough for the FCC.  (Wouldn’t it be nice if governmental agencies could agree on terminology?)  I disagree with Jonathan Linkous, CEO of the American Telemedicine Association (ATA), as quoted in Federal Computer Week–terminology DOES matter in defining what is provided. (They settled on ‘telemedicine’ a long time ago in a (futile) attempt to group everything under that term.)  Why invent yet another term and obfuscate rather than define? [Telecare Aware terminology discussion area]

Of course, if you start to read Chapter 10 (pages 197-222) of the ‘National Broadband Plan’ (link to PDF), it contains plentiful ‘recommendations’ but in context, the FCC pretty much kicks it over to Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) for implementation, both of which will surely have its hands full with this ‘national health plan’ just legislated.  Reimbursement (a major impediment to adoption), and two additional recommendations that address hospital credentialing and state licensing requirements to enable ‘e-care’ are only addressed in the context of CMS.  One good thing–I think–is clarifying the FCC/FDA regulatory requirements and the approval process for converged communications (mobile) and health care devices (pages 206-207), which could have the effect of increasing regulation.  The rest of the chapter is devoted to recommendations for spending ever more money and creating additional regulations on rural health, the Indian Health Service, reducing the ‘connectivity gap’ so that EHRs can be implemented in private practices and renaming the existing Internet Access Fund to the Health Care Broadband Access Fund.  What will move forward–the good, mediocre or the bad?  Winners and losers?  It does make your teeth hurt–again. More at Federal Computer Week