Most definitions found in this glossary are adapted with permission from this text book:
Maheu, M., Whitten, P., & Allen, A. (2001). eHealth, Telehealth & Telemedicine: A Guide to Startup and Success. New York: Jossey-Bass.
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The prevention of unauthorized access to information through the use of policies or software that determine who can have access to what data contained on a computer network (both within and outside the organization).
Describing wave-shaped electrical signals that continuously change size and shape depending on the information being transmitted. Signal variations lead to differences in volume, voice, and pitch.
Describing a communication system, such as e-mail, in which there is a lapse between the time a message is sent and the time it is received.
Asynchronous transfer mode (ATM)
A data transmission technology in which a start signal precedes each data packet, and one or more stop signals follow it. These individual packets of information are easily prioritized and routed, which enables the seamless integration of audio, video, and data. ATM also denotes the complete system of protocols and equipment associated with packet-based communication networks.
Two-way remote voice communication among multiple individuals.
A comprehensive or selective method of monitoring every operation an individual performs on information.
A method of verifying the identity of the individual sending or receiving information by use of passwords, biometrics, keys, digital or electronic signatures, and other automated identifiers.
A high-speed, high-capacity transmission facility that interconnects lower-speed distribution channels from smaller branches of the computer or telecommunication network.
The measure of a communication channel's range of frequencies that a signal occupies. Generally, higher bandwidth carries information faster than lower bandwidth. In an analog transmission, the speed of information transfer increases in terms of megahertz (cycles per second); in digital transmissions, speed is measured in megabits per second (Mbps).
The scientific measurement and analysis of human biological data using technology. A common application of biometrics is identity authentication performed by verifying retinal or iris scans, fingerprint patterns, DNA sequence characteristics, or voice patterns.
A binary digit, the basic unit of data used by computers for information storage, transmission, and entry. Represented as off or on by the digits 0 or 1 and grouped into strings of eight bits known as bytes, these units take the place of numbers, letters, and symbols in electronic media.
The number of colors or pixels of gray supported by a monitor or scanner. Also known as bit resolution or pixel depth.
Describing telecommunication over a single medium that provides multiple channels of data for high-speed transmission. Also applied to the higher bandwidth that will support real-time, full-motion audioconferencing and videoconferencing.
Program that runs on a client’s computer and communicates with Internet Web servers by connecting to Web sites and sending information to enable interaction.
Centers for Medicare & Medicaid Services (CMS)
Is the federal agency that administers the Medicare, Medicaid and Children’s Health Insurance Program.
Charge-coupled device (CDD)
A device that converts light into electronic information via sensors that collect light as a buildup of electrical charge. The signal that results from this conversion can be translated into computer code to form an image. This device is commonly used in television cameras, digital still-image cameras, and image scanners.
An Internet site or virtual community that provides real-time communication via the exchange of text messages (as well as sound and video files) between participants.
Children’s Waiver Services Program
Is a federal program that provides Medicaid-funded home and community-based services to children under age 18 who are eligible for, and at risk of, placement into an Intermediate Care Facility for the Mentally Retarded (ICF/MR).
Click stream data
Information used by Web advertisers showing the number of Web page visits or clicks of the mouse by a consumer visiting a Web site.
Cloud computing refers to the data being duplicated and stored on more than one distant computer system, the redundancy providing protection against a "crash" of any one of the cloud's computers.
A single or dual transmission wire that accommodates high bandwidth. Cable is used to transmit broadband data, voice, and video.
Coder-decoder. Hardware or software (or both) that converts an analog video signal to digital, then compresses it. At the receiving end, the signal is decompressed and converted back to analog output by a compatible codec.
Describing the ability of hardware, software, and data to work together without data loss, changes, or other manipulations. Standards-based specifications of procedures, equipment interfaces, and data formats are essential for minimizing incompatibility.
Video images that have been compressed to reduce the amount of bandwidth needed to transmit information. They can then be sent over less expensive transmission media (land-based T-1 lines rather than via satellite, POTS lines rather than ISDN, and so on).
See data compression.
Computed radiography (CR)
A system of creating digital radiographic images that uses a storage phosphor plate in a cassette. A laser beam scans the plate after it is exposed, producing a digital image.
In the computer world, limiting the disclosure of privileged information by using authorization protocols to protect that information against theft or improper use. Confidentiality of patient records and communications is both a legal and an ethical requirement for health care professionals.
The free flowing of individuals from one technology to another for routine communication.
(see also Hub Site or Distant Site) Is the site where the provider is located when delivering a telehealth service.
Convergence, refers to the blurring and meaninglessness of distinctions between different technological devices as they evolve toward common goals. An example is how computers and televisions are becoming increasingly similar, and available as hand-held devices that include telephones.
Computer-Based Patient Record Institute, Inc., an independent institute that develops and recommends standards for computerized patient records.
Critical Access Hospital (CAH)
Is a rural community hospital that receives cost-based reimbursement. The reimbursement received by CAHs is intended to reduce hospital closures and improve their financial performance.
Keeping data secret through the use of mathematical or logical functions that transform intelligible data into unintelligible data and back again.
Current Procedural Terminology (CPT) Code
Is a medical billing and administrative code set that describes medical, surgical, and diagnostic services. It is designed to communicate uniform information about health care services and procedures among providers, coders, patients, accreditation organizations and payers for administrative, financial and analytical purposes. It was revised in January of 2013.
A technique that removes extraneous characters and reduces data volume, thereby decreasing image processing demands, transmission times, bandwidth requirements, and storage space requirements. As distinguished from "lossless" compression techniques, "lossy" ones drop some information, which may or may not be clinically important, depending on the specific telehealth application.
Describing a permanent telephone or data line that is reserved exclusively for one specific purpose. Dedicated lines are usually digital and are also referred to as leased or private lines.
Digital Imaging and Communications in Medicine. A set of protocols describing how radiological images are formatted and transferred from point-to-point digital medical imaging devices. DICOM was developed by the American College of Radiology and the National Electronic Manufacturers Association (ACR/NEMA).
An image formed by independent pixels, each of which is distinguished by a digitally represented luminance level.
The conversion of analog information into digital information. Digital signals transmit audio, video, and data coded as bits. Digital technology facilitates data compression, and digital signals are less susceptible to interference than analog technology.
Distance education is defined as a formal educational process in which the majority of the instruction occurs when student and instructor are not in the same place. Instruction may be synchronous (students and instructors present at the same time) or asynchronous (students and instructors access materials on their own schedule).
(see also Hub Site or Consultant Site) Is the telehealth site where the provider is located when delivering a telehealth service.
The transmission of data from a satellite to a receiver on the ground.
Allowing telecommunication in opposite directions. Full-duplex communication channels can transmit data, audio, or video simultaneously; half-duplex channels can transmit in only one direction at a time.
Durable Medical Equipment
(DME) Is any medical equipment, such as oxygen tanks, wheelchairs or hospital beds used in the home. Newer DME devices include peripherals for smart devices.
E – Mental Health
Generic term to describe the use of information and communication technology (ICT) - in particular the many technologies related to the Internet - when these technologies are used to support and improve mental health conditions, including substance abuse and comorbid disorders.
Is the act of offering medical prescriptions over the Internet. Often, prescriptions must be accompanied by a valid provider-client/patient relationship, which may or
may not require an in-person interaction between the prescriber and patient, depending on the state.
Is a sonogram of the heart.
Is a radiology procedure that records deep structures of the body with ultrasonic waves.
Originally, this term referred to telehealth (or telemedicine) provided specifically via the Internet. More recently, it is used more broadly by some to refer to electronic and digital processes in health. It can also be found spelled eHealth or e-health.
Is a test of the electrical activity of the heart, which helps detect problems such as heart attacks and arrhythmias.
The attachment of specific codes to an electronic document for purposes of authentication. The authentication process may make use of such technologies as passwords, cryptography, and biometrics.
A system of encoding data whereby the information can be transmitted, retrieved, and decoded only by the intended recipient, who holds the “key” to interpreting the message.
Facility Fee (see also Originating Site Fee)
Is a fee paid to the originating site to compensate for the cost of facilitating a tele
Federally Qualified Health Centers (FQHCs)
Are federally designated facilities. They provide primary care and other health care services to underserved populations.
Technology employing an insulated cable with a glass core; it relies on light pulses rather than electricity to transmit audio, video, and data signals at very high speeds (90 to 150 Mbps) with low error rates.
Computer hardware and software designed to prevent internal and external unauthorized access between computer networks.
The number of frames per second (fps) displayed on a video monitor. Full-motion video is set at 25 to 30 fps. A frame rate of 15 fps or less is noticeably jerky and may be inadequate for some types of telehealth applications.
Describing the orbit of a satellite whose location relative to the earth's surface is constant, so that the satellite seems to hover over one spot.
All physical equipment related to information technology, including the computers, peripheral devices (printers, disks, scanners, and so on), cables, switches, and other components of the telecommunication infrastructure.
Health Professional Shortage Area (HPSA)
Are designated by the Health Resources and Services Administration as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), demographic (low income population) or institutional (comprehensive health center, federally qualified health center or
other public facility).
A single point of connection between workstations and other devices, enabling cost-effective telecommunication connections with remote sites.
Hub Site (see also Distant Site or Consultant Site)
Is the site at where the provider is located when delivering a telehealth service.
Information and communication technology (ICT)
Set of activities including creation, updating and revocation of user credentials, assigning rights and group membership to users, and authentication and authorization of users attempting to access any features of the information system.
In-person supervision is clinical supervision of psychological services where the supervisor is physically in the same room as the trainee.
Information technology (IT)
Using various technologies for the storage, manipulation, networking, and communication of information in audio, data, and video formats.
A careful explanation by the practitioner to the patient, usually in writing, that details proposed diagnostic or therapeutic procedures, along with their potential risks and benefits.
A program that gathers information or performs some other service at a fixed interval without one’s immediate presence. Typically, an agent program, using parameters one has provided, searches all or some part of the Internet, then gathers and presents the desired information.
Interactive Voice Response
Interactive Voice Response, (or Interactive Voice recording and IVR) is an audio-based service delivered through the communication technologies, including telephones and computers. In behavioral health care research, it is used much the same way as surveys are in conjunction with the human interviewer. It is used particularly when the questioner is concerned that a respondent might feel less comfortable providing answers to a human being, such as when asking questions about drug use or sexual behavior.
A collection of interconnected networks that speak the same computer language. The Internet now links thousands of independent networks in a global communication system.
A private network of interlinked computers used by the members of an organization or group. Many security systems allow sensitive information to be shared among intranet users.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
An independent nonprofit organization providing accreditation and related services that support performance improvement in health care organizations.
Local area network (LAN)
A network of computers, printers, servers, and other equipment, typically all located within an enterprise, that can support audio, video, and data exchange. Differentiated from metropolitan area networks (MANs) and wide area networks (WANs) by the size of the area serviced and to some extent by the protocols used; the LAN is the smallest.
Low earth orbit (LEO)
Describing satellite technology aimed to serve two-way high-speed networking, teleconferencing, telehealth, and other interactive applications.
Master patient index
An index of patients, members of health care plans, physicians, health care practitioners, payers, employers, employees, and other individuals, along with patient demographic information—such as name, address, telephone number, date of birth, and visit dates—stored in a computerized database.
Megabits (millions of bits) per second. A measure of bandwidth on a data transmission medium such as twisted pair copper cable, coaxial cable, or optical fiber. A typical uncompressed video signal requires at least 45 Mbps to facilitate transmission.
Is a program that provides health care coverage for people with lower incomes, older people, people with disabilities, and some families and children.
It provides medical coverage and long-term medical care to low-income
Medicaid Provider Manual
Is a document released by each state’s Medicaid agency, which serves as the reference document for its Medicaid program.
Medically Underserved Area (MUA)
May be a whole county or a group of contiguous counties, a group of county or civil divisions or a group of urban census tracts in which residents have a shortage of personal health services.
Is a health insurance for people age 65 or older, people under 65 with certain disabilities, and people of all ages with provides health care coverage and long-term health care care to low-income residents. Medicaid is jointly funded by the federal government and individual states, and is administered by the states.
mHealth (also known as mobile health or m-health) refers to the extension of eHealth to delivering healthcare (medical, mental and public health) information, education and services via mobile devices. Examples of mobile devices used for mHealth include smartphones such as the iPhone, Blackberry and those using Google's Droid operating system.
An antenna transmitting high-frequency radio signals (exceeding 800 megahertz) for audio, video, and data transmission. Microwave links require line-of-sight connection between transmission antennas.
Mobile phones (mobile, cell phone, or cellular telephones) are electronic devices used for two-way audio communication by means of a cellular network known as cell sites. They differ from cordless telephones, which are attached to traditional telephone land lines, such as typically found within a home or office. A mobile phone offering more advanced computing ability and connectivity is known as a smartphone.
Modulator-demodulator. A device that enables the transmission of digital data (by transforming it to and from analog form) over standard analog telephone lines and cable video lines.
Is the modifier for store and forward technologies.
Is the modifier for live video conferencing.
Multifunctionality refers to a single piece of technology (hand-held device) performing a wide variety of functions (email, web, telephone, navigational system and an almost overwhelming wave of applications or "apps") that will an increasing number of tasks.
Describing the transmission and manipulation of many types of information, including words, pictures, videos, music, numbers, and handwriting. In health care, integrated multimedia patient records can contain audio and video clips, still images, and other material.
The aggregation of individual digital transmission lines (minimum of two, maximum of eleven) into one higher-speed line by means of a hardware device known as a multiplexer. Multiplexing allows transmission of multiple sources of audio, video, or data information in a single high-capacity communication channel.
National Committee for Quality Assurance (NCQA)
A private, nonprofit organization dedicated to assessing and reporting on the quality of managed care plans.
Interconnected communication equipment used for data and information exchange. Networks can be classified by size (LAN, MAN, WAN) or by type of information carried (TCP/IP), who uses them (private or public), or how they are connected (switched or dedicated, using fiber optics or coaxial cable).
Discussion groups on the Internet that allow users to submit and read other participants’ submissions on a particular subject of mutual interest. Also referred to as the Usenet.
Proof that only the signer could have created an electronic signature.
Originating Site (see also Spoke Site or Referring Site)
Is the location of the client/patient receiving a telehealth service.
Originating Site Fee (see also Facility Fee)
Is a fee paid to the originating site to compensate for the cost of facilitating a telehealth visit.
A basic message unit for communication in packet-switched networks. A single file may be broken up into packets for transmission, with each packet finding its own path to the destination, where the packets are reassembled. Most information transmitted over the Internet is in the form of packets.
Any externally connected device attached to a videoconferencing or telemonitoring system to augment its communication or medical capabilities. Examples include electronic stethoscopes, otoscopes, ophthalmoscopes, dermascopes, graphic stands, and scanners.
Pip stands for "Picture-in-a-picture" and allows you to see yourself in a small screen while having contact with your client. This allows you to see how you appear to whomever you are addressing. If you see half your face, just your armpit, or another person in your room -- this is exactly what your client sees when she speaks with you.
The smallest and most fundamental picture element of a digital image. The greater the number of pixels in an image, the higher its resolution.
Describing the transfer of data from one computer to another.
Point-to-point Video Conference
Point-to-point video conference is a term used by ITU-T in the H.323 standard, and is in fact a basic point-to-point video call. Since per definition every call in H.323 is a conference call, the term 'point-to-point conference call' was coined.
A Web site that is intended to be the first one people see when using the Web. A portal typically has a catalogue of Web sites, a search engine, or both, and may also offer e-mail and other services to entice people to use that site as their main "point of entry" to the Web.
Plain old telephone service. The analog public switched telephone network used throughout the world, capable of voice and data transmission at up to 56 Kbps.
A system of guidelines and procedures, applying to both hardware and software, that controls communication between computer devices. Protocols are primarily concerned with three aspects of the communication process: how data are symbolized and coded, how data are transmitted, and how errors and failures are recognized and corrected.
The simultaneous capture, processing, and presentation of audio, video, and data at the time data are originated, without more than a fraction of a second delay when the frame rate is at least 30 fps.
Referring Site (see also Spoke Site or Originating Site)
Is the location of the patient receiving a telehealth service.
Remote Patient Monitoring
Uses telehealth technologies to collect medical data, such as vital signs and blood pressure, from clients/patients in one location and electronically transmit that information to health care providers in a different location. The health professionals monitor these clients/patients remotely and, when necessary, implement medical services on their behalf.
The level of detail that can be captured or displayed; in computer displays it refers to the spacing of pixels in the image and is measured in pixels per inch (ppi) or dots per inch (dpi). For example, if an image has a resolution of 72 ppi, it contains 5,184 pixels per square inch (72 pixels wide by 72 pixels high). For video displays (interactive video or teleradiology), resolution is measured in pixels by pixels (or lines) by bit depth.
Rural Health Clinic
Is a clinic in a rural, medically underserved area that has a separate reimbursement structure from the standard professional office under the Medicare and Medicaid programs.
An instrument in orbit around the earth used to amplify, receive, or transmit electromagnetic signals over a wide geographical area, or footprint.
Methods to control access and to protect information from accidental or intentional disclosure to unauthorized persons and from alteration, destruction, or loss.
Short Message Service
Short Message Service (SMS) refers to the text communication service of telephone, web or mobile phone or other communication systems. Text messages (also known as texting) use SMS.
Skilled Nursing Facility (SNF)
Is a facility that houses chronically ill, usually elderly patients, and provides long-term nursing care, rehabilitation, and other services.
A plastic device, the size of a credit card, with embedded memory. Smart cards are used, especially in Europe, for people to carry their own medical records, images, and other information.
A smartphone is a mobile phone offering more advanced computing ability and connectivity. In essence, these are handheld computers integrated into mobile phones.
Spoke Site (see also Originating Site or Referring Site)
Is the location of the clients/patient receiving a telehealth service.
Store and Forward (see also Asynchronous)
Technologies allow for the electronic transmission of medical information, such as digital images, documents, and pre-recorded videos. Asynchronous transmissions typically do not occur in real time, and take place primarily among health care professionals, to aid in diagnoses and consults, when live video or face-to-face client/patient contact is not necessary.
Describing an asynchronous connection that permits audio clips, video clips, still images, or data to be held now and transmitted or received at a later time. Store-and-forward technology can be used to create a multimedia computerized medical record.
A telecommunication system in which every user has a unique address such that direct connections between any two users can be established.
Synchronous (see also Video Conferencing)
Refers to the use of two-way interactive audio-video technology to connect users, in real time, for any type of medical service.
A tablet personal computer (tablet PC) refers to any portable personal computer that relies upon a touchscreen as its primary input device and has a wireless connection to access the Internet. Originated by Microsoft in 2001, the tablet PC is now a ubiquitous term that refers to any tablet-sized personal computer regardless of its operating system.
involves a pharmacist in one location directing the dispensing of a prescription to another employee in a separate location.
Is a health professional who sits in the exam room with clients/patients during telemedicine visits and assists the distant-site provider.
Transmitting or receiving information with the use of wire, radio, satellite, fiber-optic, or other electromagnetic or optical media for voice, data, and video communications.
Interactive electronic communication between multiple users at remote sites that allows the simultaneous exchange of voice, video, and data.
A clinical interaction between a clinician and patient, using telecommunication technology.
The detection or diagnosis of a disease by evaluating data transmitted electronically or by using peripheral instruments monitoring a remote patient.
An experienced clinician acting as a preceptor for a remote inexperienced clinician by observation via interactive telecommunication technology.
The automatic collection and transmission of data via wired or wireless media from stations based in remote locations (for example, patients’ homes) to central receiving stations (such as clinics or hospitals) for recording and analysis.
The process of using audio, video, and other electronic peripheral devices to monitor the health status of a patient at a distance.
Generally, the quality of a videoconference that gives participants the feeling that they are actually in the same room together. This is affected by the extent to which nonverbal cues, such as facial expressions, posture, dress, and physical distance, are transmitted. An especially important part of telepresence is eye contact. More specifically, telepresence may refer to the close approximation of on-site presence afforded in, for example, telesurgery by the use of haptic feedback (force feedback) devices.
A system that transmits radiographic images between enterprises. Tunneling A technique used to transmit data securely over a private network. The “tunnel” is the actual path over which the message travels. The Point-to-Point Tunneling Protocol (PPTP) has been proposed to provide rules that will allow the Internet to be used by companies as a “virtual private network.”
Telesupervision is also referred to as remote supervision or distance supervision. It involves clinical supervision of health care services through an audio and videoconferencing format where the supervisor is not in the same physical facility as the trainee.
Text messaging or texting refers to the telephone transfer of brief messages between a sender and receiver, using either a fixed line, mobile phone or other portable device such a tablet (iPad). Messages are referred to as a text in North America, Australia, the Philippines, India and the UK; as an SMS in much of Europe; and a TMS or SMS in the Middle East and Asia. The sender of a text is known as a texter.
The Health Insurance Portability and Accountability Act (HIPAA)
Is a set of national standards, which includes security and privacy of health data for electronic health care transactions, and national identifiers for providers, health insurance plans and employers.
Is a fee paid to telehealth providers for the cost of telecommunications transmission.
Describing a complete product or system in which all of the services and components have been provided by a single vendor or contractor.
A pair of copper wires that have been twisted to cancel out electronic interference. May be unshielded (standard phone wire) or shielded (enclosed in a shield that functions as a ground). Twisted pair wires form the residential portion of the hard-wired telephone system around the world.
The path from a transmitting earth station to a satellite.
Two-way transmission of video images among multiple locations in real time to bring people at physically remote locations together for meetings and teleconsultations.
A computer-based technology for simulating visual, auditory, and other sensory aspects of complex environments to create an illusion of being in a three-dimensional world. The world is designed by the computer; it is viewed through a special headset that responds to a person’s head movements while a glove responds to the person’s hand movements. For example, while in a virtual room, raising one’s gloved hand will cause a virtual object seen through the headset to move upward.
Voice over Internet Protocol
Voice over Internet Protocol (Voice over IP, VoIP, IP telephony, Internet telephony, voice over broadband (VoBB), broadband telephony, and broadband phone) refers to a group of communication protocols, transmission technologies, and methodologies for delivering voice, video and multimedia sessions over Internet Protocol (IP) networks, including the Internet rather than rather than the public switched telephone network (PSTN).
The ability of a computer to interpret auditory information in the form of spoken words. Also serves as a method for authentication with a wide variety of applications.
Exchanging information on a whiteboard, a kind of electronic shared onscreen blackboard on which users can write or draw. Whiteboards are often supported by broadband videoconferencing or computer technology.
Wide area network (WAN)
A data communication network that links distant networks and their computers to provide connectivity between separate networks located in different geographical areas.