Telehealth: Its applications for public health emergencies and disaster medical responses

To fulfill Public Health Service Act Section 319D (f) as amended by Pandemic and All Hazards Preparedness Act (December 2006), the U.S. Department of Health & Human Services (HHS) drafted a report for Congress which provided the status of a narrow set of Telehealth initiatives that might be utilized to optimize Emergency Support Function #8 efforts in service to the public during public health emergencies (PHE) or disaster medical responses (DMR). While drafting the report it became clear that there was neither a national Telehealth inventory nor a national strategic plan to incorporate and integrate such tools and Telehealth applications into response and recovery capabilities in austere environments. Support and recommendations for a national Telehealth strategy were promulgated by the HHS' Enterprise Governance Board, Institute of Medicine, and National Biodefense Science Board. The national strategy might address barriers to full integration of Telehealth into PHE and DMR such as: payment or reimbursement for telemedicine resources, integration of existing networks, Telehealth use by the National Disaster Medical System, uniform information standards, etc. It might also address the potential benefits to health officials, emergency responders and patients such as: rapid information transfer and intellectual and clinical consultation into remote and compromised environments during a response, uniform accounting and electronic asset and reimbursement strategies for Telehealth materials and services to improve situational awareness (and thus, overall incident management and crisis decision-making) and capture potentially the “arc” of a patient's encounter with the system, course of care, and final disposition.