La telesalud (salud virtual) es un conjunto diferente de tecnologías y de métodos para proporcionar servicios de medicina, de salud y de educación virtuales independientemente de la ubicación y de la distancia.

La telemedicina es la rama clínica de la telesalud (por ej., telerradiología, telehistopatología, telecardiología, salud del comportamiento).

La teleatención es la rama no clínica de la telesalud (por ej., portales de comunicación del paciente, dispositivos de monitoreo de la salud remotos, aprendizaje virtual, aplicaciones móviles para la salud, sistemas de alerta médica, dispositivos de asistencia en el hogar).

Requisitos

• Enlace de comunicación/Disponibilidad de Internet
• Ancho de banda adecuado
• Intercambio de datos electrónicos seguro

Opciones

• Sincrónico (en tiempo real)
• Asincrónico (almacenado y enviado)

La telesalud de atención primaria (Primary care telehealth, PCT) complementa la atención presencial. Se enfoca en el bienestar, en la prevención de enfermedades y en el mantenimiento de la salud en oposición a un enfoque de radar clínico que se enfoca en procedimientos de “encuéntralo y soluciónalo”. La PCT es, actualmente, el pilar para proporcionar continuidad asistencial centrada en el paciente.

• En el nivel micro, su valor nace de la experiencia de campo que demuestra aumento en el acceso a la atención, mejora en la participación del paciente y resultados de salud optimizados, y, al mismo tiempo, genera ahorro de costos para contribuir a crear sistemas de salud sostenibles.
• A nivel macro, su valor nace del reconocimiento de que las poblaciones sanas consumen menos recursos sociales y sanitarios, son más productivas y faltan menos días al trabajo.

Gough F, Budhrani S, Cohn E, et al. ATA Practice Guidelines for Live, On Demand Primary and Urgent Care. Telemedicine and e-health March 2015, 21(3): 233-241. https://doi.org/10.1089/tmj.2015.0008

Krupinski EA, Bernard J. Standards and Guidelines in Telemedicine and Telehealth. Healthcare (Basel) 2014;2:74-93.

McSwain SD, Bernard J, Burke BL, Jr., et al. American Telemedicine Association Operating Procedures for Pediatric Telehealth. Telemedicine journal and e-health. 2017;23:699-706.

Siddiqui J, Herchline T, Kahlon S, et al. Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases. Clin Infect Dis 2017;64:237-42.

Bongiovanni-Delaroziere I, Le GP, Rapp T. Cost-Effectiveness of Telemedicine: Lessons To Learn From An International Review. Value Health 2014;17:A425.

Combi C, Pozzani G, Pozzi G. Telemedicine for Developing Countries. A Survey and Some Design Issues. Appl Clin Inform 2016;7:1025-50.

Grustam AS, Severens JL, van Nijnatten J, Koymans R, Vrijhoef HJ. Cost-Effectiveness of Telehealth Interventions for Chronic Heart Failure Patients: A Literature Review. International journal of technology assessment in health care 2014:1-10.

OECD Health Policy Studies (2010). Improving Health Sector Efficiency. The role of information and communication technologies. http://ec.europa.eu/ health/eu_world/docs/oecd_ict_en.pdf. Retrieved September, 2017.

O’Gorman LD, Hogenbirk JC, Warry W. Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network. Telemed J E Health 2016;22:473-9.

Pan American Health Organization (PAHO). (2011). Integrated health service delivery networks: Concepts, policies and a roadmap for implementation in the Americas. Series Renewing Primary Care in the Americas. http://new.paho.org/ hq/dmdocuments/2011/PHC_IHSD-2011Serie4.pdf. Retrieved September, 2017

Saigi-Rubio F, Torrent-Sellens J, Jimenez-Zarco A. Drivers of telemedicine use: comparative evidence from samples of Spanish, Colombian and Bolivian physicians. Implement Sci 2014;9:128.

Saliba V, Legido-Quigley H, Hallik R, Aaviksoo A, Car J, McKee M. Telemedicine across borders: a systematic review of factors that hinder or support implementation. Int J Med Inform 2012;81:793-809.

World Health Organization. (2015). Global Observatory of eHealth. eHealth Country Profiles. http://www.who.int/goe/publications/atlas/2015/en/ Retrieved September 2017.

World Health Organization (WHO). (2010b). Telemedicine opportunities and developments in member states. Global Observatory for e-Health Series, Volume 2. http://www.who.int/ goe/publications/goe_telemedicine_2010.pdf. Retrieved September 2017.

de la Torre-Diez I, Lopez-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemedicine journal and e-health. 2015;21:81-5.

Kruse CS, Soma M, Pulluri D, Nemali NT, Brooks M. The effectiveness of telemedicine in the management of chronic heart disease – a systematic review. JRSM Open 2017;8:2054270416681747.

Kruse CS, Bouffard S, Dougherty M, Parro JS. Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review. J Med Syst 2016;40:145.

Narasimha S, Madathil KC, Agnisarman S, et al. Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies. Telemed J E Health 2017;23:459-72.

Ward MM, Jaana M, Natafgi N. Systematic review of telemedicine applications in emergency rooms. Int J Med Inform 2015;84:601-16.

Whitacre BE. Estimating the economic impact of telemedicine in a rural community. Agricultural and Resource Economics Review. 2011;40(2):172-83.

Bashshur RL, Howell JD, Krupinski EA, Harms KM, Bashshur N, Doarn CR. The Empirical Foundations of Telemedicine Interventions in Primary Care. Telemedicine journal and e-health. 2016;22:342-75.

Belt GH, Felberg RA, Rubin J, Halperin JJ. In-Transit Telemedicine Speeds Ischemic Stroke Treatment: Preliminary Results. Stroke 2016;47:2413-5.

Comin-Colet J, Enjuanes C, Verdu-Rotellar JM, et al. Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: Results of a randomized controlled trial. Journal of telemedicine and telecare 2016;22:282-95.

Ho YL, Yu JY, Lin YH, et al. Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease. J Med Internet Res 2014;16:e145.

McConnochie KM, Ronis SD, Wood NE, Ng PK. Effectiveness and Safety of Acute Care Telemedicine for Children with Regular and Special Healthcare Needs. Telemedicine journal and e-health. 2015;21:611-21.

Reider-Demer M, Raja P, Martin N, Schwinger M, Babayan D. Prospective and retrospective study of videoconference telemedicine follow-up after elective neurosurgery: results of a pilot program. Neurosurg Rev 2017.

Ronis SD, McConnochie KM, Wang H, Wood NE. Urban Telemedicine Enables Equity in Access to Acute Illness Care. Telemedicine journal and e-health. 2017;23:105-12.