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Appendix A
Definitions1
Asynchronous is a term sometimes used to describe store and forward
transmissions of medical images or information because the transmission
typically occurs in one direction at a time.
Digital Imaging and Communication in Medicine (DICOM) is a standard
for communications among medical imaging devices; a set of protocols de-
scribing how images are identified and formatted that is vendor dependent
and developed by the American College of Radiology and the National
Electronic Manufacturers Association.
Distant site is defined by CMS as the telehealth site where the provider/
specialist is seeing the patient at a distance or consulting with the patient's
provider. Other common names for this term include hub site, specialty site,
provider/physician site, and referral site. This site may also be referred to
as the consulting site.
Hub site, see distant site.
Internet protocol (IP) is the protocol by which data are sent from one
computer to another on the Internet. Each computer on the Internet has
at least one address that uniquely identifies it from all other computers on
the Internet. IP is a connectionless protocol, which means that there is no
1These terms are as defined by the American Telemedicine Association, and do not represent
any consensus of the participants of this meeting on their definitions (ATA, 2012a,b).
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134 THE ROLE OF TELEHEALTH
established connection between the end points that are communicating. The
IP address of a videoconferencing system is its phone number.
Mobile telehealth (mHealth) is the provision of health care services with
the assistance of a van, trailer, or other mobile unit in which the health care
provider might provide patient services at a distance from a normal medi-
cal facility. Services may also be provided through mobile technologies that
allow a mobile vehicle equipped with medical technologies to attach to an
existing health care facility.
Originating site is defined by CMS as where the patient and/or the patient's
physician is located during the telehealth encounter or consult. Other com-
mon names for this term include spoke site, patient site, remote site, and
rural site.
Remote patient monitoring is the use of devices to remotely collect and send
data to a monitoring station for interpretation.
Spoke site, see originating site.
Store and forward (S&F) is a type of telehealth encounter or consult that
uses still digital images of a patient for the purpose of rendering a medical
opinion or diagnosis. S&F also includes the asynchronous transmission of
clinical data from one site (e.g., patient's home) to another site (e.g., home
health agency, hospital, clinic).
Telemedicine and telehealth both describe the use of medical informa-
tion exchanged from one site to another via electronic communications
to improve the patient's health status. Although evolving, telemedicine is
sometimes associated with direct patient clinical services and telehealth
is sometimes associated with a broader definition of remote health care
services.
Videoconferencing is the real-time, generally two-way transmission of digi-
tized video images between multiple locations; this uses telecommunications
to bring people at physically remote locations together for meetings.
