Table 6.
Store-and-Forward Definitions
| AGENCY/OFFICE | DEFINITIONa,b |
|---|---|
| DOC/NIST | Utilizes ATA's definition: 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. Common types of S&F services include radiology, pathology, dermatology, and wound care. S&F also includes the asynchronous transmission of clinical data, such as blood glucose levels and electrocardiogram measurements, from one site (e.g., patient's home) to another site (e.g., home health agency, hospital, clinic). |
| DHHS/CMS | Transfer of data from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site for consultation. Asynchronous or “S&F” applications would not be considered telemedicine.c |
| DHHS/HRSA DHHS/NIH |
HRSA (NIH utilizes HRSA's definition): information that is stored in a specific format and sent to a consulting provider for a diagnosis, interpretation, confirmatory opinion, second opinion, or for any reason that the input of the consulting provider is requested |
| FCC | Remote monitoring and image transmission (“store-and-forward”) over fixed or mobile networks |
| VA | Telehealth involving S&F telehealth technologies acquire and store clinical information (e.g., data, image, sound, video) that is then forwarded to (or retrieved by) another site for clinical evaluation |
Definitions were provided by the Department/Agency representative in response to Federal Telemedicine queries. These responses should not be considered the formal, legal, or comprehensive definitions for each agency; such a determination was not within the scope of the Federal Telemedicine effort. The objective was to illustrate potential similarities and differences in telehealth-related definitions across the agencies.
No responses were received from the U.S. Department of Homeland Security, U.S. Department of Transportation, National Science Foundation, U.S. Department of Justice, and U.S. Department of Labor.
Centers for Medicare & Medicaid Services (CMS) clarified that services furnished using asynchronous applications are considered to be Medicare telehealth services under certain circumstances [see Social Security Act § 1834(m)(1) (42 USC § 1395m(m)(1))]. Although there is no Medicare prohibition on the use of asynchronous applications to deliver services under conditions where they are not considered “telemedicine,” CMS may not deem such services to constitute covered services for which payment could be made under Medicare.
ATA, American Telemedicine Association; DHHS, U.S. Department of Health and Human Services; FCC, Federal Communications Commission; HRSA, Health Resources and Services Administration; NIH, National Institutes of Health; S&F, store-and-forward; VA, Veterans Administration.