Telehealth has been in its adolescence for decades, but the COVID-19 crisis accelerated its maturation within a matter of weeks. The terms “telehealth,” “telemedicine,” and “e-health” are often used interchangeably in the literature, but basically, they represent telecommunication used for healthcare, although the technology has clearly evolved. What started as simple telephone calls now includes video-enabled visits and consults.1,2
Telehealth, defined here as the remote consultation between the clinician and the patient regardless of technology,1 is no longer an attractive niche option but now a necessity for delivering timely and safe healthcare. The ability to conduct a remote evaluation protects both patients and providers at a time when physical distancing is a priority, and both parties appreciate its availability, safety, and convenience.
As this unplanned experiment unfolds, it is useful to call out the specific use of telehealth for diagnosis. Building on the definition of diagnostic error from the National Academies of Science, Engineering, and Medicine’s report on improving diagnosis,3 the authors propose the following definition of telediagnosis:
…the co-production of an accurate and timely explanation of the patient's health problem through remote interactions and transmitted data, including the clear communication of that explanation to the patient through these interactions.
This definition is agnostic to the specific technologies (e.g., telephone or video) that connect patients with clinicians to enable diagnosis at a distance, and it encompasses both synchronous (real-time), as well as asynchronous elements (uploading of data collected remotely).
As patients and clinicians participate in telediagnosis at scale, it is vital to consider quality and safety issues that arise when it is used for the diagnosis of acute conditions. What is known? What is not known? Given the likelihood that telehealth will become a mainstay after the current COVID-19 epidemic, we need to learn about optimizing the use of telediagnosis from the massive expansion now in progress and identify emerging research priorities.
