More Study Needed to Prove Telehealth's Worth

Gienna Shaw, for HealthLeaders Media , April 12, 2011

Researchers, who published their findings in the Archives of Internal Medicine in March, reviewed ICU outcome data from 60 years' worth of studies, including those that reported data on the primary outcomes of ICU and in-hospital mortality or on the secondary outcomes of ICU and hospital length of stay.

The researchers found that while telemedicine can impact ICU mortality and length of stay, it doesn't have the same impact on inpatient hospitalizations. The study suggests that organizations that are using the technology in the ICUs are on the right track.

Other studies are ongoing. A demonstration project at Wenatchee (WA) Valley Medical Center seeks to show that remote home monitoring can reduce hospitalizations, and, as a result, lower costs among patients with diabetes, congestive heart failure, and chronic obstructive pulmonary disease.

"The idea is that you would try to catch exacerbations at a milder stage before they require hospitalization," says WVMC CEO Peter Rutherford, MD.

In the first three years of the randomized trial, the organization met the program's goal of saving 5% net of costs. The number of clinic visits went up—and because patients had already been triaged by case managers, those visits were more productive. At the same time, hospitalizations and emergency room visits declined.

The study is currently in its second phase, which will expand screenings to include other disease states such as asthma and comorbidities such as depression.

Loyola University Medical Center implemented its telehealth program about four years ago as a way to increase after-hours coverage at its 14-bed pediatric ICU.

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4 comments on "More Study Needed to Prove Telehealth's Worth"

Debby Randall (4/13/2011 at 4:37 PM)
And I would add: if the patient's choice is for telehealth[over no care or delayed care] and it is a quality equivalent, there is no compelling reason that it has to be "superior" to the traditional method. So far, avoided hospitalizations and ER visits meet patient preferences and reduce costs, too. Deborah Randall JD

Jeff Johnson (4/13/2011 at 11:37 AM)
I find it interesting that the content of the article and evidence presented appear to support the use of telemedicine as an equally effective alternative but the title line and the last comment in the article do not.

Michael W Hurst (4/13/2011 at 10:32 AM)
Agree entirely with Ken Maddock that the standard does not need to be "better than", "equal" is entirely fine. And if one uses cost-effectiveness as well as clinical effectiveness, the comparison may weigh entirely in telemedicine's favor. The challenge is that hospitals and clinics are not necessarily the billable source of this care. For many patients in many circumstances, however, not having to travel with all its attendant costs is a major reduction in the barrier to receiving care in a timely fashion.




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