Effectiveness of TeleHealth Applications

Telemedicine and telehealth seem to broadly relate to the use of various electronic communication–phone, computer, tablets, etc.–to perform activities related to health and health care.  The medium may be video, audio, text and it may be real-time or asynchronous.  An early use of telehealth was to place equipment in a patient’s home that allows monitoring of vital signs and other biometric information, so that a provider can be alerted to potential condition changes or problems and for patients or providers to adjust medications and other treatment. Telemedicine has increasingly been used to substitute for in-person medical visits, sometimes by real-time video visits, sometimes by internet chat or other technology.  It can be used for very sophisticated needs, like centralized monitoring of ICU patients, and for very simple ones, like a patient wondering if they have an ear infection.  Telemedicine has the capability to rationalize the use of capacity, create access to scarce skilled resources and lower costs.

A report from the Agency for Healthcare Research & Quality assesses the existing evidence for efficacy of various telehealth techniques and uses.   (AHRQ Report)   As is usually the case with AHRQ reports, this one is not itself a piece of research, but merely a review of existing studies, assessing their quality and results.  In this case there were 58 systematic reviews that the authors included in their analysis.  These studies used a wide variety of outcomes and methods.  The strongest evidence for benefit was found for remote patient monitoring for chronic conditions such as heart failure and respiratory disease, for communication and counseling for these patients and for use in tele-psychiatry.  In addition to identifying what the evidence to date suggests works in telehealth, the authors also identify areas for further study, particularly in regard to impact on cost outcomes as well as health ones.   The report does an excellent job of setting forth the uses and functions of telemedicine, and providing references to studies regarding outcomes.