telemedicine
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Introduction
Health care provided via telecommunication.
- technology-based delivery of health care to patients located remotely from the health-care provider
- for example, a physician (or other health care provider) in his/her office can interact with a patient at home via videophone &/or two-way interactive computer networks
- a model for delivery of telehealth servicesis the hub-&-spoke system, wherein a center with expertise in a diagnosis & management of a disease (the hub) provides telehealth services to underserved centers (the spokes).[9][19]
- considerations in advising elderly via telemedine include:
- hearing impairment
- dual-eligibility (Medicare, Medicaid)
- access to a social worker at the building (GRS11)[29]
Indications
- diagnosis & management of patients with diabetic retinopathy[15]
- roadblocks in providing care can be removed by telemedicine[21]
- may reduce unnecessary ambulance transports[25]
- integration as part of usual primary care[26]
- a telehealth visit offers an opportunities to:
- review chronic conditions
- authorize refill of medications
- check patient well-being
- review advance care planning[29]
- a telehealth visit offers an opportunities to:
- depression; therapy from lay counselor or licensed clinician of benefit[27]
Clinical trials
- telephone-based system for frequent, remote data collection after hospitalization for heart failure[10]
- did not reduce hospitalizations or improve outcomes
- patient compliance was poor
- of benefit[14]
- telemedicine program many diminish mortality if patients with major depression excluded[22]*
- telemonitoring of patients multiple serious morbidities consisting of daily assessments of weight, blood pressure, blood glucose, oxygen saturation, & peak expiratory flow with at least some real-time video conferencing reviewed by a nurse case-manager resulted in:
- increased hospitalization (52% vs 44%) vs usual care
- increased emergency department visits ((35% vs 28%)
- increased mortality (14.7% vs 3.9%)[11]
- postdischarge telephone calls to patients after hospital discharge resulted in fewer hospital readmissions 9.3% vs 11.5%, fewer emergency room visits 8.1% vs 9.4%, but more physician office visits 76.5% vs. 72.3%[12]
- the closer the intervention to the date of hospital discharge, the greater the reduction in number of hospital readmissions
- telemonitroing improves blood pressure control in patients with uncontrolled hypertension[13]
- telemedicine approach to management of Parkinson's disease non-inferior to traditional office-based approach[20]
* telemedicine program for heart failure (preserved or reduced LVEF)
- daily transmissions of body weight, blood pressure, cardiac rhythm, oxygen saturation, health status
- patient education
- algorithm-guided physician management
- 4 full-time physicians & 5 nurses during working hours & 2 on-call physicians at night (~800 patients)[22]
Notes
- visits for respiratory infections are slightly shorter when antibiotics are prescribed than when not (7.5 vs 8.0 minutes) & patient satisfaction are better with any prescription than nothing, & best with an antibiotic [23]
- patients generally are satisfied with video visits integrated with usual primary care[26]
More general terms
More specific terms
- telemedicine for detection of diabetic retinopathy
- telemedicine for management of diabetic retinopathy
- telephone appointment visit (TAV); telephone encounter
- telephone triage; call center
- virtual home care
References
- ↑ Marcin JP, Schepps DE, Page KA, Struve SN, Nagrampa E, Dimand RJ. The use of telemedicine to provide pediatric critical care consultations to pediatric trauma patients admitted to a remote trauma intensive care unit: A preliminary report. Pediatr Crit Care Med. 2004 May;5(3):251-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15115563
- ↑ Mass M Johnson-Mekota JL, Buresh KA, Gardner SE, Frantz RA, Specht JK, Wakefield B, Flanagan J. A nursing application of telecommunications. Measurement of satisfaction for patients and providers. J Gerontol Nurs. 2001 Jan;27(1):28-33. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11915094
- ↑ Hui E, Woo J. Telehealth for older patients: the Hong Kong experience. J Telemed Telecare. 2002;8 Suppl 3:S3:39-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12661617
- ↑ Grundy BL, Jones PK, Lovitt A. Telemedicine in critical care: problems in design, implementation, and assessment. Crit Care Med. 1982 Jul;10(7):471-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/7083874
- ↑ Lindberg CC. Implementation of in-home telemedicine in rural kansas: answering an elderly patient's needs. J Am Med Inform Assoc. 1997 Jan-Feb;4(1):14-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/8988469
- ↑ Wells RS, Lemak CH. Beyond adoption to sustained use: telemedicine for rural communities. Telemed J. 1996 Winter;2(4):285-93. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10165365
- ↑ Chae YM, Heon Lee J, Hee Ho S, Ja Kim H, Hong Jun K, Uk Won J. Patient satisfaction with telemedicine in home health services for the elderly. Int J Med Inf. 2001 May;61(2-3):167-73. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11311671
- ↑ Coen Buckwalter K, Lindsey Davis L, Wakefield BJ, Kienzle MG, Ann Murray M. Telehealth for elders and their caregivers in rural communities. Fam Community Health. 2002 Oct;25(3):31-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12802140
- ↑ 9.0 9.1 Schwamm LH et al. and on behalf of the American Heart Association Stroke Council and the Interdisciplinary Council on Peripheral Vascular Disease. A review of the evidence for the use of telemedicine within stroke systems of care: A scientific statement from the American Heart Association/American Stroke Association. Stroke 2009 Jul; 40:2616. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19423852
Schwamm LH et al. and on behalf of the American Heart Association Stroke Council; Council on Epidemiology and Prevention; Interdisciplinary Council on Peripheral Vascular Disease; and the Council on Cardiovascular Radiology and Intervention. Recommendations for the implementation of telemedicine within stroke systems of care: A policy statement from the American Heart Association. Stroke 2009 Jul; 40:2635. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19423851 - ↑ 10.0 10.1 Chaudhry SI et al. Telemonitoring in patients with heart failure. N Engl J Med 2010 Nov 16; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21080835 <Internet> http://dx.doi.org/10.1056/NEJMoa1010029
Desai AS and Stevenson LW. Connecting the circle from home to heart-failure disease management. N Engl J Med 2010 Nov 16 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21080836 <Internet> http://dx.doi.org/10.1056/NEJMe1011769 - ↑ 11.0 11.1 Takahashi PY et al. A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits. Arch Intern Med 2012 May 28; 172:773 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22507696
Wilson SR and Cram P. Another sobering result for home telehealth - And where we might go next. Arch Intern Med 2012 May 28; 172:779. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22507698 - ↑ 12.0 12.1 Costantino ME et al The Influence of a Postdischarge Intervention on Reducing Hospital Readmissions in a Medicare Population. POPULATION HEALTH MANAGEMENT. Volume 00, Number 00, 2013 DOI:http://dx.doi.org/ 10.1089/pop.2012.0084 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23537154
- ↑ 13.0 13.1 McKinstry B et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: Multicentre randomised controlled trial. BMJ 2013 May 24; 346:f3030 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23709583
- ↑ 14.0 14.1 Clark RA, Inglis SC, McAlister FA et al Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis. BMJ. 2007 May 5;334(7600):942. Epub 2007 Apr 10. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17426062
- ↑ 15.0 15.1 Owsley C et al Diabetes Eye Screening in Urban Settings Serving Minority Populations. Detection of Diabetic Retinopathy and Other Ocular Findings Using Telemedicine. JAMA Ophthalmol. Published online November 13, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25393129 <Internet> http://archopht.jamanetwork.com/article.aspx?articleid=1935407
- ↑ Daniel H, Sulmasy LS Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper. Ann Intern Med. Published online 8 September 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26344925 <Internet> http://annals.org/article.aspx?articleid=2434625
- ↑ Kumar G, Falk DM, Bonello RS et al The costs of critical care telemedicine programs: a systematic review and analysis. Chest. 2013 Jan;143(1):19-29. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22797291 Free PMC Article
- ↑ Agency for Healthcare Research and Quality (AHRQ) Technical Brief - Final - Jun. 30, 2016 Telehealth: Mapping the Evidence for Patient Outcomes From Systematic Reviews. https://www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=2254
- ↑ 19.0 19.1 Dorsey ER, Topol EJ State of Telehealth. N Engl J Med 2016; 375:154-161July 14, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27410924 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1601705
- ↑ 20.0 20.1 20.2 Beck CA, Beran DB, Biglan KM et al. National randomized controlled trial of virtual house calls for Parkinson disease. Neurology 2017 Aug 16 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28814455 <Internet> http://www.neurology.org/content/early/2017/08/16/WNL.0000000000004357
- ↑ 21.0 21.1 Halpren-Ruder D Why Give It Up? My Late-Career Fellowship NEJM Catalyst. Jan 16, 2018 https://catalyst.nejm.org/late-career-fellowship/
- ↑ 22.0 22.1 22.2 Koehler F, Koehler K, Deckwart O et al. Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): A randomised, controlled, parallel-group, unmasked trial. Lancet 2018 Aug 24; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30153985 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31880-4/fulltext
Cleland JFG. Clark RA. Telehealth: Delivering high-quality care for heart failure. Lancet 2018 Aug 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/3015398 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31995-0/fulltext - ↑ 23.0 23.1 Martinez KA, Rood M, Jhangiani N et al Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length: An Observational Study of Telemedicine. Ann Intern Med. 2018. Oct 2 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30285078 <Internet> http://annals.org/aim/article-abstract/2705709/antibiotic-prescribing-respiratory-tract-infections-encounter-length-observational-study-telemedicine
Martinez KA et al. Association between antibiotic prescribing for respiratory tract infections and patient satisfaction in direct-to-consumer telemedicine. Ann Intern Med 2018 Oct 1; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30285050
Zuger A How Do Patients Feel About Leaving Visits Empty-Handed? NEJM Journal Watch. Oct 2, 2018 Massachusetts Medical Society (subscription needed) http://www.jwatch.org - ↑ Barnett ML, Ray KN, Souza J et al Trends in Telemedicine Use in a Large Commercially Insured Population, 2005-2017. JAMA. 2018;320(20):2147-2149 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30480716 https://jamanetwork.com/journals/jama/article-abstract/2716547
- ↑ 25.0 25.1 Champagne-Langabeer T, Langabeer JR, Roberts KE, et al. Telehealth impact on primary care related ambulance transports. Prehosp Emerg Care 2019 Jan 9; 1-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30626250 https://www.tandfonline.com/doi/abs/10.1080/10903127.2019.1568650
- ↑ 26.0 26.1 26.2 Reed ME, Huang J, Parikh R et al. Patient-provider video telemedicine integrated with clinical care: Patient experiences. Ann Intern Med 2019 Apr 30; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31035294
- ↑ 27.0 27.1 Choi NG et al. Effect of telehealth treatment by lay counselors vs by clinicians on depressive symptoms among older adults who are homebound: A randomized clinical trial. JAMA Netw Open 2020 Aug 3; 3:e2015648. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32865577 PMCID: PMC7489833 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770049
- ↑ Croymans D, Hurst I, Han M Telehealth: The Right Care, at the Right Time, via the Right Medium. NEJM Catalyst. December 30, 2020 https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0564
- ↑ 29.0 29.1 29.2 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
Batsis JA, DiMilia PR, Seo LM, et al. Effectiveness of ambulatory telemedicine care in older adults: a systematic review. J Am Geriatr Soc. 2019;67(8):1737-1749 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31066916 PMCID: PMC6684409 Free PMC article https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.15959
Block BL, Smith AK, Sudore RL. During COVID-19, outpatient advance care planning is imperative: we need all hands on deck. J Am Geriatr Soc. 2020;68(7):1395-1397 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32359075 PMCID: PMC7267338 Free PMC article https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.16532 - ↑ Rivera V, Aldridge MD, Ornstein K, Moody KA, Chun A. RESEARCHRacial and Socioeconomic Disparities in Access to Telehealth. J Am Geriatr Soc. 2021 Jan;69(1):44-45. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33075143 PMCID: PMC8726710 Free PMC article.