The US Government’s Agency for Healthcare Research and Quality (AHRQ) released a final and fairly positive report analyzing telehealth effectiveness. It was a meta-review of 58 systematic research reviews on telehealth. Criteria were that the studies could examine real time or asynchronous telehealth, onsite or at distance, and that the patient interacted with healthcare providers for the purposes of treatment, management, or prevention of disease.
The abstract’s conclusions are positive for remote patient monitoring (RPM) for chronic conditions and for telemental health:
- Positive outcomes came from the use of telehealth for several chronic conditions and for psychotherapy as part of behavioral health
- The most consistent benefits were when telehealth was used for communication and counseling, plus remote monitoring in chronic conditions such as cardiovascular and respiratory disease
- The improvements were in outcomes such as mortality, quality of life and reductions in hospital admissions
POLITICO’s Morning eHealth has additional and most interesting background. The AHRQ was tasked by two Senators, John Thune (R-SD) and Bill Nelson (D-FL) to analyze telehealth for effectiveness through a literature review and “to give a government’s view – not an industry-funded study or a poorly-conducted academic study – on what the technology could do if, for instance, Medicare paid for more of it.” The December draft seemed to be ambiguous on telehealth studies to date, citing uneven quality and the poor definition of telehealth. (more…)
An agency of the US Department of Health and Human Services, the Agency for Health Research and Quality (AHRQ), has published, for peer review, a draft of a new report (a “technology assessment”) entitled “Telehealth: an Evidence Map for Decision making”. AHRQ, the report explains, “through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public and private sector organizations in their efforts to improve the quality of health care in the United States.”
The purpose of this new technology assessment is given as creating a review of the evidence available (essentially a literature review) so as to inform decision makers. The authors had identified 1,305 citations about telehealth of which 44 had been selected for this review. Unsurprisingly, the report says ” comparatively large volume of research reported that telehealth interventions produce positive results when used for communication/counseling and monitoring and management for several chronic conditions and for psychotherapy as part of behavioral health.”
It recommends additional primary research be carried out on topics such as telehealth for triage in urgent/primary care, management of serious paediatric conditions and the integration of behavioral and physical health. Finally, it recommends that telehealth research should be integrated into evaluation of new models of care and payment so that the potential of telehealth can be assessed in organizations that are implementing these reforms. (more…)
Ostensibly an interview about Dr Topol’s book ‘The Patient Will See You Now,’ it is more a discussion of Dr Topol’s thesis that patients in control of their data are upending the relationship between doctor (as authority) and patient. What Dr Wachter questions– is the lack of analytics to turn this into useful information for both doctor and patient. Dr Topol agrees that the data is outstripping the analytics:
The field has not been developed nearly the way it should be to get us to the virtual medical assistant, which integrates all relevant data about an individual and provides great data visualization back to that person. Once it does, we have a tremendous opportunity to help people, even to preempt illness.
Dr Topol is also widely depicted as an advocate of ‘DIY’ (do it yourself) medicine, but he is not; “This is more about acquiring diagnostic or monitoring data and still having an intimate relationship with a doctor to help guide the appropriate treatment.” Doctors will have to change their methods too. A worthy Weekend Read (and audio excerpt 08:05) in this month’s AHRQ WebM&M.
Previously in TTA: Dr Topol on his book at last year’s NYeC Digital Health Conference (contrasting with the central control-stop medical intervention at 75 advocacy of Ezekiel Emanuel); Dr Wachter on The Overdose (excerpted from his ‘Digital Doctor’ book)