The results are far better than parity with in-person visits for follow up. A group of 254 patients and 61 health care providers were the subject of a survey conducted by researchers at Massachusetts General Hospital, part of Partners HealthCare, and Johns Hopkins. It found that virtual video visits (VVVs) are perceived by the majority of patients as the same as or better than office visits in convenience and cost, at the same level of quality and personal connection. It measured responses from both patients and providers in the MGH TeleHealth (sic) program, in place since 2012, in follow up care from providers in psychiatry, neurology, cardiology, oncology and primary care (the last two added late in the survey).
The results were:
- The vast majority (94.5%) of patients preferred the travel time (minimal) and time convenience (79.5%) of the VVV
- Most patients (62.6%) and clinicians (59.0%) reported “no difference” between VVV and office visits on “the overall quality of the visit.”
- When rating “the personal connection felt during the visit”, over half–but more patients than clinicians–said that there was “no difference” with the VVV (patients, 59.1%; clinicians, 50.8%), although 32.7% of patients and 45.9% of clinicians reported that the “office visit is better”.
- They were also willing to pay for it–and that increased with distance from the doctor. Among those who traveled more than 90 minutes to an office visit, 51.5% indicated they would pay a co-payment of more than $50 for a VVV compared with 30.4% of those who traveled less than 30 minutes.
- Results graphs are here
The survey results were published in the American Journal of Managed Care. This month’s issue also examines gamification in healthcare, asynchronous communication between primary and specialty care practitioners at Geisinger, EHRs–and the relationship between data breaches and not surprisingly increased advertising expenditures after the fact to rebuild lost trust. According to this last article, breached hospitals were more likely to be large, teaching, and urban hospitals relative to the control group.
Also UPI and HealthDay.
Gartner annually issues its Hype Cycle for Emerging Technologies in the Dog Days of August, perhaps not to burst too many bubbles, derail too many fundings?
- Lo and behold, ‘mobile health monitoring ‘ is heading towards the bottom of the Trough of Disillusionment. Moreover, its recovery is projected at 5-10 years to move out of the Trough, whip through the Slope of Enlightenment and enter the sunny uplands of the Plateau of Productivity. See Gartner chart below.
A development that deserves more attention is the use of ‘gamification’ in rehab. In one program, it’s using a combination of incentives, brain stimulation and robotics. The popular Candy Crush Saga game uses a moving candy target, rewards (to higher levels) and reduced reaction times at the harder levels. The Manhasset, New York-based Feinstein Institute for Medical Research at North Shore-LIJ Health System is testing this notion with rehab for paralyzed limbs. Instead of concentrating on training other limbs to compensate for the paralyzed ones, the Non-Invasive Stroke Recovery Lab program focuses on gaining more movement in the affected limbs. Using robots to move the limb at first, then sensing when the patient is moving them on their own, they gradually train the brain to move the limb for whatever motion can be achieved. Therapists use these programs with patients to gain the “just-right” amount of challenge to maintain motivation and attention. According to their website, several programs are being tested using devices for the wrist, shoulder-elbow, hand and an anti-gravity one for the shoulder. A fifth one is in early development to improve gait post-stroke. Also in test is coupling this with trans-cranial direct current stimulation. mHealthNews. Feinstein Institute and researcher (Bruce Volpe) website.
Drug manufacturer Pfizer is also testing gamification for a different sort of rehabilitation–using Evo Challenge from Akili Interactive Labs in determining the status of and improving the abilities of those with cognitive impairments, Alzheimer’s disease (with and without amyloid in the brain) and ADHD. The game, which involves navigation around obstacles and rewards, is designed to improve the impaired processing of cognitive interference, a/k/a distractions. MedCityNews
In spite of gamification being at the peak of inflated expectations in the 2013 Gartner Hype Cycle, here’s a great example from the US journal Pediatrics of its use to encourage young people with cancer to improve their medication adherence. The subject was also covered in the BBC’s Click (starts 13.55 into the programme), and the Hope Labs website is here…
…which prompts the question as to where the best examples of gamification use to improve health & wellbeing are on this side of the Atlantic. (more…)