Telemedicine may be appropriate for delivering ‘bad news’: study

A study of a pilot telemedicine program, JeffConnect, administered by Thomas Jefferson University in Philadelphia during 2015 with 32 patients who received free primary care services via doctor-patient video consults (called telehealth here) has some interesting directional findings. The first was high overall satisfaction among the 19 respondents interviewed, including caregivers, with minimal wait times and far more convenience from home or work, aside from some difficulty in connecting. The second, and the most surprising, was this:

Patients had different perspectives on whether they prefer to hear bad news in a video call. Some said they preferred it, thinking that they could get the news earlier and be in a comfortable location with supportive people. One participant explained, “If it was something earth-shattering, you could cry in your own bedroom and not have to worry, I mean driving from downtown and you’re upset or what-not…” Others preferred to receive serious news in person, explaining, “If the doctor were telling me I have a fatal disease or a disease that could be fatal, and I have to go into immediate serious care, probably better in-person.” Several patients stated no clear preference between the 2 options.

This subject warrants more investigation with a larger cohort. Annals of Family Medicine. Also mHealth Intelligence.

Telemedicine, telehealth follow up to reduce emergency room revisits

A great deal of importance has been placed on reducing same-cause hospital readmissions, but what about emergency room (ER, Emergency Department=A&E in UK) revisits? Sometimes they are needed–for increased pain, further testing or medication checks when the staff is doubtful the patient will follow up on their own–but often not. Two telemedicine/telehealth programs in Pennsylvania aims to cut these high rates of return–up to 20 percent in a month. Thomas Jefferson University Hospital is piloting video call follow up plus a call center to phone patients at risk of revisit to help with needed appointments. A group of insurers and providers, the HealthShare Exchange of Southeastern Pennsylvania, will also share patient information among local ERs when the insurance number is entered, a measure that may prevent unneeded testing. Modern Healthcare Hat tip to our readers at Practice Unite