A randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care

Loane, Maria; Bloomer, S E; Corbett, R; Eedy, D.J.; Hicks, Nicholas; Lotery, Helen; Mathews, C; Paisley, Judy; Steele, K; Wootton, Richard

doi:10.1258/1357633001933952

Cited by 53 publications

(33 citation statements)

References 7 publications

(6 reference statements)

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“…We assumed that the outcomes of the two alternatives were similar, based on previous research evidence. [5][6][7][8][9][10] We also included administrative costs, a variable seldom examined in previous research.…”

Section: Methodsmentioning

confidence: 99%

An incremental cost analysis of telehealth in Nova Scotia from a societal perspective

et al. 2005

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We examined the costs of telehealth in Nova Scotia from a societal perspective. The clinical outcomes of telepsychiatry and teledermatology services were assumed to be similar to those for conventional face-to-face consultations. Cost information was obtained from the Nova Scotia Department of Health, the Canadian Institute for Health Information, and questionnaires to patients, physicians and telehealth coordinators. There were 215 questionnaires completed by patients, 135 by specialist physicians and eight by telehealth coordinators. Patient costs for a face-to-face consultation ranged from $240 to $1048 (all costs in Canadian dollars), whereas patient costs for telehealth were lower, from $17 to $70. However, from a societal perspective, the overall cost of providing face-to-face services was lower than for telehealth: the total costs for face-to-face services ranged from $325 to $1133, while the total costs for telehealth services ranged from $1736 to $28,084. A threshold analysis showed that, above a certain patient workload, telehealth services would be more cost-effective than face-to-face services from a societal perspective. This workload is attainable in Nova Scotia.

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Section: Methodsmentioning

confidence: 99%

An incremental cost analysis of telehealth in Nova Scotia from a societal perspective

et al. 2005

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“…Historically, store-and-forward teletechnologies that transmit data, still images, or video recordings [5][6][7] have been used for providing consultative services and monitoring chronic-health conditions [8][9][10]. However, rehabilitation depends on real-time two-way observation, communication, and interaction between the therapist and the patient.…”

Section: Literature Review Teletechnologymentioning

confidence: 99%

Development of a teletechnology protocol for in-home rehabilitation

Hoenig

Sanford²,

Butterfield³

et al. 2006

JRRD

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Abstract-Our ability to provide in-home rehabilitation is limited by distance and available personnel. We may be able to meet some rehabilitation needs with videoconferencing technology. This article describes the feasibility of teletechnology for delivering multifactorial, in-home rehabilitation interventions to community-dwelling adults recently prescribed a mobility aid. We used standard telephone lines to provide twoway video and audio interaction. The interventions included prescription of and/or training in functionally based exercises, home-hazard assessment, assistive technology, environmental modifications, and adaptive strategies. Patients were evaluated in three transfer and three mobility tasks, and appropriate treatment was provided over the course of four visits. To date, 13 of the 14 subjects enrolled in the rehabilitation study have completed all four visits (56 visits total). Equipment-related problems were most common early in the study, particularly on the initial visit to a subject's house.We identified (mean ± standard deviation [SD]) 13.1 ± 7.9 mobility/self-care problems per subject and made 12.5 ± 8.3 recommendations per subject to address those problems. At 6-week follow-up, 60.1 percent of our recommendations had been implemented. The greatest number of problems was identified for tub transfers (mean ± SD = 3.4 ± 1.4), the greatest number of recommendations was made for toilet transfers (mean ± SD = 3.1 ± 3.4), and the most frequently implemented recommendations were for transition between locations. Overall, our results show promise that both the telerehabilitation technology and intervention procedures are feasible.

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“…It has also been shown that there are few differences in the type or complexity of cases referred for teledermatology or in-person consultation 5 . There is still some debate regarding the economic value of teledermatology, but as technology costs have continued to decrease and as more variables have been incorporated into the cost-benefit models, cost-savings have been noted [6][7][8][9] .…”

mentioning

confidence: 99%

The challenges of following patients and assessing outcomes in teledermatology

et al. 2004

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We retrospectively reviewed the follow-up and outcomes of 50 store-and-forward teledermatology patients, and compared the findings with those from a control group of 50 patients who had been seen in person. Patient records were examined for a six-month period following the initial referral to a dermatologist. Variables examined included medical records from the referral, evidence of actions taken (e.g. biopsy), evidence of follow-up visits, and what (if any) clinical outcomes were noted. There were few differences between the teledermatology and in-person groups. The main difference was whether there was any report in the record that the referring clinician took some action based on the consultation with the specialist: there were more reports of action being taken in the teledermatology group than in the in-person group. Reports of outcomes were found in only 6% and 8% of the records of the teledermatology and in-person groups, respectively. The challenges of assessing outcomes in teledermatology for rural patients include patient loss to follow-up, lack of information in the patient records and low rates of patient return to the referring clinician for follow-up.

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A randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care

Cited by 53 publications

References 7 publications

An incremental cost analysis of telehealth in Nova Scotia from a societal perspective

An incremental cost analysis of telehealth in Nova Scotia from a societal perspective

Development of a teletechnology protocol for in-home rehabilitation

The challenges of following patients and assessing outcomes in teledermatology

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