A systematic review of economic analyses of telehealth services using real time video communication

Abstract

BackgroundTelehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery. This systematic review assesses the economic value of one type of telehealth delivery - synchronous or real time video communication - rather than examining a heterogeneous range of delivery modes as has been the case with previous reviews in this area.MethodsA systematic search was undertaken for economic analyses of the clinical use of telehealth, ending in June 2009. Studies with patient outcome data and a non-telehealth comparator were included. Cost analyses, non-comparative studies and those where patient satisfaction was the only health outcome were excluded.Results36 articles met the inclusion criteria. 22(61%) of the studies found telehealth to be less costly than the non-telehealth alternative, 11(31%) found greater costs and 3 (9%) gave the same or mixed results. 23 of the studies took the perspective of the health services, 12 were societal, and one was from the patient perspective. In three studies of telehealth to rural areas, the health services paid more for telehealth, but due to savings in patient travel, the societal perspective demonstrated cost savings. In regard to health outcomes, 12 (33%) of studies found improved health outcomes, 21 (58%) found outcomes were not significantly different, 2(6%) found that telehealth was less effective, and 1 (3%) found outcomes differed according to patient group. The organisational model of care was more important in determining the value of the service than the clinical discipline, the type of technology, or the date of the study.ConclusionDelivery of health services by real time video communication was cost-effective for home care and access to on-call hospital specialists, showed mixed results for rural service delivery, and was not cost-effective for local delivery of services between hospitals and primary care.

Online genetic counseling from the providers’ perspective: counselors’ evaluations and a time and cost analysis

“…2 Depending on the modality chosen, introduction of telemedicine applications may not only have impact on patients and presymptomatic clients, but also on professionals and healthcare costs. Several reports indeed support its favorable cost-effectiveness, (http://www.americantelemed.org/docs/default-source/policy/examplesof-research-outcomes-telemedicine's-impact-on-healthcare-costand-quality.pdf) 6,7 but also point to technical and privacy issues. 1, 2 Reports on interactive telemedicine application in genetics mainly originate from countries with large traveling distances.…”

Telegenetics: a systematic review of telemedicine in genetics services

“…9,10 The data relating to the cost-effectiveness of telemedicine are also mixed; a recent review found that synchronous video communication was cost effective for home care and access to on-call hospital specialists but not for the local delivery of services between hospitals and primary care. 11 Despite the lack of consensus within the literature regarding the effectiveness of telemedicine in improving the quality of, or access to health care, its use remains widespread. 12 Telemedicine may be particularly effective in medical specialties in which verbal interactions are a key part of the assessment process, such as in psychiatry and neurology.…”

Telemedicine uptake among Genetics Professionals in Europe: room for expansion

“…A common goal of telemedicine applications throughout various medical disciplines is to provide an effective, efficient, and patient-friendly way of care. [1][2][3] Moreover, it can reach patients who are difficult to reach by conventional 'in-person' care methods, for example, due to large distances and traveling costs. 4,5 Telemedicine has been introduced in various medical disciplines, including clinical genetics, where it has been referred to as telegenetics.…”