Interactive telemedicine: effects on professional practice and health care outcomes

Flodgren, Gerd; Rachas, Antoine; Farmer, Andrew; Inzitari, Marco; Shepperd, Sasha

doi:10.1002/14651858.cd002098.pub2

Cited by 634 publications

(684 citation statements)

References 455 publications

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“…Two randomized trials of telemonitoring in CHF patients [21] and COPD [34] patients did not show a reduction in rehospitalizations. A recent Cochrane review of telemonitoring in heart failure that included studies where participants were recruited from the hospital showed no consistent benefit relative to hospitalization or mortality but improved quality of life [35]. IVR interventions appear to have the potential to affect positive quality of life outcomes on both patients and their care partners [36]; however, these outcomes were not the focus of this study.…”

Section: Discussionmentioning

confidence: 74%

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Ritchie

Houston

Richman

et al. 2016

Behav. Med. Pract. Policy Res.

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Care transitions from the hospital to home remain a vulnerable time for many patients, especially for those with heart failure (CHF) and chronic obstructive pulmonary disease (COPD). Despite regular use in chronic disease management, it remains unclear how technology can best support patients during their transition from the hospital. We sought to evaluate the impact of a technology-supported care transition support program on hospitalizations, days out of the community and mortality. Using a pragmatic randomized trial, we enrolled patients (511 enrolled, 478 analyzed) hospitalized with CHF/COPD to "E-Coach," an intervention with conditionspecific customization and in-hospital and postdischarge support by a care transition nurse (CTN), interactive voice response post-discharge calls, and CTN follow-up versus usual post-discharge care (UC). The primary outcome was 30-day rehospitalization. Secondary outcomes included (1) rehospitalization and death and (2) days in the hospital and out of the community. ECoach and UC groups were similar at baseline except for gender imbalance (p = 0.02). After adjustment for gender, our primary outcome, 30-day rehospitalization rates did not differ between the E-Coach and UC groups (15.0 vs. 16.3 %, adjusted hazard ratio [95 % confidence interval]: 0.94 [0.60, 1.49]). However, in the COPD subgroup, ECoach was associated with significantly fewer days in the hospital (0.5 vs.

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Section: Discussionmentioning

confidence: 74%

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Ritchie

Houston

Richman

et al. 2016

Behav. Med. Pract. Policy Res.

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“…[6] Flodgren et al found that the use of telemedicine in the management of heart failure cases had outcomes comparable to the traditional face-to-face approach. [7] They also reported that telemedicine could improve blood glucose control in those with diabetes. [7] Willis Towers Watson surveyed several employers and reported that because of the convenience and efficiency of telemedicine, it has been implemented in their employee's benefits.…”

Section: Effectiveness Of Telemedicinementioning

confidence: 99%

“…[7] They also reported that telemedicine could improve blood glucose control in those with diabetes. [7] Willis Towers Watson surveyed several employers and reported that because of the convenience and efficiency of telemedicine, it has been implemented in their employee's benefits. [8] The effectiveness of telemedicine is ultimately related to the health care provider, the healthcare system involved, the patient population, and the disease course.…”

Section: Effectiveness Of Telemedicinementioning

confidence: 99%

Telemedicine: New horizons in healthcare

Radfar

Chevalier

Rouse

et al. 2017

JHA

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Objective: Telemedicine allows physicians to provide medical care remotely through audiovisual technology. Telemedicine may address many challenges facing our society: an aging population, chronic disease management, and healthcare cost. With this work, we attempt to evaluate how telemedicine can effect a change in these challenges, and evaluate what obstacles prevent some providers from using it. Methods: In this work, the cost-effectiveness, success of telemedicine care, usefulness in reaching developing and underdeveloped areas, difficulties preventing the use of telemedicine, and proposals to overcome these challenges were reviewed and analyzed. Results: Cost of telemedicine was reported 19% less expensive than traditional face-to-face care. In several studies, telemedicine was documented to have had equal or better outcomes for obstructive sleep apnea, geriatrics, heart failure, preventative medicine, and patient compliance. Difficulties in using telemedicine include affordability of equipment, lack of technical support in developing or underdeveloped areas, legality of licensure and patient privacy and satisfaction. Conclusions: Although cost savings and convenience are major advantages of this technology, concerns with delivery barriers and challenges require cautious embracement of telemedicine. A great deal of research is needed to show that telemedicine improves patient centered outcomes.

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“…Recent studies among adults show promising results. A Cochrane review demonstrated lower glycated hemoglobin (HbA1c) in adults allocated to telemedicine including mHealth apps [9], and a meta-analysis of 55 randomized controlled trials (RCTs) found that telemedicine improved clinical outcomes [10]. A systematic review assessed the effectiveness of self-management applications in long-term conditions and found that six of nine studies significantly improved outcomes [11].…”

Section: Introductionmentioning

confidence: 99%

Testing a Smartphone App (Young with Diabetes) to Improve Self-Management of Diabetes Over 12 Months: Randomized Controlled Trial (Preprint)

Castensøe-Seidenfaden¹,

Husted²,

Jensen³

et al. 2017

Preprint

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Interactive telemedicine: effects on professional practice and health care outcomes

Cited by 634 publications

References 455 publications

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

Telemedicine: New horizons in healthcare

Testing a Smartphone App (Young with Diabetes) to Improve Self-Management of Diabetes Over 12 Months: Randomized Controlled Trial (Preprint)

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