The Doctor Is Always Home
Telemedicine offers patients the ability to communicate with their doctors without ever leaving their home. Despite the obvious benefits for rural and housebound individuals, both patients and physicians have been slow to accept this new way of practicing medicine. For many physicians, there has simply not been enough evidence that telemedicine is effective. Assistant Professor Jami DelliFraine and Associate Professor Kathryn Dansky, both of health policy and administration, recently presented a comprehensive analysis of Telemedicine clinical studies at the British Royal Society of Medicine Telehealth and E-Health meeting in London and say that telemedicine does work.
Jami DelliFraine
Says DelliFraine, "Though there are a large number of studies of telemedicine, those studies have been so diverse that the overall efficacy of telemedicine remained unclear. The research has been in different settings, using different measures of effectiveness and showing conflicting results." DelliFraine and Dansky attempt to provide a useful and comprehensive synthesis of the research. They reviewed over 145 health sciences articles evaluating telemedicine, 49 of which provided statistically sound assessments of the clinical effectiveness. Their analysis of the overall picture? The studies do suggest that telemedicine works--particularly for chronic conditions that require constant monitoring.
Telemedicine can include a number of means for patients to communicate with their doctors--from units to collect blood sugar readings to computers with audio/video links allowing doctors and nurses to view how a wound is healing and to listen to a patient's heart and lungs. It appears that these devices, allowing exchange of information between office visits, do help patients maintain their health and stay out of emergency rooms and doctors' offices. According to the studies, many patients using telemedicine report generally better health status, less severe symptoms, and better self-management behaviors than patients without access to the technology.
Given the still rapidly increasing costs of health care in the U.S., telemedicine may provide the best avenue for reducing costs while still improving the quality of health care services. A number of barriers need to be overcome--health care professionals are reluctant to accept new technologies, and in an era of identity theft, patients are understandably concerned about privacy over phone lines and faulty equipment. However, "the benefits do outweigh these concerns," says DelliFraine, "particularly for individuals suffering from conditions requiring close monitoring." It is also a mode of treatment that could be useful in rural areas currently underserved by physicians. Preliminary information also indicates it could also be useful in treatment of obesity, though DelliFraine cautions, "we need more work in those areas."