The technology of telehealth or Telemedicine is being applied actively in healthcare. There are various studies that examine the influence of telemedicine on participants: the results demonstrate that telehealth can provide better results than an on-site treatment. Although it might sound doubtful, Davis et al. (2011) conducted a study about the influence of Telemedicine on the treatment of pediatric obesity. For this research, the authors combined family-based behavioral treatments with Telemedicine to evaluate whether it would be effective or not. While family-based behavioral treatments are empirically supported, the use of Telemedicine could either improve or worsen the impact of these treatments. However, as Davis et al. (2011) state, such approach was well received by patients and provides; moreover, “feasibility and satisfaction data regarding the Telemedicine intervention were positive” (p. 71). Thus, this technology can be applied both as a tool to gather information and as a new, innovative approach to off-set treatment.
In another study, Telemedicine was used to provide a complex evidence-based practice to patients living in rural areas, where there was a lack of mental health staff. In this case, Telemedicine was used as a tool for treatment: patients “received evidence-based care from an on-site primary care provider,… telephone pharmacist, tele-psychologist and tele-psychiatrist” (Fortney et al., 2014). The main aim was to see whether there would be a positive treatment response and changes in depression severity. The results of the study have shown that the use of Telemedicine provided better outcomes than the implementation of the same practice but with the help of local staff (Fortney et al., 2014). Thus, Telemedicine has proven to be extremely useful in the world of behavioral health.
RPM and Telemedicine
There are various studies that indicate that RPM and Telemedicine are capable of improving health and financial outcomes across the USA. Demaerschalk, Raman, Ernstrom, and Meyer (2012) conducted a study where they evaluated the impact of the Telemedicine on patients who experienced “acute ischemic stroke in rural underserved communities” (p. 230). The authors stated that Telemedicine consultations resulted in more accurate decision-making compared to phone consultations only (Demaerschalk et al., 2012). Although Telemedicine consultations took more time (they were approx. 8 min. longer), they allowed medical staff to come to a more accurate decision. The correctness of the decision-making was 96% if it was conducted via Telemedicine and 83% if it was a telephone consultation (Demaerschalk et al., 2012, p. 232).
The financial outcomes of Telemedicine remain to be vague. Nevertheless, it should not be assumed that Telemedicine is not capable of being cost-effective. Franzini, Sail, Thomas, and Wueste (2011) evaluated the cost-effectiveness of a Telemedicine-ICU program. According to the authors, while using Telemedicine for patients with SAPS II ≤ 50 was not cost-effective at all, it helped to decrease mortality rates among the sickest patients without bringing additional costs (Franzini et al., 2011). Telemedicine allowed the hospital facility to lower mortality rates by 11.4% (Franzini et al., 2011). Thus, although Telemedicine might not be effective for all ICU patients, it is still capable of decreasing mortality among the sickest ones.
While some patients might not be willing to share their eData, HIPAA regulations and HIE consent models exist to ensure that all data will be secured and protected. Since these regulations provide a set of specific rules, patients should understand that their privacy will be protected.
References
Davis, A. M., James, R. L., Boles, R. E., Goetz, J. R., Belmont, J., & Malone, B. (2011). The use of TeleMedicine in the treatment of paediatric obesity: Feasibility and acceptability. Maternal & Child Nutrition, 7(1), 71-79.
Demaerschalk, B. M., Raman, R., Ernstrom, K., & Meyer, B. C. (2012). Efficacy of telemedicine for stroke: Pooled analysis of the Stroke Team Remote Evaluation using a Digital Observation Camera (STRokE DOC) and STRokE DOC Arizona telestroke trials. Telemedicine and e-Health, 18(3), 230-237.
Fortney, J. C., Pyne, J. M., Mouden, S. B., Mittal, D., Hudson, T. J., Schroeder, G. W., & Rost, K. M. (2013). Practice-based versus telemedicine-based collaborative care for depression in rural federally qualified health centers: A pragmatic randomized comparative effectiveness trial. American Journal of Psychiatry, 170(4), 414-425.
Franzini, L., Sail, K. R., Thomas, E. J., & Wueste, L. (2011). Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system. Journal of Critical Care, 26(3), 329-339.