Telehealth Opens Doors to Enhance Health Outcomes and Reduce Costs
Telehealth solutions are making significant inroads to reverse high health care expenditures and reduce noncompliance with prescription therapies – issues that especially impact those living with chronic disease.
By engaging patients in health education through classes, patient portals, real-time patient-provider consultations, online discussion forums and more, telehealth strategies empower providers to monitor disease progression and intervene with patients at an earlier stage, when conditions may be more easily treated.
A digital conduit that delivers medical care, health education, and public health services, telehealth connects multiple users in separate locations. Telehealth services consist of diagnosis, treatment, assessment, monitoring, communications and education. It includes a broad range of telecommunications, health information, videoconferencing, and digital image technologies.
And what’s best of all? Telehealth is working in many situations. Here are a few examples:
Case Study #1: Telehealth plays an instrumental role in supporting the care of veteran patients with chronic conditions. They are part of a national program from the US Veterans Health Administration to coordinate the care of veterans with chronic conditions at home and avoid unnecessary admission to long-term institutional care. The program included the systematic implementation of health informatics, home telehealth, and disease management technologies for six conditions including diabetes mellitus, congestive heart failure, hypertension, posttraumatic stress disorder, chronic obstructive pulmonary disease, and depression.
Patients involved in the program benefitted from a 25 percent reduction in the number of bed days of care and a 20 percent reduction in hospital readmissions. According to a study of the program, the basis for reduced utilization of health care resources for the patients involved was due to the program’s foundation in patient self-management, disease management and the use of virtual visits.
Case Study #2: At Partners HealthCare in Boston, a home telehealth program focusing on cardiac care resulted in a 50 percent reduction in heart failure hospital readmissions, for a total cost savings of more than $10 million since 2006. The Connected Cardiac Care Program is a centralized telemonitoring and self-management and preventive care program for heart failure patients that combines telemonitoring with nurse intervention and care coordination, coaching and education. The daily transmission of weight, heart rate, pulse and blood pressure data by patients enables providers to more effectively assess patient status and provide just-in-time care and patient education.
Patients in the program use equipment – a home monitoring device with peripherals to collect weight, blood pressure, and heat rate measurements, and a touch-screen computer to answer questions about symptoms – on a daily basis for four months. Telemonitoring nurses monitor these vitals, respond to out-of-parameter alerts, and guide patients through structured biweekly heart failure education.
Cost to the patients? Zero.
Case Study #3: A telehealth strategy using webinars had a small but “positive impact on hypertensive patients” in Brazil, in terms of their adherence to antihypertensive drugs, low salt diet and physical activity. The program was managed by Family Health Teams (FHTs) consisting of doctors, nurses, nurse technicians and community health agents. According to researchers studying the program, the vast majority of practitioners do not specialize in primary care, and only recently have specialized courses emerged to provide that training.
“Given the country’s continental dimensions, high demand, and inadequate amount of training and continuing education centers for primary care professionals, telehealth presents itself as a promising strategy to improve access to training, leading to the improvement of hypertension,” they noted.
Despite growing evidence that telehealth is working for more and more patients, concerns remain about security, privacy and medical liability, with critics also arguing that telehealth lacks common standards. Government agencies, they say, have often been slow to reimburse patients for many telehealth services. Further, some health professionals argue that telehealth threatens to compromise the doctor-patient relationship.
Tell us what you think. Do the advantages of telehealth outweigh possible drawbacks? Have you leveraged telehealth services, either as a patient or provider?
