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8/23/2013
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Telemedicine Improves Patient Outcomes: Study

Researchers at UC Davis Children's Hospital find that telemedicine consults improved pediatric patient outcomes in rural areas.

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Telemedicine technology is a hot commodity these days -- but is it actually effective in improving patient outcomes? Researchers at UC Davis Children's Hospital say it is.

Researchers found telemedicine consults significantly improved outcomes for patients treated in rural pediatric emergency departments that lack pediatric specialists. They also found a physician was more likely to adjust the patient's diagnosis and course of treatment after a face-to-face video conference with a specialist.

"Telemedicine is going to be the future," said Madan Dharmar, an assistant research professor in UC Davis's pediatric telemedicine program and the study's lead author. "The shortage of physicians in rural communities isn't going to be solved by increasing the number of physicians, but by increasing the number of physicians available over telemedicine."

[ What could the private sector learn from the VA's telehealth model? Read Why The Private Sector Lags VA In Telehealth. ]

Only 3% of pediatric critical care specialists live in rural areas, serving the 21% of U.S. children who live in those areas.

The face-to-face communication was responsible for improved outcomes, according to James Marcin, director of the UC Davis Children's Hospital Pediatric Telemedicine Program and the study's senior author. "More time is spent on a video consult than a phone consult. Rural doctors asked more questions and UC doctors provided more recommendations when video conferencing.

"When you go to see the doctor, they don't come in with their eyes closed," Marcin added. "We'll be better at providing better advice when we open our eyes."

Researchers examined data collected from five rural California pediatric emergency departments from 2003 to 2007. The EDs were equipped with uniform telemedicine technology, which was met with some resistance at first.

"Some of the rural doctors [who] were old-school said, 'I can just use the phone; why should I use this?'" Marcin said. "But when physicians used it, they liked it and they used it more."

To aid the adoption process, UC Davis doctors conducted periodic test calls to check in and help the rural doctors adjust to the technology. Some were uncomfortable seeing themselves on the screen, Marcin said, so the test calls helped them acclimate.

The benefits of telehealth are increasingly being recognized. Florida state senator Arthenia Joyner is sponsoring a bill that would make Florida the 20th state to require private insurers to cover telehealth services.

"The technology is readily available," Marcin said. "There's no excuse why it shouldn't be used."

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ANON1245959207624
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ANON1245959207624,
User Rank: Apprentice
9/3/2013 | 1:33:31 PM
re: Telemedicine Improves Patient Outcomes: Study
More time spent in video conferences than in audio conferences -- that doesn't necessarily mean those are "better" conferences. How about providing some real DATA showing patient outcomes? I was a Principal Investigator for a large mid-western telemedicine group and know that the time required for some video consultations was considered a negative aspect of the technology by both urban medical center specialists and rural generalists.

The data set you make reference to is 2003 to 2007. This is ANTIQUE in terms of the technology (as well as medical care).
ChrisMurphy
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ChrisMurphy,
User Rank: Author
8/26/2013 | 8:03:56 PM
re: Telemedicine Improves Patient Outcomes: Study
I think it's a matter of picking the right spots for telemedicine. Doctors of course can't do everything remotely -- exams that rely on touch are impossible today, for example. But right now it's such an under-utlitized resource, held back fare more by payment models than by technology, that we're far from the extreme of over-using it.
jaysimmons
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jaysimmons,
User Rank: Apprentice
8/26/2013 | 6:47:53 PM
re: Telemedicine Improves Patient Outcomes: Study
I agree, the technology is available so there really shouldn't be major reasons why telemedicine isn't being widely implemented or why insurance companies aren't covering telehealth services. There are a lot of positives, which in my opinion outweigh the negatives out there. In this case, giving physicians the ability to communicate with specialists remotely is an amazing concept that should be more widely accepted. I think one of the greatest things about health IT is the ease in which providers could potentially communicate with each other and obtain advice from peers, whether it is using telehealth services or even website forums.

Jay Simmons
Information Week Contributor
David F. Carr
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David F. Carr,
User Rank: Author
8/26/2013 | 1:50:09 PM
re: Telemedicine Improves Patient Outcomes: Study
Any discussion of the drawbacks? Can it really be true that there are none?
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