Telehealth chronic disease self-management effective for boosting care to isolated areas

Telehealth chronic disease self-management programs can be effective for boosting care access to isolated areas, research published this month in Telemedicine and e-Health has determined.

The study's authors--from the University of Toronto, the Women's College Research Institute of Toronto and Public Health Ontario--noted that in rural areas, education for chronic conditions is hard to spread because of limited access and funds.

In their study, 19 chronic disease self-management via telehealth programs (tele-CDSMPs) were delivered to 13 rural communities. After participating in either a single telehealth site or one linked to more communities, 44 people participated in a focus group. The following four themes emerged from the focus group:

  1. The program bridges the access gap
  2. Group dynamics are important in participation of the program
  3. Strong leaders must take charge in the program
  4. Program participants wanted extended session time

Transportation, lack of session time and access to Internet-based resources were identified as barriers to success in the telehealth programs.

Statistically significant improvements from baseline to four-month follow-up were found for self-efficacy, exercise behavior, cognitive symptom management, communication with physicians, psychological well-being, energy, health distress and self-related health, the study's authors found. More favorable results were found for online delivery than telephone delivery.

"Our findings suggest overall the tele-CDSMP was a positive experience for participants and that tele-CDSMPs are an effective option to increasing access to more geographically isolated communities," the authors said.

Telehealth isn't only about knowing the patient and the treatment--knowing the technology is equally important, Leigh Ann Chandler Poole, M.D., a nurse practitioner at the University of Alabama, said at the 2013 mHealth Summit in Washington, D.C., last week.

Poole said telehealth is about datasets, as well as practical implications and quality improvement. Alabama's program, she said, teaches students the importance of taking pictures of the equipment used for telehealth consultation, and learning how to operate it. In addition, the program teaches do's and don'ts for lighting, background room locations and basic camera functionality to ensure smooth visits.

The Centers for Medicare & Medicaid Services recently announced changes to Medicare's 2014 physician fee schedule to expand coverage for telehealth services.

To learn more:
- read the study in Telemedicine and e-Health

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