Report: More research needed on emerging telemedicine models

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While evidence supports the use of telemedicine for a scenario like remote monitoring of patients with chronic conditions, there is little research to support its use in other areas, such as maternal health, according to a technical brief from the Agency for Healthcare Research and Quality (AHRQ).

The Pacific Northwest Evidence-based Practice Center in Portland, Oregon, analyzed 58 systematic reviews assessing the vast amount of research and conducted interviews with key stakeholders in the industry to create an “evidence map” for telemedicine for AHRQ. A draft of the report was released in December.

The work grew from a push by Sens. Bill Nelson (D-Fla.) and John Thune (R-S.D.) for evidence backing expanded access to telemedicine.

While much of the literature reviewed showed positive results from use of telemedicine, such a review is difficult because studies vary so widely in setting, by condition, technology and expected impact, according to the report. Even the technology can be used in myriad ways--from videoconferencing and remote monitoring to image exchange and streaming media to wireless communications.

The reviewers, however, said there is strong evidence to support the effectiveness of telehealth for specific uses including monitoring patients with chronic conditions, communication and counseling for patients with chronic conditions and psychotherapy as part of behavioral health. For these applications, the focus of future research should be on broader implementation and addressing barriers, they said.

Other uses have been studied less, including triage for urgent care/primary care, maternal health, and pediatric cancer and chronic pediatric health conditions. Evidence for these use cases is less clear, according to the authors. In addition, while teledermatology has been widely studied, the research has largely been on diagnostic accuracy rather than patient outcomes.

Future research also needs to cover new healthcare organizational models and payment models, the report's authors added.

To learn more:
- here's the technical brief