Passive, telephone-based telemedicine is hardly common sense

It's hard not to sound smug when commenting on studies that beg questions that are obvious to anyone with a hint of knowledge about health IT, so I make no apologies for what I'm about to say: Duh!

This is the reaction I had to a Los Angeles Times story about a Yale University study--presented at a recent American Heart Association meeting and published in the prestigious New England Journal of Medicine--that found little difference in hospital readmission rates of newly discharged patients with heart failure, whether they called in weight measurements and symptoms to their doctors or not.

"We had a lot of faith and hope that providing increased information could improve outcomes," study leader Dr. Sarwat I. Chaudhry reportedly said at the AHA meeting in Chicago. "Obviously that wasn't enough."

The Times writer offered this summary: "It was a good, commonsense idea that simply didn't work out."

Well, one person's common sense is another person's, "What were they thinking?" I'm that other person.

Keeping in touch with one's doctor on a daily basis after receiving inpatient care for heart failure isn't a bad idea, nor is monitoring one's weight. But, as happened in the Yale study, patients don't stick with the program. According to the Times, only 55 percent of study participants still were making at least three calls per week six months after discharge.

Plus, self-reported symptoms can't catch everything a wearable monitor can. Give the patients a small, wireless sensor to strap on to their bodies each day and let the sensor automatically report real-time data via the Internet or a cell phone--or at least send warnings to clinicians when there's an abnormal reading. That's what I call modern telemedicine. Asking patients to remember to pick up the telephone may be telemedicine by traditional definitions, but the technology is hopelessly stuck in the 20th century. - Neil