Telehealth consultations produce effective outcomes

“Telehealth for Acute and Chronic Care Consultations,” a new report released by the Agency for Healthcare Research and Quality (AHRQ), which reviewed use of the technology in various settings and for various conditions, indicates that telehealth consultations produced mostly positive outcomes.

AHRQ said the aim of the study was to “maximize the utility of available information by presenting the results in formats that support decision makers at various levels (e.g., regulators, providers, and payers) as they consider policy and practice changes related to telehealth for consultation.”

The agency said it combined a broad systematic review of various clinical indications, with an exploratory decision model for one selected clinical application. Both systematic reviews and decision analyses have accepted methodologies, but they are not frequently used in tandem, explained AHRQ in a news release, adding that “In this sense, this project is experimental as it strives to provide the results of a traditional systematic review of the available research and explore how the addition of decision analysis might be used to increase the utility of evidence for decision makers.”

Key questions explored:

1. Are telehealth consultations effective in improving clinical and economic outcomes? Clinical and economic outcomes may include, but are not limited to, mortality and morbidity, patient-reported outcomes, quality of life, utilization of health services, and cost of services.

2. Are telehealth consultations effective in improving intermediate outcomes? Intermediate outcomes include both outcomes that precede the ultimate outcomes of interest (e.g., mediators) and secondary outcomes. Intermediate outcomes may include, but are not limited to, access to care, patient and provider satisfaction, behavior, and decisions (e.g., patient completion of treatment, provider antibiotic stewardship); volume of services; and healthcare processes (e.g., time to diagnosis or treatment).

3. Do telehealth consultations result in harms, adverse events, or negative unintended consequences?

4. What are the characteristics of telehealth consultations that have been the subject of comparative studies?

Key outcomes include:

·   Remote intensive care unit consultations likely reduce mortality.

·   Specialty telehealth consultations likely reduce patient time in the emergency department.

·   Telehealth consultations in emergency services likely reduce heart attack mortality.

·   Remote consultations for outpatient care likely improve access and clinical outcomes.

·   More detailed telehealth consultation costs and outcomes data would improve modeling assumptions.

·   Future research should employ rigorous methods and standardized outcomes for consistent measurement of telehealth consultation effectiveness.