Turning to technology to change the way patients with chronic disorders communicate with their primary care team seems like a great idea. But the reality is that, at least as its used today, it's not accomplishing the original aim.
A British study of patients with chronic diseases equipped with telehealth technology to reduce the demands on their primary care providers failed to show any reduction. The research was published by BMC (Biomedcentral) Health Services Research and based on a long term study of more than 2,000 patients, half of them in a control group using no telehealth technology.
The researchers noted that most telehealth studies have focused on hospital patients, and that very few studies are available that investigate the impact of telehealth on patients and their primary care providers.
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"Up until recently, studies that looked at primary care tended to focus on specific populations or issues, such as mental health problems or geographically dispersed communities," the BMC article reported. "The few studies that have considered similar forms of telehealth to those tested in this trial, have often reported more positive findings than here. For example, a feasibility study in 20 elderly patients indicated a time saving for the GP, while a study of home telemonitoring in heart failure patients found reductions in use of clinic visits. However these studies were much smaller than this trial and for this reason may have recruited unrepresentative patients."
So the researchers undertook a more ambitious study. They basically found no change in "touches" between physician and telehealth-equipped patient.
"We found no evidence to support the theory that telehealth alters rates of contact with general practices," the article said. "Our adjusted estimate suggested telehealth was associated with an increase of 4 percent in general practitioner consultations but this was not statistically significant on this sample.
"The use of home-based telehealth for people with chronic disease did not appear associated with changes in the frequency with which people contacted general practitioners and practice nurses. This suggests that fears that the widespread increase in the use of this technology may increase the burden on primary are unfounded," they concluded.
"Conversely, we did not find evidence that telehealth led to a significant reduction in GP workload. We note that the way that telehealth impacts on primary care roles may be influenced by a number of other features in the health system. The challenge is to ensure that these systems lead to better integration of care than fragmentation."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
