A systematic review of economic analyses of telehealth services using real time video communication

Each week, we select an article from an influential journal that has broad implications for health care and has just become available for free online.

As defined in this week’s article, “Telehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery.”

These are appealing rationales, all right, and the authors set out to see whether telehealth lives up to its own ambitions. To do this, they conducted a meta-analysis, which looks at results across multiple studies. The authors conclude that telehealth generally lives up to its aims – it usually costs less, it often (but not always) improves patient outcomes, and it’s generally more convenient for patients. Picture someone in the Australian Outback who otherwise might have to drive 200 miles to see a health professional, and you can imagine the advantage of “seeing” your doctor from a room in the back of the local post office or something. 

Reading the article in detail, it’s clear that you get the best results when the telehealth system is set up with greatest care, so if this is a panacea it’s not a simple one.

Check out the abstract below or go right to the free full text.

PubMed Citation:

BMC Health Serv Res. 2010 Aug 10;10:233.

A systematic review of economic analyses of telehealth services using real time video communication.

Wade VA, Karnon J, Elshaug AG, Hiller JE.

Discipline of Public Health, The University of Adelaide, North Tce, Adelaide 5005, Australia. victoria.wade@adelaide.edu.au

Abstract

BACKGROUND: Telehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery. This systematic review assesses the economic value of one type of telehealth delivery–synchronous or real time video communication–rather than examining a heterogeneous range of delivery modes as has been the case with previous reviews in this area.

METHODS: A systematic search was undertaken for economic analyses of the clinical use of telehealth, ending in June 2009. Studies with patient outcome data and a non-telehealth comparator were included. Cost analyses, non-comparative studies and those where patient satisfaction was the only health outcome were excluded.

RESULTS: 36 articles met the inclusion criteria. 22(61%) of the studies found telehealth to be less costly than the non-telehealth alternative, 11(31%) found greater costs and 3 (9%) gave the same or mixed results. 23 of the studies took the perspective of the health services, 12 were societal, and one was from the patient perspective. In three studies of telehealth to rural areas, the health services paid more for telehealth, but due to savings in patient travel, the societal perspective demonstrated cost savings. In regard to health outcomes, 12 (33%) of studies found improved health outcomes, 21 (58%) found outcomes were not significantly different, 2(6%) found that telehealth was less effective, and 1 (3%) found outcomes differed according to patient group. The organisational model of care was more important in determining the value of the service than the clinical discipline, the type of technology, or the date of the study.

CONCLUSION: Delivery of health services by real time video communication was cost-effective for home care and access to on-call hospital specialists, showed mixed results for rural service delivery, and was not cost-effective for local delivery of services between hospitals and primary care.

Leave a Reply