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Health Outcomes of Telehealth

Written by Dr. Rieka Yu
Published on January 8, 2024
Research Highlights

 

Telehealth can address a range of issues from healthy diets to urgent care issues.

 

Telehealth improves certain health outcomes for pregnant women, children with diabetes, and elderly patients.

 

Telehealth can lead to the overprescription of antibiotics.

There are multiple options for telehealth.

The available telehealth options include talking to a provider on the phone or video call, sending and receiving secure messages, emailing, texting, and using a remote monitoring device to collect vital signs (Table 1; Department of Health and Human Services (HHS 2023).

 

Types of telehealth care include but is not limited to (HHS 2023):

  • Urgent care issues
  • Prescription management
  • Mental health treatment
  • Physical therapy
  • Notifications to exercise or stick with treatment plan
  • Health instructions for diet, mobility, or stress

 

For information on telehealth limitations, see our Broadband & Telemedicine Science Note.

 

Telehealth has some positive effects on patients.

While there are many studies comparing health outcomes of telehealth to in-person health visits, there are few studies comparing telehealth access to a lack of healthcare access.

  • Overall, telehealth is expected to improve patient outcomes due to access to healthcare and timeliness of care (Mahtta et al. 2021).

 

Texting health recommendations to pregnant mothers had mixed effects on outcomes (DeNicola et al. 2020).

  • Texting reduced smoking and led to a greater continuation of breastfeeding.
  • Texting did not affect vaccination rates or healthy eating.
  • Texting had mixed effects on rates of physical activity.
  • The use of a mobile app focusing on pelvic floor muscle training decreased incontinence severity.

 

Telehealth sometimes reduced Cesarian sections, blood glucose levels, and insulin requirements in pregnant women with pre-existing diabetes (DeNicola et al. 2020). Access to remote monitoring devices reduced rates of preeclampsia and medical interventions for high blood pressure in pregnant women.

  • Most of these studies on diabetic pregnant women were performed in high middle-income European countries.

 

When telemedicine was implemented in NY schools, students with diabetes reported lower blood sugar levels and had fewer urgent calls to doctors (Izquierdo et al. 2009). In WY, access to teleconsultation services for children resulted in fewer children being prescribed psychotropic drugs and at lower doses (Hilt et al. 2015). Teleconsultation also redirected children from treatment facilities to alternative community treatments (Hilt et al. 2015). School-based telemedicine in rural NC reduced the likelihood of avoidable emergency department visits (Mayfield et al. 2023).

 

In elderly patients, remote monitoring reduced mortality due to any cause and heart failure-related hospitalizations (Clark 2018). Elderly patients that enrolled in a home-based pulmonary rehabilitation program also showed improvements in shortness of breath, exercise capacity, depression, and quality of life (Drwal et al. 2022).

 

Telehealth can lead to overprescribing.

Compared to face-to-face visits, telehealth visits led to the overprescribing of antibiotics for adults and children (Mehrotra et al. 2013, Ray et al. 2019). This overprescription may be due to physicians being cautious in their treatment when they are unable to directly examine patients (Mehrotra et al. 2013). Antibiotic management followed guidelines less strictly in telehealth settings compared to other settings (Ray et al. 2019).

 

Table 1. Overview of how telemedicine is used for different services. Table adapted from Tuckson et al. 2017.

 

References

Clark RA. 2018. Telehealth in the Elderly with Chronic Heart Failure: What Is the Evidence? In “Telehealth for Our Ageing Society: Selected Papers from Global Telehealth 2017.” Eds. MEL van den Berg & AJ Maeder. IOS Press. Amsterdam, Netherlands. https://books.google.com/books?id=0MFVDwAAQBAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false.

DeNicola N, Grossman D, Marko K, Sonalkar S, Tobah YSB, Ganju N, Witkop CT, Henderson JT, Butler JL, & Lowery C. 2020. Telehealth Interventions to Improve Obstetric and Gynecologic Health Outcomes. Obstetrics & Gynecology. 135(2), 371-382. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012339/pdf/ong-135-371.pdf.

Department of Health and Human Services. 2023. What is telehealth? Accessed December 21, 2023. https://telehealth.hhs.gov/patients/understanding-telehealth.

Drwal KR, Hurst D, & Wakefield BJ. 2022. Effectiveness of a Home-Based Pulmonary Rehabilitation Program in Veterans. Telemedicine and e-Health. https://www.liebertpub.com/doi/10.1089/tmj.2022.0050.

Hilt RJ, Barclay RP, Bush J, Stout B, Anderson N, & Wignall JR. 2015. A Statewide Child Telepsychiatry Consult System Yields Desired Health System Changes and Savings. Telemedicine and e-Health. 21(7), 533-537. https://www.liebertpub.com/doi/10.1089/tmj.2014.0161.

Izquierdo R, Morin PC, Bratt K, Moreau Z, Meyer S, Ploutz-Snyder R, Wade M, & Weinstock RS. 2009. School-Centered Telemedicine for Children with Type 1 Diabetes Mellitus. The Journal of Pediatrics. 155(3), 374-379. https://www.jpeds.com/action/showPdf?pii=S0022-3476%2809%2900234-0.

Mahtta D, Daher M, Lee MT, Sayani S, Shishehbor M, & Virani SS. 2021. Promise and Perils of Telehealth in the Current Era. Current Cardiology Reports. 23(115). https://link.springer.com/article/10.1007/s11886-021-01544-w.

Mayfield CA, Priem JS, Effinger T, McGinnis, & Grinton P. 2023. School-Based Telemedicine and Reduced Avoidable Emergency Care Among Rural Pediatric Patients. Telemedicine and e-Health. 29(12), 1819-1827. https://www.liebertpub.com/doi/10.1089/tmj.2023.0013.

Mehrotra A, Paone S, Martich GD, Albert SM, & Shevchik GJ. 2013. A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection. JAMA Internal Medicine. 173(1), 72-74. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1392490.

Ray KN, Shi Z, Gidengil CA, Poon SJ, Uscher-Pines L, & Mehrotra A. 2019. Antibiotic Prescribing During Pediatric Direct-to-Consumer Telemedicine Visits. Pediatrics. 143(5), e20182491. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565339/pdf/PEDS_20182491.pdf.

Tuckson RV, Edmunds M, & Hodgkins M. 2017. Telehealth. New England Journal of Medicine. 377, 1585-1592. https://www.nejm.org/doi/full/10.1056/nejmsr1503323#article_citing_articles.

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