AHRQ Review of Telehealth Evidence Offers a Research Roadmap

The Agency for Healthcare Research and Quality (AHRQ) recently published a comprehensive overview of the evidence on telehealth and patient outcomes. One key takeaway: Sufficient evidence exists to show the effectiveness of telehealth for several specific uses and types of patients, but not to judge the cost-effectiveness of telehealth more broadly.

AHRQ, an agency within the Department of Health and Human Services, commissioned a high-level overview of the literature in 2015. CTeL Board member Karen Rheuban, M.D., was one of six “key informants” for the study.
The researchers created an evidence map of 58 systematic reviews that synthesized the impact of telehealth interventions on clinical outcomes, utilization, or cost.

The resulting technical brief, Telehealth: Mapping the Evidence for Patient Outcomes from Systematic Reviews, was finalized June 30, 2016.

A significant finding is that “telehealth interventions produce positive outcomes when used for remote patient monitoring, broadly defined, for several chronic conditions and for psychotherapy as part of behavioral health.”

The review found the most consistent benefit when telehealth was used for communication and counseling or remote monitoring in chronic conditions like cardiovascular and respiratory disease. Patient outcomes – mortality, quality of life, and reductions in hospital admissions – improved with the use of telehealth.

The technical brief outlines a research framework for telehealth based on the strength of the evidence for various uses.

For remote patient monitoring and communication/counseling of patients with chronic conditions and for psychotherapy as part of behavioral health, telehealth research should shift away from studying effectiveness. It should instead focus on how to promote broader implementation and address barriers.

Telehealth for consultation, uses in intensive care units, and applications in maternal and child health have a sufficient evidence base and are ripe for systematic reviews that synthesize the evidence.

Telehealth for triage in urgent/primary care, management of serious pediatric conditions, patient outcomes for teledermatology, and the integration of behavioral and physical health have a limited evidence base. These topics would benefit from additional primary research.

The authors note that the evidence for telehealth’s impact on utilization and cost is limited and deserves more research attention. They stress that telehealth research should be integrated into evaluation of new models of care and payment, particularly value-based models where use of telehealth may improve the ability to share risk and attain quality and related outcomes.

Click here to access Telehealth: Mapping the Evidence for Patient Outcomes from Systematic Reviews.

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