An initiative was launched last year by the U.S. Department of Health and Human Services (HHS)  for new ways that technology can improve postoperative recovery and hospitalization follow-up.

Telehealth is the key and has significantly contributed to avoiding rehospitalization.  An example of this is cited by Ottawa Hospital in Canada who employs an automated phone system to pinpoint adverse reactions to medications and improve patient compliance to medications and recommendations.

What is Telehealth 

Telehealth refers to the delivery of healthcare and health information by telecommunications.  Its broad scope encompasses medical discussions by phone to long distance robotic surgery.

The difference between this and telemedicine is that it includes preventative, informative and curative solutions in healthcare.

Benefits of Telehealth:

According to a study at JAMA Surgery, advantages provided by tele health for patients who have undergone ambulatory surgery include:

  • Patient satisfaction increases
  • Saves Time
  • Saves Money

Study Setup

  • 141 patients were followed at VA Palo Alto Hospital in California
  •  Surgery chosen was elective open hernia repair (115) and laparoscopic cholecystectomy (gall bladder removal) (26)
  •  Procedures were selected for well recognized and infrequent surgical complications
  • Patients received a call from a Physician Assistant 2 weeks after surgery.
  • Transcript of the call focused on   Current activity level, post op complications (pain, fever, healing of incision) and any issues the patient had

Results

  •  Follow-up by  only tele health was accepted by 63 hernia patients and 19 cholecystectomy patients
  • 100% of the gall bladder patients had no complications
  • 3  hernia repair patients experienced adverse reactions of which one needed hospital admission.

Conclusions

  • Almost all the patients surveyed were content with the tele health follow-up.
  • Savings on travel time was significant (140 mile average round trip distance)

Additional Benefits and Uses of Telehealth

NonClinical

  • Patient education-Teleseminars, webinars, continuing medical education courses, grand rounds
  • Healthcare management
  • Videoconferencing

Clinical

  • Electronic transmission of medical data, radiological images, health records for diagnosis and treatment
  • Health advice by telephone
  • Real-time measurements (of cardiovascular system, glucose levels, pain times and levels

Added Proof

One of the largest,randomized control trials of telehealth in the world, involved 6191 patients and 238 GP practices across three sites, Newham, Kent and Cornwall. Three thousand and thirty people with one of three conditions( COPD, Chronic Heart Failure and Diabetes) were included in the study and were assessed by  City University London, University of Oxford, University of Manchester, Nuffield Trust, Imperial College London and London School of Economics.

Results showed:

  • 45% reduction in mortality rates
  • 20% reduction in emergency admissions
  • 15% reduction in A&E visits
  • 14% reduction in elective admissions
  • 14% reduction in bed days
  • 8% reduction in tariff costs

The DownSide

Of course the practice of tele health must be restricted to patients who are in relative stability.  Those patients who are extremely high risk, do run the danger of increased mortality and significant morbidity.

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