The limits to telehealth

The marriage of medicine and the Internet to create telehealth has fostered a mini-industry around the world with seemingly boundless opportunities – the ability to save health institutions money, to save frail patients or those far away from a hospital or doctor travel time and to improve patient outcomes.

However, a recent telemedicine study by the British Journal of Medicine may have found some limits.

Released late last month, the study questioned 759 people in England with long term heart-related or diabetic conditions who transmitted vital sign and other medical data in various ways from home to clinicians, or spoke to them over video links, over a 12 month period. The same questions were asked of a control group that got standard treatment. The goal: Find out whether their health-related quality of life changed.

The result: Hardly any difference noted.  “More research is required to understand the many potential beneficial and harmful mechanisms by which telehealth could affect patient reported outcomes,” it concluded. “However, our findings strongly suggest no net benefit from telehealth; therefore, it should not be used as a tool to improve health related QoL (quality of life) or psychological outcomes.”

Why is QoL important? It’s one of the promised benefits. If patients feel someone can monitor their condition often, they might feel better despite having a bad medical condition. On the other hand, if patients feel anxious about connecting technology to telephones, broadband devices or videocams, their sense of well-being won’t improve.

And remember there’s a cost involved: Usually someone has to pay for specialized equipment.

All this is not to say that telehealth still isn’t valuable for reasons other than improving QoL: It still can be a time saver when infirm people find it hard to travel to a doctor. But the British study does suggest the benefits of telemedicince shouldn’t be oversold.

Here’s a link to a BBC story on the study.

For the study itself click here.

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