Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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Randomized Controlled Trial
Evaluation of home telehealth following hospitalization for heart failure: a randomized trial.
Previous studies have found that home-based intervention programs reduce readmission rates for patients with heart failure. Only one previous trial has compared telephone and videophone to traditional care to deliver a home-based heart failure intervention program. The objective of this study was to evaluate the efficacy of a telehealth-facilitated postdischarge support program in reducing resource use in patients with heart failure. ⋯ All subjects reported higher disease-specific quality of life scores at 1 year. There was evidence of the value of telephone follow-up, but there was no evidence to support the benefit of videophone care over telephone care. Rigorous evaluation is needed to determine which patients may benefit most from specific telehealth applications and which technologies are most cost-effective.
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The incidence of infectious diseases in the United States has been increasing since 1980. Re-emergent conditions, multidrug-resistant bacteria, newly identified infections, and bioterrorism have prompted public health surveillance and control initiatives, including the use of telehealth technology. Infectious diseases, such as West Nile Virus, pose a particular threat to rural areas, where access to infectious disease specialists (IDS) is limited. ⋯ Ninety percent of telehealth patients were able to remain at their local hospital for treatment. Results were statistically significant only for selected outcomes and conditions. IDS treatment for the conditions studied is equally effective when delivered via telehealth as when delivered via in-person methods.
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Heart failure (HF) is associated with high direct and indirect costs to the patients and the healthcare system. This systematic review aims to analyze existing economic data to determine whether telemonitoring of patients with HF will result in decreased costs. The Scopus and PubMed databases were searched independently by two reviewers for journal articles that reported on an economic analysis (i.e., calculated monetary amounts or percentage change in costs) of a study using a HF telemonitoring system. ⋯ The study found a 3.5% lower travel cost for patients using telemonitoring compared to those in the usual care group. The single study that was found for indirect costs described the willingness to pay for telemedicine by patients with HF (55% of the patients with HF were willing to pay $20 to access telemedicine, and 19% were willing to pay $40). Available data from existing studies suggest that although HF telemonitoring will require an initial financial investment, it will substantially reduce costs in the long term, particularly by reducing rehospitalization and travel costs.
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A retrospective noncomparative consecutive case series was conducted to evaluate the clinical outcomes of a novel teleophthalmology program linking optometrists to retina specialists in Alberta, Canada. One hundred seventy-one patients, referred by optometrists via teleophthalmology to a group retina practice between June 2004 and May 2006 underwent stereoscopic, mydriatic digital photography. Images were transmitted to a secure Web server and analyzed by a retina specialist. ⋯ When compared to conventional consultation methods, teleophthalmology reduced average travel distance and time by 219.1 km and 2.7 hours, respectively. Teleophthalmology reduced office visits to the retina specialist by 48% while improving the efficiency of clinical examination, testing, and treatment. Patients benefited through reduced travel time and distance.