Clinical outcomes resulting from telemedicine interventions: a systematic review

doi:10.1186/1472-6947-1-5

BMC Medical Informatics and Decision Making

Volume 1

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Helfand M
Wallace J
Kraemer D
Patterson P
Shapiro S
Greenlick M

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Research article

Clinical outcomes resulting from telemedicine interventions: a systematic review

William R Hersh¹^,4 , Mark Helfand ¹^,4 , James Wallace¹^,4 , Dale Kraemer ¹^,4 , Patricia Patterson ¹^,2^,4 , Susan Shapiro²^,4 and Merwyn Greenlick ³^,4

¹Division of Medical Informatics & Outcomes Research, Oregon Health & Science University, BICC, 3181 SW Sam Jackson Park Rd, Portland, OR 97201, USA

²School of Nursing, Oregon Health & Science University. BICC, 3181 SW Sam Jackson Park Rd, Portland, OR 97201, USA

³Department of Public Health & Preventive Medicine, Oregon Health & Science University, BICC, 3181 SW Sam Jackson Park Rd, Portland, OR 97201, USA

⁴Evidence-Based Practice Center, Oregon Health & Science University, BICC, 3181 SW Sam Jackson Park Rd, Portland, OR 97201, USA

author email corresponding author email

BMC Medical Informatics and Decision Making 2001, 1:5doi:10.1186/1472-6947-1-5


Published:	26 November 2001

Abstract

Background

The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based.

Methods

Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis). All included articles were abstracted and graded for quality and direction of the evidence.

Results

A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery.

Conclusions

Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.