Tuesday, September 24, 2013

Telehealth Looks To Be On A Bit Of A Roll At Present - Especially With Evidence Being Provided Of Some Success.

All sorts of interesting things have appeared this week. First we had.

Telehealth can cut costs for cancer patients

17th Sep 2013
TELEHEALTH consultations for cancer patients significantly reduce travel and accommodation costs, an analysis of a Queensland model has found.
Researchers led by the director of the department of medical oncology at the Townsville Hospital, Associate Professor Sabe Sabesan, reviewed 605 teleoncology consultations conducted with 147 patients.
They compared the cost of providing the services with estimated expenses associated with face-to-face care.
Projected costs included anticipated aeromedical retrievals as well as the likely travel and accommodation required for patients, specialists and patient escorts.
These figures were matched against the cost of setting up the model of care, including the purchase and maintenance of equipment and staff costs.
The results, published last week by the MJA, revealed a total net saving of more than $320,000.
MJA 2013; 199(6):414-17
More here
Then we had a US report covering another Australian study.

Telehealth reduces healthcare use, but produces too many alerts

September 20, 2013 | By Susan D. Hall
Self-monitoring along with nurse oversight helped reduce care costs by $2,931 per person among patients with chronic obstructive pulmonary disease (COPD) in an Australian study published in Telemedicine and e-Health.
Participants were taught to measure their blood pressure, weight, temperature, pulse, and oxygen saturation levels daily and transmit that information by telephone to a secure website, monitored by a nurse. There were fewer emergency room visits and hospital admissions among the telehealth group--nearly half as many--vs. a control group, though not at a statistically significant level. However, the cost savings added up from the use of fewer resources, according to the paper.
In addition, the telehealth participants reported increased confidence in their ability to manage their condition and less anxiety.
However, a review of health failure patients treated by a Massachusetts home health agency monitoring similar data found only three percent of alerts were associated with ED visits and hospitalizations. Because the nurses had to follow up on every alert, that meant they spent a lot of time trying not to miss the few meaningful alerts, according to a second study at Telemedicine and e-Health.
Many of the false alarms were generated when patients did a poor job of taking their vitals. Meanwhile, 22 percent of cardiac-related ED visits and hospitalizations had no alerts associated with them. The study points to anxiety as a key predictor of ED visits and hospitalizations among heart-failure patients, a factor that must be addressed, the authors said.
More here:
We also have this:

Mental-health help goes online

Mystrength.com is there to help those who can’t wait to see a therapist

Sep 13, 2013, 4:00am MDT
Reporter- Denver Business Journal
The digital revolution let people with physical ailments visit websites such as WebMD and diagnose their own conditions for the past 10 years. But Scott Cousino saw what it couldn’t do — help Americans with mental-health ailments aid themselves without a therapist.
In 2010, Cousino — an online-education professional who had overcome a bout of severe depression in his 20s — began working on myStrength.com. The website provides mental-health checks, affirmations and other supplemental help to people whose therapists aren’t available.
Three years later, eight community behavioral-health networks in Colorado use the website, it’s expanded to six other states and officials from the National Council for Community Behavioral Healthcare have created an exclusive relationship with the Denver company to advance the use of technology as a mental-health treatment extender.
“It’s like taking your therapist home with you. It empowers consumers to take charge of their treatment,” said Rick Doucet, CEO of Community Reach Center, which serves about 13,000 people in Adams County. “We haven’t seen the end of what technology can do to help us.”
Mental health is the No. 1 disability in the United States, affecting 25 percent of Americans at some point in their lives. Nearly 20 percent of employer health costs are tied to it, and untreated symptoms can hurt productivity and lead to many missed work days.
MyStrength.com takes evidence-based resources and turns them into interactive tools. Users are asked to tell the site about their energy levels, can complete e-learning curriculum about depression, can track their mental-health state, and post inspirational and spiritual photos or messages that help them.
More here:
Last for now we come back to Australia.

Push to expand telehealth MBS items

13 September, 2013 Paul Smith
The Federal Government is under pressure from a state health minister to extend Medicare rebates to GPs for telehealth consultations with public hospital specialists.
Under current rules, MBS items for GPs to sit in on telehealth consultations can only be claimed when the specialist is in private practice.
However Queensland Health Minister Lawrence Springborg says the arrangement is unfair -- both to GPs and public hospital patients -- and is calling for the system to be revamped.
"Medicare funds are for consultations with doctors with a right of private practice," Mr Springborg said.
"It excludes patients under the care of public hospital specialists which is unfair given that, if you are a private hospital patient under the care of the same GP, maybe the same specialist, you get access [to the telehealth rebates]."
Following the introduction of the telehealth items two years ago, GPs have sat in on more than 32,000 video conferencing consultations with specialists.
More here:
Really quite a busy week in the telehealth area and nice to see there is a lot of reporting of actual clinical and benefits trials.

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