Page 5 Unlocking The Potential of Physician to Patient Telehealth Services The Information Technology & Innovation Foundation

counseling, research has found that telehealth services can be just as effective as traditional
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face-to-face visits.
One provider of telehealth services in the United States is Teladoc, which provides patients
24/7 access to a doctor by phone or Internet. It provided 120,000 patient consultations in
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2013. A study of the Teladoc service found that the most common conditions for which
patients sought treatment were acute respiratory illnesses, urinary tract infections, and skin
problems. While there has not been an extensive review of the quality of care, one study
found that patients using Teladoc were less likely than patients receiving in-person
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treatment to need follow-up visits for the same condition.

An area where telehealth has had particular success is in dermatology. Dermatologists often
make diagnoses based on conversations with patients and visual examinations, and so
videoconferencing has proven remarkably effective. Multiple studies have found that
dermatologists can diagnose patients just as reliably at a distance as they can in person
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using either store-and-forward technology or live video conferencing. Patients can easily
snap a picture and send the digital image to their doctor and have a virtual face-to-face
conversation. Kaiser Permanente Northern California reports that its dermatologists have
been able to diagnose and treat 80 percent of the cases they see using only a virtual
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encounter.
Telehealth is also useful for managing chronic diseases. Chronic diseases, which are
prolonged in duration and unlikely to go away, include diabetes, asthma, conditions of the
circulatory system, heart disease, and mental illness. These diseases, once diagnosed, are
best treated with continual care. Traditional office visits leave much to be desired. Treating
a chronic illness can be expensive and time-consuming for a patient, who often must take
off time from work to travel to and from the doctor’s office, wait to be seen, and then
spend time at the appointment. Gaps in care can lead to unnecessary hospital stays and
contribute to morbidity. Telehealth programs can help place remote monitoring systems in
patients’ homes to track vital statistics and generate daily reports on their condition; such
information is then relayed to caregivers. In addition, when they do need to consult a
caregiver, they can often do so remotely.

The Veterans Health Administration (VHA) became the largest user of remote monitoring
in the United States after it implemented a national program in 2003. The Care
Coordination/Home Telehealth program uses telehealth technology to monitor and care
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for over 92,000 veterans with chronic diseases or recovering from recent hospitalization.
The majority of these patients (85 percent) use messaging and monitoring devices to track
vitals and provide daily reports on their condition. Fifteen percent use either video
telemonitors or videophones that allow doctors to communicate audio-visually with the
patient. Nurses are able to track changes in vitals and conditions remotely and have the
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ability to intervene before negative trends become serious enough to require
hospitalization.

The main benefits reported by the VHA come from reducing unnecessary hospitalizations.
The VHA reported that its post-cardiac-arrest care program resulted in a 51 percent
reduction in hospital readmission for heart failure and a 44 percent reduction in

THE INFORMATION TECHNOLOGY & INNOVATION FOUNDATION | MAY 2014 PAGE 5