The Growth Channel

Your telehealth summer reading: Highlights from MedPAC, AHRQ, and NEJM

by Tracy Walsh

This summer has been a hot season for telehealth—between MedPAC’s June Report to Congress, AHRQ’s June Technical Brief on Telehealth, and the review article in this month’s issue of The New England Journal of Medicine, telehealth has been getting a lot of attention.

All three publications grapple with questions about when telehealth is an appropriate substitute for in-person care and how it can be used to greatest effect. And given the policy implications of MedPACs reports, the value of AHRQ best practices for hospital administrators, and NEJM’s sway among clinicians, this surge in renewed interest in telehealth could be a signal that more provider organizations are ready to adopt the new technologies.

But if you don’t have time to read the nearly 150 pages from these three reports, don’t worry! We’ve summarized the major highlights below:

Academic literature offers strong evidence that telehealth has positive clinical and financial outcomes when applied in three instances:

  • For remote patient monitoring for chronic conditions
  • Communication and counseling for chronic conditions
  • Psychotherapy for behavioral health

AHRQ’s meta-analysis across 58 systematic reviews found that these three applications of telehealth most consistently improve outcomes like mortality, quality of life, and reduced hospital readmissions.

But measuring the impact of telehealth is often challenging because the term is not consistently defined across research studies.

One of the biggest obstacles in evaluating the case for telehealth is the fact that “telehealth” can vary across multiple dimensions: by the modality (e.g., virtual visit, remote patient monitoring, asynchronous store and forward), by the platform used (e.g., computer, smartphone, peripheral device), and by the service being offered (e.g., primary care, urgent care, specialty care).

Many of the reviews that have been published to date have not made an apples-to-apples comparison in their assessment of “telehealth,” so it’s always a good idea to check the methodology before placing too much stock in a single study.

Conclusive evidence on the value of telehealth is most sparse among specialty applications.

The research has yet to catch up with the rapidly expanding use cases for telehealth, particularly when it comes to specialty consults. While telehealth has been successfully applied in the context of behavioral health and stroke intervention, other specialty services represent areas of emerging opportunity and have yet to be studied and adopted on a broader scale.

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