Telemedicine for the Medicare population

Agency for Healthcare Research and Quality
Record ID 32002000337
English
Authors' objectives:

The goal of this report was to assess telemedicine services that substitute for face-to-face medical diagnosis and treatment and that may apply to the Medicare population. We focused on three distinct telemedicine study areas - store-and-forward, self-monitoring/testing, and clinician-interactive services.

Authors' results and conclusions: A total of 455 telemedicine programs were identified, representing 30 medical specialties and serving many diverse populations. The number of telemedicine encounters has increased steadily. The evidence for the diagnostic effectiveness of store-and-forward telemedicine is strongest in dermatology. The benefit is more equivocal for other specialties, as it is for improved access, provider or patient satisfaction, and cost benefit. The evidence for self-monitoring/testing telemedicine is equivocal for all specialties, with positive results tempered by compromised study designs. The benefit of clinician-interactive telemedicine services is also questionable, with teledermatology faring less well and the results in other specialties limited by marginal study designs.
Authors' recommendations: Existing telemedicine programs demonstrate that the technology can be made operational, but most of the studies assessing the efficacy or cost are insufficient to permit definitive statements about the evidence supporting (or not supporting) the use of telemedicine. Future studies should focus on the use of telemedicine in conditions where burden of illness and/or barriers to access for care are significant. Recent innovations in the design of randomized controlled trials for emerging technologies should be adopted. Journals publishing telemedicine-evaluation studies must set high standards for methodologic quality so that evidence reports need not rely on studies with marginal methodologies.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.ahrq.gov/clinic/epcsums/telmedsup.htm
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Medicare
  • Remote Consultation
  • Telemedicine
Contact
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name: martin.erlichman@ahrq.hhs.gov
Contact Email: martin.erlichman@ahrq.hhs.gov
Copyright: Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.