Electronic Health Records

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Telehealth for chronic disease patients improves satisfaction

By Jennifer Bresnick

Patients suffering from common chronic conditions such as hypertension, depression and anxiety, or obesity, found high satisfaction and clinical value in scheduled telehealth consults with their physicians, according to a Massachusetts General Hospital study published in Telemedicine and eHealth online.  Physicians involved in the remote care sessions, which included questionnaire’s about a patient’s health status, also reported that the virtual meetings saved time, allowed for more continuous follow-up, and gave a better overall picture of the patient’s wellbeing.

The study examined the impact of online follow-up for patients with ten common diseases: hypertension, arthritis, diabetes, anxiety, depression, GERD, headaches, asthma, back pain, and weight control issues.  After seeing their primary care physician for one of these issues, patients were sent an online survey asking about improvements or declines in overall health as well as disease-specific questions to answer on a scale from zero to three.  Physicians reviewed the answers within one business day of completion, the study says, and then scheduled a video chat, phone call, or in-person consult as necessary.

One hundred and seventy five patients, aged 24 to 90, completed the surveys by the end of the study.  On average, the patients spent less than ten minutes completing the questionnaire, while physicians spent just over 3.5 minutes reviewing the responses and making recommendations.  The patients found the method to be quick and convenient, and they reported high satisfaction with the clinical efficacy of the quiz.  Physicians, meanwhile, were pleased that the questionnaires provided enough information for informed clinical decision making.

The study suggests that “once patients and physicians are given the opportunity to use an alternative system of care, the experience can be a satisfying one,” the authors write.  “Making these systems adapt to the office workflow is very important to clinician satisfaction.  Traditional physical examination was not performed as a part of these visits but was performed as a portion of the office visit that preceded the virtual follow-up.  The clinical satisfaction with the virtual follow-up visit suggests that, for the conditions evaluated, a physical exam was not required for patient and clinician satisfaction.”

While the patient benefits of telehealth meetings are obvious, since online consults have been shown to cut down on travel time, transportation costs, and work absences or childcare expenses, the healthcare system as a whole may benefit significantly from the integration of online care into the daily workflow.  The time savings involved for the clinician – cutting a typical 15 minute patient consult down to 3.5 minutes for the online review – may also represent financial benefit to the beleaguered healthcare system.

Although challenges remain for an industry tangled up in numerous reimbursement restrictions and licensing laws that make telemedicine a difficult proposition, adoption of the online follow-up has been swift within Massachusetts, the study notes.  “Adoption has been brisker than the typical personal health record implementation,” the authors add, “which can induce clinician anxiety around interminable open-ended exchanges.  The minimal clinician time investment, facilitated by the careful scripting of questions…has led to broader adoption.”




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