May 9, 2008 Telehealth, using telecommunication technology to deliver health care, is increasingly being used to improve the delivery and availability of health care services to patients. A University of Missouri researcher found that patients who received a telehealth intervention from care providers had significantly delayed hospital readmission rates when compared to patients who received traditional care.
"Telehealth interventions have the potential to allow for earlier detection of key clinical symptoms, triggering early intervention from providers and reducing the need for patient hospitalization," said Bonnie Wakefield, associate research professor in the MU Sinclair School of Nursing. "Reducing the length and frequency of hospital stays can lower healthcare costs for patients and hospitals, which helps patients manage their diseases and ultimately feel better."
To understand how the use of technology affects patient-provider interactions, Wakefield evaluated the effectiveness of a telehealth home-based intervention in patients with heart failure. Patients were selected randomly to receive follow-up by telephone or videophone after hospitalization for heart failure. According to Wakefield, previous research on traditional clinic visits found that quality patient-provider relationships can improve patient satisfaction, adherence to treatment, clinical outcomes and understanding of information.
"Telehealth does not necessarily change the care providers give. Rather, it changes the communication channel between clinicians and patients to minimize geographic barriers and enhance delivery of service," Wakefield said. "According to patients, it is not important how the interaction happens, but just that it happens. People who suffer from chronic illnesses usually wait three to six months between office appointments with their care providers. With video and telephone technology, nurses have the ability to interact regularly with patients and provide a sense of security. Patients discuss concerns on a frequent basis, and nurses give advice and detect problems that the patient might not notice."
Wakefield said it is critical to match technologies to patient needs and further evaluation is needed to determine which patients may benefit most from specific telehealth applications and which technologies are most cost effective.
"Although older patients may not be accustomed to using technology, it doesn't mean they aren’t willing to learn," Wakefield said. "Older patients feel they are contributing to society and education by testing innovative technology. They appreciate when health care professionals take time to invest in their well-being."
The study, "Home Telehealth for Heart Failure," will be published in the Journal of Telemedicine and e-Health. It was funded by the Department of Veterans Affairs Health Services Research and Development Service. Wakefield's work experience includes 22 years at the Veterans Affairs Medical Center in Iowa City, Iowa. Her most recent position at the VA in Iowa City was Associate Chief, Nursing Research.
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