The Potential for Telehealth Consultations in Cardiology and dermatology in NL
In 2011, Labrador-Grenfell Health proposed a CHRSP topic to study the potential health and economic benefits of telehealth technologies, including improved access to specialists, decreased wait times, decreased out-of-pocket costs and work days lost to travel for health reasons. NLCAHR partnered with Labrador-Grenfell Health and with the Canadian Agency for Drugs and Technologies in Health (CADTH) to address this topic. The original CHRSP study proposed to address a broad range of specialties in a number of different service contexts, such as consultations, case management, and discharge planning. Through consultations with our partners, the scope of the project was refined to two specialties that do not yet have an in-province telehealth program: cardiology and dermatology. The CHRSP Project Team included a senior administrator from Labrador-Grenfell Health, clinical specialists in cardiology and dermatology, local telehealth experts from NLCHI, and CHRSP staff at NLCAHR. This team, in conjunction with CADTH, refined the original research question for this project to the following: What does the scientific literature tell us about the clinical effectiveness and cost-effectiveness of telehealth technologies for specialist-patient consultations in the fields of cardiology and dermatology, considering the expected patient populations and given the social, geographic, economic, health system, health technology, and political contexts of Newfoundland and Labrador? KEY FINDINGS: 1. There is insufficient available evidence to conclusively support either telecardiology or teledermatology consultations as an effective alternative to face-to-face consultations with patient/clients who live in rural or remote parts of Newfoundland and Labrador. Therefore, this report is limited to asserting that the evidence suggests the potential effectiveness of the telehealth consultations described below. 2. When teledermatology consultations are compared with conventional face-to-face consultations, the available evidence suggests that teledermatology consultations result in reliable diagnoses and management plans for most dermatologic conditions. 3. It is important to note that the available evidence strongly cautions against the use of store-and-forward teledermatology consultations for pigmented or atypical lesions as some studies show a significantly higher rate of inappropriate and potentially life-threatening management plans derived from such teledermatology consultations when compared with management plans derived from face-to-face consultations. 4. The available evidence suggests that, in both telecardiology and teledermatology, specialist-patient consultations may increase the number of such telehealth consultations while reducing inappropriate in-person referrals. 5. The available evidence suggests that both telecardiology and teledermatology are cost-effective from a societal perspective, provided that a telehealth communications infrastructure is already in place and operational (as is the case in Newfoundland and Labrador). The available evidence also suggests that both telecardiology and teledermatology are cost-effective from a patient/client perspective. 6. No evidence was found in the research literature to support or contradict the possibility that telehealth services would increase physician specialist workloads or overall cost to the health service payer/health system. 7. The available evidence suggests that patient satisfaction with teledermatology consultations is equal to satisfaction levels with face-to-face consultations.
30 Nov -0001
Faculty of Medicine
NL Centre For Applied Health Research Contextualized Health Research Synthesis Program
Strategic Research Theme
Information and Communication Technology
Well-being, Health and Biomedical Discovery