A systematic review of the efficacy of telemedicine for making diagnostic and management decisions

Hersh, William R.; Helfand, Mark; Wallace, James A.; Kraemer, Dale F.; Patterson, Patricia; Shapiro, Susan; Greenlick, Merwyn R.

doi:10.1258/135763302320272167

Cited by 142 publications

(107 citation statements)

References 63 publications

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“…In addition to being effective for most care outcomes, the intervention was well accepted by pediatricians, who largely expressed high levels of satisfaction with the intervention model and would recommend it to other pediatricians. The intervention model was designed to be able to be disseminated widely, by combining quality improvement methods, 15 telemedicine, 16,17 and an innovative, Internet-based interface. This is the first randomized trial to demonstrate the efficacy of a quality improvement intervention in improving community-based pediatricians' ADHD assessment and treatment practice behaviors.…”

Section: Discussionmentioning

confidence: 99%

Use of an Internet Portal to Improve Community-Based Pediatric ADHD Care: A Cluster Randomized Trial

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Although evidence-based guidelines for pediatric attention-deficit/hyperactivity disorder (ADHD) care exist, adherence to the guidelines in communitybased settings has been problematic. Effective interventions that improve the quality of pediatricians' ADHD care and are ready for widespread dissemination do not currently exist. WHAT THIS STUDY ADDS:By using a cluster-randomized trial design, results of this study provide evidence that a quality improvement intervention that is conducive to widespread dissemination improves the ADHD assessment and treatment behaviors of community-based pediatricians.abstract OBJECTIVE: To determine the effectiveness of a quality improvement program to improve pediatricians' adherence to existing, evidencebased, attention-deficit/hyperactivity disorder (ADHD) practice guidelines. METHODS: Forty-nine community-based pediatricians at 8 practices participated in a cluster-randomized trial. Practices were matched according to the numbers of pediatricians and the proportions of patients receiving Medicaid. The medical charts for a random sample of patients with ADHD for each of the participating pediatricians were examined at baseline and 6 months. All practices participated in 4 sessions of training, including didactic lectures and office flow modification workshops. Practices were then given access to an ADHD Internet portal that allowed parents, teachers, and pediatricians to input information (eg, rating scales) about patients, after which information was scored, interpreted, and formatted in a report style that was helpful for assessment and treatment of patients with ADHD. Physicians evaluated their practice behaviors quarterly and addressed underperforming areas. RESULTS: Pediatricians in the intervention group, compared with those in the control group, demonstrated significantly higher rates of many American Academy of Pediatrics-recommended ADHD care practices, including collection of parent (Cohen's d ϭ 0.69) and teacher (d ϭ 0.68) rating scales for assessment of children with ADHD, use of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (d ϭ 0.85), and use of teacher rating scales to monitor treatment responses (d ϭ 1.01). CONCLUSION: A quality improvement intervention that can be widely disseminated by using Internet-based information technology significantly improved the quality of ADHD care in community-based pediatric settings.

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Section: Discussionmentioning

confidence: 99%

Use of an Internet Portal to Improve Community-Based Pediatric ADHD Care: A Cluster Randomized Trial

et al. 2011

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“…[23][24][25][26] Although there is a growing body of literature on the clinical effectiveness and outcomes of telemedicine, applications in the fields of obesity and nutrition have only recently been described. [27][28][29][30][31] Moreover, most research into the effectiveness and outcomes of telemedicine interventions has been conducted in adults. [29][30][31] To assess whether clinical consultations delivered by telemedicine improve quality of care, the effect of consultations on objective measures, namely, diagnostic and management decisions and clinical outcomes, must be measured.…”

Section: Introductionmentioning

confidence: 99%

“…[27][28][29][30][31] Moreover, most research into the effectiveness and outcomes of telemedicine interventions has been conducted in adults. [29][30][31] To assess whether clinical consultations delivered by telemedicine improve quality of care, the effect of consultations on objective measures, namely, diagnostic and management decisions and clinical outcomes, must be measured. 29,30 Hence, the first goal of this study was to investigate the effects of telemedicine consultations for pediatric obesity on the above fundamental outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…[29][30][31] To assess whether clinical consultations delivered by telemedicine improve quality of care, the effect of consultations on objective measures, namely, diagnostic and management decisions and clinical outcomes, must be measured. 29,30 Hence, the first goal of this study was to investigate the effects of telemedicine consultations for pediatric obesity on the above fundamental outcomes. The second goal of this study was to determine whether telemedicine-driven changes in diagnosis and management decisions were associated with improvements in clinical outcomes in patients who had more than one consultation.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

Shaikh

Cole

Marcin

et al. 2008

Telemedicine and e-Health

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“…[19][20][21][22] Other studies analyzed the economic effect of in-home disease care using the u-healthcare system. [23][24][25][26][27][28] Kang and Lee 29 conducted a cost-benefit analysis based on data from the national health insurance service, the Korean National Health and Nutrition Examination Survey, and research results of remote patient monitoring from outside the country. Lee 30 emphasized the necessity for an in-depth examination of the economic feasibility and validity of telemedicine based on its performance, cost, and benefit.…”

Section: Introductionmentioning

confidence: 99%

How the Awareness of u-Healthcare Service and Health Conditions Affect Healthy Lifestyle: An Empirical Analysis Based on a u-Healthcare Service Experience

Youm

Park²

2015

Telemedicine and e-Health

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Objective: The objectives of this study are (1) to establish a ubiquitous healthcare (u-healthcare) center for those who wish to use u-healthcare, allowing them to experience the service, and (2) to evaluate the users' awareness and expectations of the service based on their overall assessment. Materials and Methods: To establish the u-healthcare center, a kiosk, devices for health checkup, a body-type examination system, and a physical fitness assessment system were installed. Also, a u-healthcare Web site was developed. A survey was conducted on 280 individuals who visited the u-healthcare center and used the service, to determine (1) individual awareness of u-healthcare before using the service and their change of perception after use, (2) factors that affect the use of u-healthcare, and (3) the effects of disease awareness on exercise habits. Results: Only 25.4% of the participants were aware of u-healthcare, and only 36% who saw the u-healthcare center recognized that it was where the u-healthcare service was provided. The group of individuals who were willing to use the u-healthcare showed statistically significant differences in their satisfaction with the overall environment of the center, as well as the specificity of the descriptions, examination results, kindness of the staff, and their responses. Additionally, the group of individuals who were diagnosed with chronic diseases and the group who were not showed statistically significant differences in the number of days on which they exercised lightly or took a walk. Conclusions: To promote the usage of u-healthcare service, the understanding of the service and the credibility of examination results need to be increased by sharing successful cases. Furthermore, to expand the use of the system that allows a person to regularly check his or her state of health, a lifelong periodical management system linked with another medical welfare program will be needed.

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A systematic review of the efficacy of telemedicine for making diagnostic and management decisions

Cited by 142 publications

References 63 publications

Use of an Internet Portal to Improve Community-Based Pediatric ADHD Care: A Cluster Randomized Trial

Use of an Internet Portal to Improve Community-Based Pediatric ADHD Care: A Cluster Randomized Trial

Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity

How the Awareness of u-Healthcare Service and Health Conditions Affect Healthy Lifestyle: An Empirical Analysis Based on a u-Healthcare Service Experience

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