Assessment of the Cost-Effectiveness and Clinical Outcomes of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease

Ho, Yi‐Lwun; Yu, Jiun-Yu; Lin, Yen-Hung; Huang, Ching–Chang; Hsu, Tse-Pin; Chuang, Pao-Yu; Hung, Chi‐Sheng; Chen, Ming-Fong

doi:10.2196/jmir.3346

Cited by 48 publications

(42 citation statements)

References 26 publications

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“…The telehealth care system in this study is not only a health monitoring system, but also a tool that assists in decision making. Fortunately, our previous studies have shown that the Telehealth Center of the National Taiwan University Hospital has provided effective telehealth care for chronic cardiovascular disease patients and has reduced medical costs and the burden on caregivers [ 43 - 45 ]. A previous study has also indicated that the data analytics in the telehealth care system could assist clinicians at the point of care [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

A Telesurveillance System With Automatic Electrocardiogram Interpretation Based on Support Vector Machine and Rule-Based Processing

Ho¹,

Huang²,

Lin³

et al. 2015

JMIR Med Inform

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BackgroundTelehealth care is a global trend affecting clinical practice around the world. To mitigate the workload of health professionals and provide ubiquitous health care, a comprehensive surveillance system with value-added services based on information technologies must be established.ObjectiveWe conducted this study to describe our proposed telesurveillance system designed for monitoring and classifying electrocardiogram (ECG) signals and to evaluate the performance of ECG classification.MethodsWe established a telesurveillance system with an automatic ECG interpretation mechanism. The system included: (1) automatic ECG signal transmission via telecommunication, (2) ECG signal processing, including noise elimination, peak estimation, and feature extraction, (3) automatic ECG interpretation based on the support vector machine (SVM) classifier and rule-based processing, and (4) display of ECG signals and their analyzed results. We analyzed 213,420 ECG signals that were diagnosed by cardiologists as the gold standard to verify the classification performance.ResultsIn the clinical ECG database from the Telehealth Center of the National Taiwan University Hospital (NTUH), the experimental results showed that the ECG classifier yielded a specificity value of 96.66% for normal rhythm detection, a sensitivity value of 98.50% for disease recognition, and an accuracy value of 81.17% for noise detection. For the detection performance of specific diseases, the recognition model mainly generated sensitivity values of 92.70% for atrial fibrillation, 89.10% for pacemaker rhythm, 88.60% for atrial premature contraction, 72.98% for T-wave inversion, 62.21% for atrial flutter, and 62.57% for first-degree atrioventricular block.ConclusionsThrough connected telehealth care devices, the telesurveillance system, and the automatic ECG interpretation system, this mechanism was intentionally designed for continuous decision-making support and is reliable enough to reduce the need for face-to-face diagnosis. With this value-added service, the system could widely assist physicians and other health professionals with decision making in clinical practice. The system will be very helpful for the patient who suffers from cardiac disease, but for whom it is inconvenient to go to the hospital very often.

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Section: Discussionmentioning

confidence: 99%

A Telesurveillance System With Automatic Electrocardiogram Interpretation Based on Support Vector Machine and Rule-Based Processing

Ho¹,

Huang²,

Lin³

et al. 2015

JMIR Med Inform

Self Cite

View full text Add to dashboard Cite

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“…Two studies conducted non-randomised open intervention studies (36,37) . The remaining studies have used a retrospective observational study design (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) , a prospective observational study design (53)(54)(55)(56)(57) four of them were cohort (53)(54)(55)(56) , a pre post design (58)(59)(60)(61) , and one descriptive study (62) .…”

Section: Clinical Outcomementioning

confidence: 99%

“…The most common speciality reporting economic outcomes was paediatrics (n=7) (63)(64)(65)(66)(67)(68)(69) . Simple cost analysis was used by (n=14) (52,(63)(64)(65)(66)(67)(70)(71)(72)(73)(74)(75)(76)(77) studies measuring the cost avoidance, cost saving and added revenue. While (n=15) (27,30,35,58,68,69,(78)(79)(80)(81)(82)(83)(84)(85)(86) studies conducted a cost minimization analysis as a method to assess the economic benefits of telemedicine.…”

Section: Economicmentioning

confidence: 99%

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

AlDossary

Martin‐Khan

Bradford

et al. 2017

International Journal of Medical Informatics

108

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Our systematic review identified only 137 telemedicine services. This suggests either telemedicine service implementation is still not a part of mainstream clinical services, or it is not being reported in the peer-reviewed literature. The depth and the quality of information were variable across studies, reducing the generalisability. The reporting of service implementation and planning strategies should be encouraged. Given the fast paced technology driven environment of telemedicine, this may enable others to learn and understand how to implement sustainable services. The key component of planning was underreported in these studies. Studies applying and reporting more rigorous methodology would contribute greatly to the evidence for telemedicine.

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“…The survey conducted during 2009-2010 in remote regions of the Brazilian state of Minas Gerais shows that the teleconsultations can avert 80.8% of referrals and 45.5% of transportation costs [14]. Many other studies also verified that telemedicine could greatly reduce the healthcare cost, shorten the waiting time, and improve the utilization efficiency of health resources [15][16][17][18].…”

Section: Introductionmentioning

confidence: 97%

Impact of Telemedicine on Healthcare Service System Considering Patients’ Choice

Wang

Zhang

Zhao

et al. 2019

Discrete Dynamics in Nature and Society

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Telemedicine is an effective way to alleviate the congestion of hospitals and improve the utilization of medical resources. In this paper, we develop a stylized queue model to study whether the hospital should adopt telemedicine service and in which form (the gatekeeper system or dual-channel service system) the hospital should provide telemedicine service. Patients’ delay sensitivity and transportation cost are also considered in our model. Our main results follow. First, in most cases, telemedicine service can help to reduce the total cost of the healthcare system, and patients treated online or offline can both benefit from the adoption of telemedicine. Second, the dual-channel healthcare system is more flexible than the traditional outpatient system and the gatekeeper system. There exists an optimal market segmentation of the two channels in the dual-channel healthcare system. Finally, we find that the hospital should implement the telemedicine when the transportation cost is high or patients have a large gap between online and offline waiting sensitivity.

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Assessment of the Cost-Effectiveness and Clinical Outcomes of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease

Cited by 48 publications

References 26 publications

A Telesurveillance System With Automatic Electrocardiogram Interpretation Based on Support Vector Machine and Rule-Based Processing

A Telesurveillance System With Automatic Electrocardiogram Interpretation Based on Support Vector Machine and Rule-Based Processing

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

Impact of Telemedicine on Healthcare Service System Considering Patients’ Choice

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