A review of published studies by Canadian researchers finds that a video-based telehealth program offers similar clinical outcoes as in-person care, while improving efficiencies and boosting patient satisfaction.
Video-based telemedicine can substitute for in-person care for patient living with chronic kidney disease (CKD), according to a recent review of published studies in the Clinical Journal of the American Society of Nephrology.
In an analysis of 24 telehealth studies published between 1997 and 2020 in 10 countries, researchers from St. Michael’s Hospital of Unity Health in Toronto and the Ontario-based University Health Network found the telehealth has been used to effectively facilitate care for patients in various stages of CKD. More recently, they found that programs are using consumer-based technology and devices, including wearables, to improve access for people who have difficulties getting to a clinic or hospital.
According to the research, video-based telemedicine platforms not only produced comparable clinical outcomes to in-person care, but also improved workflows and increase patient satisfaction.
“This is encouraging, but as the latest technologies are streamlined into routine health care, the ‘digital divide’ will become more pronounced, negatively impacting those without access to broadband internet connections, video-capable devices, and those with limited technology literacy,” Stephanie W. Ong, BScPhm, MSc, of the University Health Network, said in a statement issued by the American Society of Nephrology. “This is an area that deserves further study.”
Many healthcare providers shifted from in-person care to virtual care during the pandemic to reduce stress on hospitals and clinics and cut down on chances of transmitting the COVID-19 virus. Providers often found themselves trying telehealth for the first time or experimenting with new platforms and tools during this time.
With healthcare organizations looking to resume in-person care as the pandemic wanes, many of those providers are asking to be allowed to continue using telemedicine, or to at least create hybrid platforms that can support both in-person and virtual care. Specialists, including nephrologists, are particularly keen on embracing telehealth to improve care management and coordination for patients who would prefer more services in the home.
“The nature of CKD care makes it particularly amenable to virtual care given that relevant history, review of laboratory investigations, and counselling can all be conducted via virtual platforms,” Ann Young, MD, PhD, of St. Michael’s Hospital of Unity Health, said in the ASN statement. “The main obstacle of virtual care is the lack of a physical exam. Virtual visits are a powerful tool, but in certain clinical settings, a physical exam is necessary. Finding the appropriate balance between virtual visits and in-person visits is key.”
In the study, Ong also cautioned that some patients might not have the resources to acquire telemedicine technology or the broadband to use it. She worried that too much of an emphasis on digital health tools could exacerbate the digital divide, further distancing patients from the care they need.
“This is an area that deserves further study,” she said.
An editorial written by physicians from George Washington University in Washington DC and a patient perspective authored by Julie Glennon of West Palm Beach, FL, accompanied the study. Both cited concerns for patients unfamiliar with the technology or who lack access to broadband or equipment, but felt that the benefits could outweigh the challenges.
“Patients can benefit from access to their care providers, receive multidisciplinary care, include distant relatives in visits, and have the convenience of staying at home,” GWU physicians Susie Lew, MD, and Neal Sikka, MD, wrote in their editorial. “For those that are skeptical about telehealth, we feel that a telehealth visit is better than no visit at all for a new or existing patient.”
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.