Brett Moran1,2, Travis Frazier3, Larry Steven Brown4, Molly Case5, Srinivas Polineni6, Lonnie Roy4. 1. Clinical Informatics Department, Parkland Health, Dallas, Texas, USA. 2. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 3. Enterprise Data Services Department, Parkland Health, Dallas, Texas, USA. 4. Health Systems Research, Parkland Health, Dallas, Texas, USA. 5. Virtual Care Division, Parkland Health, Dallas, Texas, USA. 6. Strategic Planning and Business Development, Parkland Health, Dallas, Texas, USA.
Abstract
Background: The clinical effectiveness of audio-only telemedicine has not been fully quantified. The pandemic afforded a unique situation to retrospectively observe clinical outcomes of care for three disease cohorts within three care models, including audio-only telemedicine. Methods: Patients were classified into three care models: audio-only telemedicine, in-person, and hybrid. Each model was compared with an aggregate group before the onset of the pandemic and within each group during the pandemic. Each disease cohort was evaluated in cross-sectional and paired analyses. Results: Patients (n = 52,720) were grouped within one of three care models. A majority (n = 48,335) of patients qualified for the "pre" group comparison. The audio-only telemedicine care model showed similar control of renal disease, hypertension control, and diabetes management than in-person and hybrid care models. Conclusions: Audio-only telemedicine appears to be noninferior to in-person or hybrid models for chronic disease management for the diseases studied. In all instances, it had similar control compared with the in-person care model. We acknowledge the limitations of this study, including convenience sampling and a limited observation timeframe. Audio-only telemedicine should be considered a viable care model modality that can be integrated into options for patient care. Further study and investment are warranted, as it provides efficacy and convenience to health systems (Clinical Registration Number # 32449).
Background: The clinical effectiveness of audio-only telemedicine has not been fully quantified. The pandemic afforded a unique situation to retrospectively observe clinical outcomes of care for three disease cohorts within three care models, including audio-only telemedicine. Methods: Patients were classified into three care models: audio-only telemedicine, in-person, and hybrid. Each model was compared with an aggregate group before the onset of the pandemic and within each group during the pandemic. Each disease cohort was evaluated in cross-sectional and paired analyses. Results: Patients (n = 52,720) were grouped within one of three care models. A majority (n = 48,335) of patients qualified for the "pre" group comparison. The audio-only telemedicine care model showed similar control of renal disease, hypertension control, and diabetes management than in-person and hybrid care models. Conclusions: Audio-only telemedicine appears to be noninferior to in-person or hybrid models for chronic disease management for the diseases studied. In all instances, it had similar control compared with the in-person care model. We acknowledge the limitations of this study, including convenience sampling and a limited observation timeframe. Audio-only telemedicine should be considered a viable care model modality that can be integrated into options for patient care. Further study and investment are warranted, as it provides efficacy and convenience to health systems (Clinical Registration Number # 32449).
Authors: Allison A Lewinski; Conor Walsh; Sharron Rushton; Diana Soliman; Scott M Carlson; Matthew W Luedke; David J Halpern; Matthew J Crowley; Ryan J Shaw; Jason A Sharpe; Anastasia-Stefania Alexopoulos; Amir Alishahi Tabriz; Jessica R Dietch; Diya M Uthappa; Soohyun Hwang; Katharine A Ball Ricks; Sarah Cantrell; Andrzej S Kosinski; Belinda Ear; Adelaide M Gordon; Jennifer M Gierisch; John W Williams; Karen M Goldstein Journal: J Med Internet Res Date: 2022-08-26 Impact factor: 7.076