Telemedicine Research Highlights: Advancing Access and Equity in Patient Care

Maternal telehealth care may benefit more from basic digital infrastructure than sophisticated technological solutions

When examining the landscape of information and communication technologies in Latin American and Caribbean countries, Capasso and colleagues identified disparities in access to digital health persist in remote and rural communities particularly, with limitations in digital infrastructure (2). The main facilitators in adoption of digital health were provider training and availability of adequate equipment, internet, and technology. Often, telemedicine is thought to require complex digital platforms to increase healthcare access, but this study suggests that investing in universal digital coverage may be a more sustainable solution to improve telehealth access for reproductive care in remote and rural communities.

Telemedicine improves access to health information while improving patient satisfaction during routine HIV care

As new tools and interventions in telemedicine are developed, there is a need to evaluate their efficacy compared to standard care alone. In their mixed methods clinical trial from 2011, León and colleagues evaluated a telemedicine tool their team created, Virtual Hospital platform, which includes virtual consultations, telepharmacy, a virtual library and virtual community (3). While clinical and quality of life parameters were similar between those with the telemedicine intervention and those without the intervention, there was high technical satisfaction among users and providers, giving patients direct access to their medical results and health information. This forward-thinking clinical trial demonstrates how telemedicine can be used to improve access to providers, resources, and medical information at a time when individual internet access and the movement towards electronic health records was increasing globally.

COVID-19 illustrates the importance of considering health equity when implementing telemedicine

With the roll-out of telemedicine, it is vital to evaluate equitable access across different populations, especially during a pandemic. Here Khatana and colleagues utilized real-world data to identify patterns in sociodemographic characteristics of patients who had at least one telemedicine encounter during the study period (4). They identified that there were differences in utilization across different sub-groups, with lower odds of receiving telemedicine among older, male, and non-Hispanic Black patients. These findings help us understand disparities in access across different groups and in different regions, which can be leveraged to improve equitable availability of telemedicine by targeting intervention efforts.

Telephone support and telemonitoring significantly reduced the odds of deaths and hospitalization due to heart failure compared to usual care

With the growth of telemedicine research, systematic reviews can be a valuable tool to evaluate telemedicine interventions. In their systematic review, Kotb and colleagues compare the impact of different telemedicine options for heart failure (5). Specifically, the authors compared telephone support, telemonitoring, video monitoring or electrocardiographic monitoring among patients with heart failure. Synthesizing the findings of 30 randomized controlled trials, they found that telephone support and telemonitoring significantly reduced the odds of deaths and hospitalization due to heart failure compared to usual care. Systematic reviews and meta-analysis manuscripts, such as the one described here, help lawmakers assess the impact of telemedicine on health outcomes to generate policy and direct implementation efforts. This work has been cited in several policy documents generated by the Norwegian Institute of Public Health and the Organisation for Economic Co-operation and Development (OECD) (6-7).