New Study Suggests Several Factors for Telehealth Success

Sarasota, FL (WorkersCompensation.com) – Prior to COVID, even with advanced technology, as high as 74 percent of patients were unaware of telemedicine. Several studies have already shown an increase in usage during the pandemic, especially for mental health and initial evaluations of sprains and strains. While the costs for telemedicine services are somewhat comparable to an in person evaluation, some reports show more dollars are being spent on telehealth services than ever before.

With predictions of a resurgence of COVID in the coming weeks, telemedicine could again see another bump in usage. Before you rush to schedule that patient for a virtual visit however, you might want to take a deeper look according to a study published this month in JAMA Network.

While remote electronic devices have been in use for several years to monitor chronic diseases, the use of remote technology to monitor vision is still graining ground, even though in some counties, ophthalmology visits account for as high as 10 percent of all outpatient visits.

Researchers from Standford University and UCL Institute of Ophthalmology in the UK asked what the barriers and enablers were to patient engagement of vision monitoring software that was app based, and could be accomplished from home. The patients were offered a smart phone app that was operated as a Home Vision Monitor (HVM) to self-test their vision. In addition, the researchers conducted a patient survey to capture their experience. The full results were then analyzed by regression and software. Odds ratio measured the results of compliance, use rate, and associations of patient uptake.

Uptake and active use was defined as a successful install with at least one subsequent use. Engagement was gaged by compliance and use rate. Compliance was defined as use for 4 continuous weeks with twice weekly vision checks.

Of the total 417 patients that were observed, 56.6 percent were female, and the mean age was 72.8. The active patients that utilized the app totaled 258, equating to 61.9 percent. The total non-active patients accounted for 38.1 percent at 158. Of the 258 active users, a little over half were compliant at 64.3 percent. The total of active but non-compliant patients was 35.7 percent, totaling 92 patients.

The researchers noted that comfort level with technology had a bearing on the rate of use and compliance, as well as vision quality. Additionally, compliance was higher for patients with neovascular age-related macular degeneration than those with macular retinal edema.

During the course of the study, 26 alerts were triggered for worsening vision. Eighteen of the patients had subjectively noticed a change in their vision, however 8 patients had not. As a result, a total of 11 patients moved their appointments up, and the remaining already had a prescheduled appointment. In 22 of the 26 patients, active disease was discovered during the clinic visit.

Overall, 88 percent of the patients expressed a desire to receive feedback from the results of the monitoring system.

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