Telemedicine

Question 1

What are some advantages to telemedicine? (7)

Answer 1

More access and convenience
Increased specialist input
Increased patient care
Increase patient engagement
Cost savings- less physical space and reduced condition complication
Reduced all cause hospitalisation and disease specific
Reduced length of stay

Question 2

How does telemedicine affect heart failure and blood pressure outcomes? (3 each)

Answer 2

Heart failure:
50% of hospitalisations is due to poor adherence to recommendations
Telephone support and ECG monitoring causes a reduction in all cause and cardiac hospitalisations
Mortality rate unclear

Blood pressure:
Medications management, home blood pressure monitoring, transmission of BP by smartphone
Remote BP monitoring = 4.4/ 2.1 mmHg decrease
Is it cost effective? Does it discriminate against people with disabilities/ visual impairment?

Question 3

What are some disadvantages to telemedicine? (3)

Answer 3

Biases?
Uncertainty of effect
Is it condition specific?

Question 4

What are some challenges to telemedicine? (12)

Answer 4

Effective?
Clinical outcomes?
Internet access?
Prescribing?
Language barrier
ICT education
Legal framework 
Cost effectiveness
Discrimination against disabled/ homelessness 
Personal motivation 
Balancing F2F and telemedicine
Educating patients

Question 5

What are some benefits of telemedicine in low and middle income countries? (6)

Answer 5

• Improves access to patient care
• Improves specialist input
• Improves disease progression
• Improves continuity
• Improves cost savings
• Improves health education

Question 6

How are diabetes and psychiatric disorders improved by using telemedicine? (4)

Answer 6

Diabetes

• Texts, telephone, video conferencing, smartphone apps
• Improved HbA1C
• Improved adherence

Psychiatric disorders
- Favours intervention.