In CADTH’s 2022 Health Technology Trends to Watch: top 10 list, Remote Diagnostics, Remote Monitoring and Remote Care Management is listed as the number one trend. As a result, this month we are featuring 5 resources related to remote healthcare!
1. CADTH reports on Remote Monitoring
2. Canada Health Infoway. Providing safe and high-quality virtual care: A guide for new and experienced users: Clinician Change Virtual Care Toolkit. 2022.
3. Lim C, Rosenfeld L, Nissen N, Wang P, Patel Pharm N, Powers B, Huang H. Remote care management for older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness: A systematic review. Journal of the Academy of Consultation-Liaison Psychiatry. 2022;63(1):198-212.
Background: Comorbidity of psychiatric and medical illnesses among older adult populations is highly prevalent and associated with adverse outcomes. Care management is a common form of outpatient support for both psychiatric and medical conditions in which assessment, care planning, and care coordination are provided. Although care management is often remote and delivered by telephone, the evidence supporting this model of care is uncertain. Objective: To perform a systematic review of the literature on remote care management programs for older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness. Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A multidatabase search was performed. Articles were included for review if they studied fully remote care management for older adult populations with elevated prevalence of depression or anxiety and chronic medical illness or poor physical health. A narrative synthesis was performed. Results: A total of 6 articles representing 6 unique studies met inclusion criteria. The 6 studies included 4 randomized controlled trials, 1 case-matched retrospective cohort study, and 1 pre-post analysis. Two studies focused on specific medical conditions. All interventions were entirely telephonic. Five of 6 studies involved an intervention that was 3 to 6 months in duration. Across the 6 studies, care management demonstrated mixed results in terms of impact on psychiatric outcomes and limited impact on medical outcomes. No studies demonstrated a statistically significant impact on health care utilization or cost. Conclusions: Among older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness, remote care management may have favorable impact on psychiatric symptoms, but impact on physical health and health care utilization is uncertain. Future research should focus on identifying effective models and elements of remote care management for this population, with a particular focus on optimizing medical outcomes.
4. Cardile D, Corallo F, Cappadona I, lelo A, Bramanti P, Buono V, Ciurleo R, De Cola M. Auditing the audits: A systematic review on different procedures in telemedicine. International journal of environmental research and public health. 2023;20(5):4484.
Telemedicine is a process of delivering health care using information and communication technologies. Audit and feedback (A&F) constitute a systematic intervention that is aimed at collecting data, which are subsequently compared with reference standards and then returned to health care operators through feedback meetings. The aim of this review is to analyse different audit procedures on and by mean of telemedicine services and to identify a practice that is more effective than the others. Systematic searches were performed in three databases evaluating studies focusing on clinical audits performed on and by means of telemedicine systems. Twenty-five studies were included in the review. Most of them focused on telecounselling services with an audit and a maximum duration of one year. Recipients of the audit were telemedicine systems and service users (general practitioners, referring doctors, and patients). Data resulting from the audit were inherent to the telemedicine service. The overall data collected concerned the number of teleconsultations, service activity, reasons for referral, response times, follow-up, reasons why treatment was not completed, technical issues, and other information specific to each telemedicine service. Only two of the considered studies dealt with organizational aspects, and of these, only one analysed communicative aspects. The complexity and heterogeneity of the treatments and services provided meant that no index of uniformity could be identified. Certainly, some audits were performed in an overlapping manner in the different studies, and these show that although attention is often paid to workers’ opinions, needs, and issues, little interest was shown in communicative/organizational and team dynamics. Given the importance and influence that communication has in teamwork and care settings, an audit protocol that takes into account intra- and extra-team communication processes could be essential to improving the well-being of operators and the quality of the service provided.
5. Asrar F, Saint-Jacques D, Williams D. Outer space assets offer benefits to health care: Family doctors play a key role in supporting innovative work. Canadian Family Physician. 2022;68(11):797-798, 800.
“Technological requirements of spaceflight drive innovation and economic growth. Outer space assets, such as satellites, have played roles in Canadians’ daily and digital lives for decades, but most do not realize it. The Global Positioning System that we use for navigation and the weather forecasts and traffic reports that we check as we plan our activities all involve space technology.1 Similarly, benefits that space technology can offer health care are not well known.”
