Display options
Share it on

Open Med. 2009 Jun 02;3(2):e69-91.

Asynchronous telehealth: a scoping review of analytic studies.

Open medicine : a peer-reviewed, independent, open-access journal

Amol Deshpande, Shariq Khoja, Julio Lorca, Ann McKibbon, Carlos Rizo, Donald Husereau, Alejandro R Jadad

PMID: 19946396 PMCID: PMC2765770

Abstract

BACKGROUND: Asynchronous telehealth captures clinically important digital samples (e.g., still images, video, audio, text files) and relevant data in one location and subsequently transmits these files for interpretation at a remote site by health professionals without requiring the simultaneous presence of the patient involved and his or her health care provider. Its utility in the health care system, however, still remains poorly defined. We conducted this scoping review to determine the impact of asynchronous telehealth on health outcomes, process of care, access to health services, and health resources.

METHODS: A search was performed up to December 2006 of MEDLINE, CINAHL, HealthSTAR, the Database of Abstracts of Reviews of Effectiveness, and The Cochrane Library. Studies were included if they contained original data on the use of asynchronous telehealth and were published in English in a peer-reviewed journal. Two independent reviewers screened all articles and extracted data, reaching consensus on the articles and data identified. Data were extracted on general study characteristics, clinical domain, technology, setting, category of outcome, and results. Study quality (internal validity) was assessed using the Jadad scale for randomized controlled trials and the Downs and Black index for non-randomized studies. Summary data were categorized by medical specialty and presented qualitatively.

RESULTS: The scoping review included 52 original studies from 238 citations identified; of these 52, almost half focused on the use of telehealth in dermatology. Included studies were characterized by diverse designs, interventions, and outcomes. Only 16 studies were judged to be of high quality. Most studies showed beneficial effects in terms of diagnostic accuracy, wait times, referral management, and satisfaction with services. Evidence on the impact of asynchronous telehealth on resource use in dermatology suggests a reduction in the number of, or avoidance of, in-person visits. Reports from other clinical domains also described the avoidance of unnecessary transfer of patients.

CONCLUSIONS: A significant portion of the asynchronous telehealth literature involves its use in dermatology. Although the quality of many original studies remains poor, at least within dermatology, there is consistent evidence suggesting that asynchronous telehealth could lead to shorter wait times, fewer unnecessary referrals, high levels of patient and provider satisfaction, and equivalent (or better) diagnostic accuracy when compared with face-to-face consultations. With the exception of a few studies in pediatric asthma, the impact of this intervention on individual health outcomes remains unknown.

References

  1. J Telemed Telecare. 2004;10(2):94-8 - PubMed
  2. Telemed J E Health. 2004 Winter;10(4):437-43 - PubMed
  3. J Telemed Telecare. 2001;7 Suppl 1:52-3 - PubMed
  4. Clin Exp Dermatol. 2003 Jul;28(4):356-9 - PubMed
  5. Mayo Clin Proc. 1999 Aug;74(8):764-9 - PubMed
  6. J Am Acad Dermatol. 2002 Jul;47(1):68-72 - PubMed
  7. Hawaii Med J. 2004 Oct;63(10):310-3 - PubMed
  8. Injury. 2005 Apr;36(4):560-6 - PubMed
  9. Nurs Health Sci. 2004 Sep;6(3):229-36 - PubMed
  10. Telemed J. 1999 Fall;5(3):265-71 - PubMed
  11. Arch Pediatr Adolesc Med. 2005 Apr;159(4):389-93 - PubMed
  12. J Telemed Telecare. 2005;11(4):191-3 - PubMed
  13. Comput Methods Programs Biomed. 2001 Mar;64(3):201-14 - PubMed
  14. Am J Speech Lang Pathol. 2006 Feb;15(1):45-56 - PubMed
  15. Indian J Pathol Microbiol. 2004 Oct;47(4):480-5 - PubMed
  16. J Telemed Telecare. 2002;8(6):319-24 - PubMed
  17. J Telemed Telecare. 2004;10(6):337-41 - PubMed
  18. J Telemed Telecare. 1999;5 Suppl 1:S95-9 - PubMed
  19. J Eur Acad Dermatol Venereol. 2004 Nov;18(6):665-9 - PubMed
  20. Int J Circumpolar Health. 2004 Dec;63(4):387-400 - PubMed
  21. Ann R Coll Surg Engl. 2004 Jul;86(4):239-42 - PubMed
  22. Arch Dermatol. 1997 Feb;133(2):171-4 - PubMed
  23. Control Clin Trials. 1996 Feb;17(1):1-12 - PubMed
  24. Plast Reconstr Surg. 2002 Aug;110(2):452-6 - PubMed
  25. Mayo Clin Proc. 1999 Aug;74(8):753-7 - PubMed
  26. Isr Med Assoc J. 2005 Aug;7(8):487-90 - PubMed
  27. Arch Pathol Lab Med. 2000 Nov;124(11):1653-6 - PubMed
  28. Med Inform Internet Med. 1999 Jul-Sep;24(3):189-99 - PubMed
  29. Pac Health Dialog. 2004 Sep;11(2):243-7 - PubMed
  30. J Epidemiol Community Health. 1998 Jun;52(6):377-84 - PubMed
  31. Telemed J E Health. 2003 Winter;9(4):351-60 - PubMed
  32. Telemed J E Health. 2001 Winter;7(4):293-316 - PubMed
  33. Int J Dermatol. 2006 Mar;45(3):220-9 - PubMed
  34. J Telemed Telecare. 2000;6(1):50-3 - PubMed
  35. J Telemed Telecare. 1999;5 Suppl 1:S85-6 - PubMed
  36. BMJ. 2002 Jun 15;324(7351):1434-7 - PubMed
  37. Am J Health Syst Pharm. 2003 Oct 1;60(19):1976-81 - PubMed
  38. BMC Med Res Methodol. 2005 Feb 16;5(1):8 - PubMed
  39. J Telemed Telecare. 2005;11(7):354-60 - PubMed
  40. J Postgrad Med. 2005 Oct-Dec;51(4):308-11 - PubMed
  41. Br Dent J. 2005 Nov 26;199(10):659-62, discussion 653 - PubMed
  42. Cochrane Database Syst Rev. 2000;(2):CD002098 - PubMed
  43. J Telemed Telecare. 2001;7(3):125-38 - PubMed
  44. Telemed J E Health. 2002 Fall;8(3):333-41 - PubMed
  45. Laryngoscope. 1999 Sep;109(9):1433-7 - PubMed
  46. Int J Dent Hyg. 2004 Nov;2(4):161-4 - PubMed
  47. Telemed J. 1996 Fall;2(3):201-10 - PubMed
  48. Telemed J. 1998 Fall;4(3):267-76 - PubMed
  49. Med Inform Internet Med. 2003 Jun;28(2):73-84 - PubMed
  50. J Telemed Telecare. 2005;11(6):294-7 - PubMed
  51. Inform Prim Care. 2004;12(2):85-90 - PubMed
  52. J Telemed Telecare. 2002;8(5):297-301 - PubMed
  53. J AAPOS. 2001 Oct;5(5):291-6 - PubMed
  54. IEEE Trans Biomed Eng. 2002 Dec;49(12):1452-62 - PubMed
  55. J Telemed Telecare. 2004;10(1):29-33 - PubMed
  56. Telemed J E Health. 2000 Winter;6(4):379-84 - PubMed
  57. J Telemed Telecare. 2005;11 Suppl 2:S61-4 - PubMed
  58. Pathology. 2001 Nov;33(4):498-503 - PubMed
  59. AJR Am J Roentgenol. 1997 May;168(5):1353-5 - PubMed
  60. Telemed J E Health. 2004 Summer;10(2):138-46 - PubMed
  61. Telemed J. 1999 Winter;5(4):323-37 - PubMed
  62. Pediatrics. 2005 May;115(5):1273-82 - PubMed
  63. J Telemed Telecare. 2004;10(1):21-4 - PubMed
  64. Proc AMIA Symp. 2002;:325-9 - PubMed
  65. Clin Orthop Relat Res. 2005 Jun;(435):250-7 - PubMed
  66. Clin Exp Dermatol. 2005 May;30(3):209-14 - PubMed
  67. J Telemed Telecare. 2000;6 Suppl 1:S1-3 - PubMed
  68. J Endourol. 1999 Apr;13(3):141-6 - PubMed
  69. Health Technol Assess. 2003;7(41):1-90 - PubMed
  70. Hum Pathol. 2001 Dec;32(12):1300-3 - PubMed
  71. Telemed J E Health. 2003 Spring;9(1):95-101 - PubMed
  72. CMAJ. 2001 Sep 18;165(6):765-71 - PubMed
  73. J Telemed Telecare. 2004;10(1):39-43 - PubMed
  74. J Telemed Telecare. 2000;6 Suppl 1:S90-2 - PubMed
  75. J Calif Dent Assoc. 2003 Aug;31(8):601-8 - PubMed
  76. Telemed J E Health. 2005 Feb;11(1):56-62 - PubMed
  77. Cutis. 2000 Jul;66(1):61-2 - PubMed
  78. J Med Syst. 2004 Dec;28(6):575-9 - PubMed
  79. CMAJ. 2006 Nov 21;175(11):1362 - PubMed
  80. Arch Dermatol. 2002 Jan;138(1):53-8 - PubMed
  81. J Telemed Telecare. 2001;7 Suppl 1:45-6 - PubMed
  82. Telemed J. 1997 Spring;3(1):1-10 - PubMed
  83. Telemed J. 1999 Fall;5(3):309-13 - PubMed
  84. Natl Med J India. 2004 Jan-Feb;17(1):17-9 - PubMed
  85. Telemed J E Health. 2004 Winter;10(4):422-31 - PubMed
  86. Br J Dermatol. 2001 Feb;144(2):328-33 - PubMed
  87. J Telemed Telecare. 2006;12(2):75-8 - PubMed
  88. Hum Pathol. 2001 Dec;32(12):1334-43 - PubMed
  89. Acad Radiol. 2003 Jul;10(7):794-7 - PubMed
  90. Telemed J E Health. 2002 Fall;8(3):313-21 - PubMed
  91. J Cutan Med Surg. 2001 Mar-Apr;5(2):111-6 - PubMed
  92. Clin Exp Dermatol. 2006 Jan;31(1):13-8 - PubMed
  93. J Telemed Telecare. 2003;9(6):321-7 - PubMed
  94. Pac Health Dialog. 2000 Sep;7(2):29-35 - PubMed
  95. Curr Probl Dermatol. 2003;32:24-31 - PubMed
  96. Med Inform Internet Med. 1999 Apr-Jun;24(2):121-34 - PubMed
  97. J Telemed Telecare. 2006;12(2):83-7 - PubMed
  98. J Digit Imaging. 1999 May;12(2 Suppl 1):168-74 - PubMed
  99. Stud Health Technol Inform. 1999;64:179-84 - PubMed
  100. Otolaryngol Head Neck Surg. 1999 Jan;120(1):62-72 - PubMed
  101. Int J Med Inform. 2004 Feb;73(1):65-73 - PubMed
  102. Stud Health Technol Inform. 2000;77:1117-21 - PubMed
  103. Ann Intern Med. 2007 Aug 21;147(4):224-33 - PubMed
  104. J Telemed Telecare. 2003;9(2):89-94 - PubMed
  105. J Telemed Telecare. 2004;10 Suppl 1:44-7 - PubMed
  106. Br J Dermatol. 2000 Dec;143(6):1241-7 - PubMed

Publication Types