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