If you choked at the headline you may choke even more at the way the UK’s website for GPs Pulse actually writes up a recently-published Mayo Clinic study. Apart from the anti-telehealth bias in the item Telemedicine ‘trebles death rate’ in elderly patients, they mangled the terminology for the second time in as many weeks. (See TA item here.) They even did it in the headline, you notice. However, do read it, and its associated comments. That aside, this study and the way it has been reported (Reuters source story for many of the reports) should worry everyone in the industry. However, Laurie Orlov blasts away at the issues it raises in There goes telehealth, taking it on the chin again. A good read.
I have commented at the end of the Pulse article after Steve’s entry.
It was a small study and patients had multiple co-morbidities.
The telehealth mortality rate (14.7%) was consistent with what the researchers expected from their stratification strategy for the population covered (13%).
The ‘usual care’ group had a lower than expected mortality rate of 3.9%.
Of course, comparing the telehealth and usual care groups gives a significant difference. However, the usual care group was lower than expected adding to any difference.
The researchers offered some reasons in the paper as to why there may be difference but no firm conclusions were reached.
The article appears to have left out the 13% figure.
Mike Clark (@clarkmike)
Not only the low N and a certain lack of geographic diversity, but also the age of the survey group–mean of 80.3 years. In short, an old, high risk (as stated) group that may have other preferences (e.g. active carers).
Some other questions for the researchers:
• did the users find the old-style Intel Health Guide and the peripherals easy to use or confusing?
• was there a consistency pattern (i.e. they used it at first and fell off?) How well did they use the telehealth?
• the care management methodology. Were these patients being actively ‘managed’ with access to a care manager, home health assistance and education, or was that left to the ‘brick’?
Hi Donna – Mayo actually published ease-of-use data in this published piece from last year: http://www.ncbi.nlm.nih.gov/pubmed/21612521. Here’s an excerpt from that study: “On an average, participants rated telemonitoring as minimally burdensome, rated themselves confident in using the monitor, and positively rated telemonitoring for clinical communication. Qualitative analysis revealed a predominant theme that telemonitoring increases patient awareness of their health and also that telemonitoring prompts action.” Hope that helps. Happy to talk with you in more detail if you’d like.