PCORI Answers Critical Questions
Evidence gaps leave unclear whether telehealth strategies are effective for particular conditions, patient populations, or settings. Also unclear is which telehealth approaches work best. PCORI funds studies that seek to help patients, clinicians, and others answer critical questions, such as:
Insurer: Is providing treatments for hepatitis C virus (HCV) for injection drug users in methadone clinics via telemedicine more effective than referring people in such clinics to get HCV care from liver specialists outside of the clinics?
Patient: Would I get the same quality of care through a virtual house call with my specialist as I would by going to her clinic, which is a long drive from my home?
Clinician: I have several patients with high blood pressure. Is telehealth effective in helping people reduce their risks of stroke and other conditions that go along with hypertension?
Study Results that Support Better-Informed Decisions
Adults with the chronic skin disease psoriasis who used an online program to get care from dermatologists and their primary care providers experienced as much improvement in their condition as patients who got in-person care in a clinic, this study found. The findings, reported in JAMA Network Open, add to evidence about the potential for telehealth to serve as a more widely accessible option for getting specialty care for chronic skin conditions.
Many children who are Medicaid participants with mental health problems don’t receive the care they need, in part because families must first undergo a complex referral process to community mental health clinics (CMHCs) for diagnostic and therapeutic mental health services. Reporting in Pediatrics, this study found that compared with parents who had usual referrals, those who had video chat referrals were three times more likely to finish screening for specialty mental health care at the CMHC.
Telehealth Study Spotlights
April Armstrong, MD, MPH, Associate Dean of Clinical Research, Vice Chair and Professor of Dermatology at the University of Southern California, defines what online care means to her PCORI-funded project which compared in-person visits to online care for patients with psoriasis and shares some of the advantages and concerns an online care model can have for patients and their clinicians.
Many children growing up in rural Alaska get frequent ear infections, which can lead to hearing loss and other problems. This study is comparing a new process for referral to an audiologist using school-based mobile screening versus the usual standard of care where families of children who need further screening receive a letter inviting them to travel to a clinic for evaluation. The aim is to see which approach works best to identify children with hearing loss.
Clinics that provide exercise, yoga, and other nondrug therapies for people with multiple sclerosis are scarce in some areas. This study compares the benefits of an exercise program when patients receive it in a clinic versus at home via internet or telephone.
2019 PCORI Annual Meeting Breakout
The Potential and Challenges for Telehealth to Improve Access to Care
This breakout session highlighted two PCORI-funded projects and addressed the question of how the research enterprise can keep up to meet the evidence needs of decision makers in a rapidly evolving field.