Telehealthcare for long term conditions | BMJ | 8- TELEMEDECINE & TELEHEALTH by PHARMAGEEK |

Summary points

Telehealthcare is personalised healthcare delivered over a distance; data are transferred from the patient to the professional, who then provides feedback

In patients with severe long term conditions, such as problematic asthma and diabetes, telehealthcare can reduce hospital admissions without increasing mortality

Potential pitfalls include user interface problems, technical problems, and safety concerns such as data loss and confidentiality

Telehealthcare can alter the doctor-patient relationship so try to humanise the interaction

Consider workflows, to minimise unintended disruptions to normal routines

Careful assessment of effectiveness, cost effectiveness, and safety considerations is needed before introduction


Telehealthcare is the provision of personalised healthcare over a distance.1 It has the three following essential components2w1:

The patient provides data such as a voice recording, video, electrocardiography, or oxygen saturation that gives information about the illness.

Information is transferred electronically to a healthcare professional at a second location.

The healthcare professional uses clinical skills and judgment to provide personalised feedback tailored to the individual.

Telehealthcare can be delivered by both synchronous and asynchronous (such as store and forward) technologies (fig 1⇓). For example, telephone and video conferencing enable consultations in real time. An example of asynchronous communication would be storing two weeks’ of spirometry results in a batch and forwarding these on to a healthcare provider, who responds by email or telephone.

Telehealthcare is related to, but distinct from telemedicine, where technology is used to share information over a distance between healthcare providers.2


Why is interest in telehealthcare increasing?

Healthcare systems globally are facing major challenges such as ageing populations, increasing numbers of people living with long term conditions, patients in remote areas or with limited mobility, and increasing expectations for patient centred healthcare.w2 w3 Telehealthcare offers potential solutions to these challenges (see box 1),3 but the acceptability and effectiveness, and the safety considerations associated with its adoption need careful consideration.


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Via rob halkes