Appropriate Use of Telehealth Visits in Endocrinology: Policy Perspective of the Endocrine Society

Varsha G Vimalananda; Juan P Brito; Leslie A Eiland; Rayhan A Lal; Spyridoula Maraka; Marie E McDonnell; Radhika R Narla; Mara Y Roth; Stephanie S Crossen

doi:10.1210/clinem/dgac494

Appropriate Use of Telehealth Visits in Endocrinology: Policy Perspective of the Endocrine Society

J Clin Endocrinol Metab. 2022 Nov 23;107(11):2953-2962. doi: 10.1210/clinem/dgac494.

Authors

Varsha G Vimalananda^{1

2}, Juan P Brito^{3

4}, Leslie A Eiland⁵, Rayhan A Lal^{6

7

8}, Spyridoula Maraka^{3

9

10}, Marie E McDonnell^{11

12}, Radhika R Narla^{13

14}, Mara Y Roth¹³, Stephanie S Crossen^{15

16}

Affiliations

¹ Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts 01730, USA.
² Section of Endocrinology, Diabetes, Nutrition & Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
³ Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Division of Diabetes, Endocrinology & Metabolism, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁶ Division of Endocrinology, Department of Medicine, Stanford University, Stanford, California, USA.
⁷ Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA.
⁸ Stanford Diabetes Research Center, Stanford University, Stanford, California, USA.
⁹ Division of Endocrinology and Metabolism, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
¹⁰ Section of Endocrinology, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.
¹¹ Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹² Harvard Medical School, Boston, Massachusetts, USA.
¹³ Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, Washington, USA.
¹⁴ VA Puget Sound Health Care System, Seattle, Washington, USA.
¹⁵ Division of Endocrinology, Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California, USA.
¹⁶ Center for Health and Technology, University of California Davis Health, Sacramento, California, USA.

Abstract

Objective: This work aims to guide clinicians practicing endocrinology in the use of telehealth (synchronous patient-clinician visits conducted over video or telephone) for outpatient care.

Participants: The Endocrine Society convened a 9-member panel of US endocrinologists with expertise in telehealth clinical care, telehealth operations, patient-centered care, health care delivery research, and/or evidence-based medicine.

Evidence: The panel conducted a literature search to identify studies published since 2000 about telehealth in endocrinology. One member extracted a list of factors affecting the quality of endocrine care via telehealth from the extant literature. The panel grouped these factors into 5 domains: clinical, patient, patient-clinician relationship, clinician, and health care setting and technology.

Consensus process: For each domain, 2 or 3 members drew on existing literature and their expert opinions to draft a section examining the effect of the domain's component factors on the appropriateness of telehealth use within endocrine practice. Appropriateness was evaluated in the context of the 6 Institute of Medicine aims for health care quality: patient-centeredness, equity, safety, effectiveness, timeliness, and efficiency. The panel held monthly virtual meetings to discuss and revise each domain. Two members wrote the remaining sections and integrated them with the domains to create the full policy perspective, which was reviewed and revised by all members.

Conclusions: Telehealth has become a common care modality within endocrinology. This policy perspective summarizes the factors determining telehealth appropriateness in various patient care scenarios. Strategies to increase the quality of telehealth care are offered. More research is needed to develop a robust evidence base for future guideline development.

Keywords: consensus statement; endocrinology; guidelines; policy perspective; telehealth; telemedicine; virtual care.

Published by Oxford University Press on behalf of the Endocrine Society 2022.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Ambulatory Care
Endocrinology*
Evidence-Based Medicine
Humans
Policy
Telemedicine*

Abstract

Publication types

MeSH terms

Grants and funding