Changes in diagnosis, treatment, and clinical improvement among patients receiving telemedicine consultations

Telemed J E Health. 2005 Feb;11(1):36-43. doi: 10.1089/tmj.2005.11.36.

Abstract

The aim of this study was to determine whether outpatient telemedicine specialty consultations to primary care clinicians result in changes in a patient's diagnosis, treatment management, and clinical outcomes. Medical records of patients who received two or more clinical telemedicine consultations in dermatology, psychiatry, and endocrinology were evaluated in a nonconcurrent retrospective analysis. Three indicators were used to measure changes in the processes of care and clinical outcomes: change in diagnosis, change in treatment, and patient clinical improvement. A retrospective review of 223 individual telemedicine patient medical records was conducted. Specialty telemedicine consultations were found to result in changes in diagnoses in 48% of the cases, changes in treatment therapy in 81.6% of the cases, and clinical improvement in 60.1%. These results are consistent with previous literature that has assessed changes in processes of care and outcomes from face-to-face specialty consultations in outpatient clinics. Changes in diagnosis and treatment therapy were found to be associated with clinical improvement with odds ratios (ORs) of 2.66 (95% confidence interval [CI]: 1.47-4.83) and 11.22 (95% CI: 4.49-31.48), respectively. This study found that telemedicine consultations resulted in changes in diagnosis and treatment regimens and also are associated with clinical improvements.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • California
  • Child
  • Child, Preschool
  • Diagnosis*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Observer Variation
  • Quality of Health Care
  • Referral and Consultation*
  • Telemedicine*
  • Therapeutics*