TY - JOUR
T1 - Telemedicine infectious diseases consultations and clinical outcomes
T2 - A systematic review
AU - Burnham, Jason P.
AU - Fritz, Stephanie A.
AU - Yaeger, Lauren H.
AU - Colditz, Graham A.
N1 - Funding Information:
Financial support. This work was supported by grant number UL1 TR002345, sub-award KL2 TR002346, from the National Institutes of Health (NIH)–National Center for Advancing Translational Sciences (NCATS), components of the NIH, and the NIH Roadmap for Medical Research. This publication, in whole or in part, was supported by The Foundation for Barnes-Jewish Hospital and their generous donors and the Washington University Institute of Clinical and Translational Sciences, which is, in part, supported by the NIH/NCATS, CTSA grant UL1TR002345. This work was also supported by the Agency for Healthcare Research and Quality (AHRQ; grant number R01-HS024269 to S.A.F.).
Funding Information:
This work was supported by grant number UL1 TR002345, sub-award KL2 TR002346, from the National Institutes of Health (NIH)?National Center for Advancing Translational Sciences (NCATS), components of the NIH, and the NIH Roadmap for Medical Research. This publication, in whole or in part, was supported by The Foundation for Barnes-Jewish Hospital and their generous donors and the Washington University Institute of Clinical and Translational Sciences, which is, in part, supported by the NIH/NCATS, CTSA grant UL1TR002345. This work was also supported by the Agency for Healthcare Research and Quality (AHRQ; grant number R01-HS024269 to S.A.F.).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background. Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction. Methods. We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225. Results. From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. Conclusions. Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice.
AB - Background. Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction. Methods. We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225. Results. From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. Conclusions. Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice.
KW - Clinical outcomes
KW - Infectious diseases consultation
KW - Mortality
KW - Systematic review
KW - Telemedicine
UR - http://www.scopus.com/inward/record.url?scp=85079169470&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofz517
DO - 10.1093/ofid/ofz517
M3 - Review article
C2 - 31879674
AN - SCOPUS:85079169470
SN - 2328-8957
VL - 6
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 12
ER -