Telehealth Technologies –Are They Useful or Simply Risky and Costly for Patients with Hypertension? - Abstract
Hypertension is a prevalent condition, affecting 31% (67 million) of American adults; it is not under control for more than 50%. The disease contributed to or caused the deaths of 348,000 Americans in 2008, and like other chronic diseases, requires ongoing management and self-care. Self management, however, is complex and patients require ongoing support. Several recent telehealth offerings provide a means with which to foster the knowledge and skills necessary for those with hypertension and diabetes to engage in successful self-management.
This manuscript considers the applicability, efficacy, and cost effectiveness of telehealth for individual patients and populations with high blood pressure (HBP). Risks associated with telehealth delivery and interventions are also highlighted. For the purposes of this paper, telehealth is broadly defined as telecommunication technologies, which include but are not limited to mobile phones, computers, the Internet, supporting software, and emergent offerings. Telehealth is a broad term, encompassing telemedicine, mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders.
Telemedicine may have considerable utility for people diagnosed with HBP, but there are also considerable risks. Telehealth technology is rapidly evolving even in the absence of fully proven cost effectiveness and efficacy. For patients with poor access or social barriers that constrain access, telemedicine can be a particularly effective tool. Considering cost of in-patient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider.
Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of healthcare providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events need to be obtained. Additional risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for HBP self-management.