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Asynchronous Telehealth: Systematic Review of Analytic Studies and Environmental Scan of Relevant Initiatives

Last updated: January 30, 2008
Issue: 101
Result type: Report

Technology

Asynchronous telehealth refers to the storage of clinically important digital samples and relevant data (e.g., pictures of moles or surgical wounds and radiological images) from any location and forwarding them to a health care professional at a distant site for assessment at a convenient time.

Issue

Asynchronous telehealth could reduce wait times and optimize access to specialized services. There is, however, uncertainty about its effectiveness in health care services.

Methods and Results

This systematic search of studies for any modality of asynchronous telehealth in English in peer-reviewed journals assessing health outcomes, economic outcomes, and health services impact identified 52 original studies, with almost half of them focused on teledermatology. While there was no formal economic analysis, related economic outcomes were extracted from the clinical reviews. Two independent teams of reviewers screened all articles and independently extracted data. The environmental scan, which included Google searches, identified 39 organizations (five in Canada) that are using a combination of real-time and asynchronous services.

Asynchronous telehealth refers to the storage of clinically important digital samples and relevant data (e.g., pictures of moles or surgical wounds and radiological images) from any location and forwarding them to a health care professional at a distant site for assessment at a
convenient time.

Implications for Decision Making

  • Asynchronous telehealth could optimize health care delivery. Compared with face-to-face consultations, asynchronous telehealth has demonstrated shorter wait times, fewer unnecessary referrals, high levels of patient and provider satisfaction, better diagnostic accuracy, and better access to services in locations that lack health professionals.
  • Uncertainty remains regarding cost-effectiveness and resource use. Most cost savings were associated with a decrease in patient travel expenses, lost time from work, or caregiver reimbursement. It is unclear whether the use of asynchronous telehealth for triage leads to faster care or improved health outcomes and whether it works beyond small pilot projects.
  • Opportunities for further understanding exist. By formulating and promoting projects with pragmatic objectives and reasonable outcomes, Canadian policy makers have an opportunity to increase the efficiency of health care services and foster a collaborative framework among existing institutions.