PRP069: Providing patients with telemedicine technology: a systematic review

Joshua Bell, BS; Nina Singh; Laura Gottlieb, MD, MPH; Emilia De Marchis, MD, MAS; Oanh Nguyen; Courtney Lyles, PhD

Abstract

Context: The COVID-19 pandemic led to a dramatic increase in health care delivery via telemedicine. This shift highlighted inequities in access to required technology, such as broadband internet and video connectivity. Barriers to telemedicine care may exacerbate existing health care disparities. Objective: Conduct a systematic review to identify interventions evaluating the impact of providing patients with technology--including devices and connectivity--to support telemedicine access. Study Design: Systematic review. GRADE criteria was used to rate study quality. Dataset: Articles published in Pubmed, EMBASE, CINAHL, Web of Science, Google, clinicaltrials.gov, and conference abstracts. Population Studied: Peer-reviewed and grey literature published through July 20, 2020 that assessed health care-based interventions to provide patients with devices and/or internet connectivity and reported on telemedicine access and/or usage. Eleven articles met these inclusion criteria. Outcome Measures: Data extraction included: study population, setting, intervention design, details on device/connectivity provision, outcomes evaluated (health care access, utilization, and cost; patient and provider satisfaction; and health), and risk of bias. Results: Eleven articles reflecting eight unique interventions were included. 91% (N=10/11) were rated low or very low quality, primarily related to study design. Studies measuring health care utilization (45%; N=5/11) reported increases in patient encounters. Studies examining patient and clinician satisfaction with technology provision (55%; N=6/11) reported overall positive experiences. Only four studies reported on health outcomes, cost, or technology performance (36%; N=4/11), and found positive results. Conclusions: Findings from this systematic review indicate that providing material technological supports to patients can facilitate telemedicine access, is acceptable to both patients and clinicians, and may lead to improved health outcomes. The low number and quality of existing studies limit the strength of this evidence. Future research should continue to explore health care interventions to facilitate equitable access to health care via telemedicine.
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Diane Harper
harperdi@med.umich.edu 11/21/2021

Thank you for sharing with us at NAPCRG.

Jack Westfall
jwestfall@aafp.org 11/22/2021

Thanks for your terrific work on this research. The Graham Center is adding to our portfolio of telehealth research and your work is very intereting. Hope you can connect with us at the Robert Graham Center https://www.graham-center.org/rgc/home.html

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