Real-Time (Synchronous) Telehealth in Primary Care: Systematic Review of Systematic Reviews

TECHNOLOGY: Real-time telehealth involves the use of information and communication technologies (e.g., a minimum set of video cameras, computer displays, and a secure high-speed Internet connection) to enable individuals to communicate live (or synchronously) over long and short distances. ISSUE: Although real-time telehealth has been used for at least 50 years worldwide, a barrier to widespread adoption could be a lack of reliable evidence to provide the basis for policy, management, and clinical decisions. METHODS AND RESULTS: A systematic identification of studies on telehealth modalities published in English in peer-reviewed journals, assessing health outcomes, process of care, resource utilization, and user satisfaction in primary care, yielded 31 publications. Two independent teams of reviewers screened and extracted data and conducted quality assessments. While there was no formal economic analysis, any related economic outcomes were extracted from clinical reviews. The results from high quality reviews indicated that real-time telehealth could be as effective as in-person care among patients with psychiatric and neurological problems, and could reduce the number of hospital admissions and mortality rates among patients with chronic conditions such as congestive heart failure.