Appropriate Use of Telehealth Visits in Endocrinology: Policy Perspective of the Endocrine Society

Author:

Vimalananda Varsha G12ORCID,Brito Juan P34,Eiland Leslie A5,Lal Rayhan A678,Maraka Spyridoula3910,McDonnell Marie E1112ORCID,Narla Radhika R1314,Roth Mara Y13,Crossen Stephanie S1516

Affiliation:

1. Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System , Bedford, Massachusetts 01730 , USA

2. Section of Endocrinology, Diabetes, Nutrition & Weight Management, Department of Medicine, Boston University School of Medicine , Boston, Massachusetts , USA

3. Knowledge and Evaluation Research (KER) Unit, Mayo Clinic , Rochester, Minnesota , USA

4. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic , Rochester, Minnesota , USA

5. Division of Diabetes, Endocrinology & Metabolism, Department of Internal Medicine, University of Nebraska Medical Center , Omaha, Nebraska , USA

6. Division of Endocrinology, Department of Medicine, Stanford University , Stanford, California , USA

7. Division of Endocrinology, Department of Pediatrics, Stanford University , Stanford, California , USA

8. Stanford Diabetes Research Center, Stanford University , Stanford, California , USA

9. Division of Endocrinology and Metabolism, Department of Medicine, University of Arkansas for Medical Sciences , Little Rock, Arkansas , USA

10. Section of Endocrinology, Central Arkansas Veterans Healthcare System , Little Rock, Arkansas , USA

11. Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts , USA

12. Harvard Medical School , Boston, Massachusetts , USA

13. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington , Seattle, Washington , USA

14. VA Puget Sound Health Care System , Seattle, Washington , USA

15. Division of Endocrinology, Department of Pediatrics, University of California Davis School of Medicine , Sacramento, California , USA

16. Center for Health and Technology, University of California Davis Health , Sacramento, California , USA

Abstract

Abstract Objective This work aims to guide clinicians practicing endocrinology in the use of telehealth (synchronous patient-clinician visits conducted over video or telephone) for outpatient care. Participants The Endocrine Society convened a 9-member panel of US endocrinologists with expertise in telehealth clinical care, telehealth operations, patient-centered care, health care delivery research, and/or evidence-based medicine. Evidence The panel conducted a literature search to identify studies published since 2000 about telehealth in endocrinology. One member extracted a list of factors affecting the quality of endocrine care via telehealth from the extant literature. The panel grouped these factors into 5 domains: clinical, patient, patient-clinician relationship, clinician, and health care setting and technology. Consensus Process For each domain, 2 or 3 members drew on existing literature and their expert opinions to draft a section examining the effect of the domain’s component factors on the appropriateness of telehealth use within endocrine practice. Appropriateness was evaluated in the context of the 6 Institute of Medicine aims for health care quality: patient-centeredness, equity, safety, effectiveness, timeliness, and efficiency. The panel held monthly virtual meetings to discuss and revise each domain. Two members wrote the remaining sections and integrated them with the domains to create the full policy perspective, which was reviewed and revised by all members. Conclusions Telehealth has become a common care modality within endocrinology. This policy perspective summarizes the factors determining telehealth appropriateness in various patient care scenarios. Strategies to increase the quality of telehealth care are offered. More research is needed to develop a robust evidence base for future guideline development.

Funder

National Institutes of Health

Lilly, Inc.

National Institute for Diabetes and Digestive and Kidney Diseases

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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