In-Person Versus Tele-Infectious Disease (Tele-ID) Care: Is One Better?

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Abstract

We compared outcomes at 3 community hospitals before and after switching from in-person to a Tele-ID group from an academic medical center. Compared to in-person, Tele-ID received significantly more consultations with similar outcomes for length of hospital stay, transfers, readmission, and mortality. Tele-ID is a suitable alternative for community settings.

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Most cited references 18

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Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs.

Steven Schmitt, Daniel McQuillen, Ronald Nahass … (2014)

Previous studies, largely based on chart reviews with small sample sizes, have demonstrated that infectious diseases (ID) specialists positively impact patient outcomes. We investigated how ID specialists impact mortality, utilization, and costs using a large claims dataset. We used administrative fee-for-service Medicare claims to identify beneficiaries hospitalized from 2008 to 2009 with at least 1 of 11 infections. There were 101 991 stays with and 170 336 stays without ID interventions. Cohorts were propensity score matched for patient demographics, comorbidities, and hospital characteristics. Regression models compared ID versus non-ID intervention and early versus late ID intervention. Risk-adjusted outcomes included hospital and intensive care unit (ICU) length of stay (LOS), mortality, readmissions, hospital charges, and Medicare payments. The ID intervention cohort demonstrated significantly lower mortality (odds ratio [OR], 0.87; 95% confidence interval [CI], .83 to .91) and readmissions (OR, 0.96; 95% CI, .93 to .99) than the non-ID intervention cohort. Medicare charges and payments were not significantly different; the ID intervention cohort ICU LOS was 3.7% shorter (95% CI, -5.5% to -1.9%). Patients receiving ID intervention within 2 days of admission had significantly lower 30-day mortality and readmission, hospital and ICU length of stay, and Medicare charges and payments compared with patients receiving later ID interventions. ID interventions are associated with improved patient outcomes. Early ID interventions are also associated with reduced costs for Medicare beneficiaries with select infections.

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Assessment of Patient Preferences for Telehealth in Post–COVID-19 Pandemic Health Care

Zachary Predmore, Elizabeth Roth, Joshua Breslau … (2021)

This survey study assesses the factors associated with continued use of telehealth services, including experience with, cost of, and benefits or barriers to video-based clinician visits among adult patients.

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A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

Agathe Leon, César Cáceres, Emma Fernández-Covelo … (2011)

Background Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. Methodology We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. Findings Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. Conclusions Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. Trial Registration Clinical-Trials.gov: NCT01117675.

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Author and article information

Contributors

Nupur Gupta

J Ryan Bariola

John W Mellors

Rima C Abdel-Massih

Journal

Journal ID (nlm-ta): Open Forum Infect Dis

Journal ID (iso-abbrev): Open Forum Infect Dis

Journal ID (publisher-id): ofid

Title: Open Forum Infectious Diseases

Publisher: Oxford University Press

ISSN (Electronic): 2328-8957

Publication date Collection: August 2022

Publication date (Electronic): 18 August 2022

Publication date PMC-release: 18 August 2022

Volume: 9

Issue: 8

Electronic Location Identifier: ofac410

Affiliations

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania, USA

Infectious Disease Connect, Inc , Pittsburgh, Pennsylvania, USA

Author notes

Correspondence: Nupur Gupta, DO, MPH, UPMC, 3601 Fifth Ave, Suite 5B, Pittsburgh, PA 15213 ( guptan8@ 123456upmc.edu ).

Potential conflicts of interest. R. C. A.-M. is the co-founder, chief medical officer, and shareholder of ID Connect, Inc. J. W. M. is a consultant to Gilead Sciences, receives grant support from Gilead Sciences through the University of Pittsburgh, owns share options in ID Connect, Inc, and is a shareholder of Abound Bio. All other authors report no potential conflicts.

Article

Publisher ID: ofac410

DOI: 10.1093/ofid/ofac410

PMC ID: 9423376

PubMed ID: 36046699

SO-VID: b90f7a34-9d7f-448b-8edd-f398cb3f1760

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

History

Date received : 02 June 2022

Date accepted : 05 August 2022

Date: 29 August 2022

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Pages: 4

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In-Person Versus Tele-Infectious Disease (Tele-ID) Care: Is One Better?

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Abstract

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Telemedicine

Most cited references 18

Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs.

Assessment of Patient Preferences for Telehealth in Post–COVID-19 Pandemic Health Care

A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

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