6
doc • February - March 2014
Kentucky
Use of Telemedicine
Technology in Monitoring
Compliance in Patients
By Thomas W. Miller
Ph.D. ABPP, Staff
Writer
According to recent figures from the Centers
for Disease Control and
Prevention, chronic diseases are the leading
causes of death and disability and account
for seven out of 10 deaths in the United
States each year. More than half of these
deaths are due to heart disease, cancer, and
stroke. Treatment for patients with comorbid chronic conditions costs up to seven
times as much as treatment for patients
with only one chronic condition. Emerging
evidence supports the feasibility and costeffectiveness of using home telemedicine
monitoring to promote health and chronic
disease management.
Clinical telemedicine uses video conferencing, specialty cameras and diagnostic tools
such as electronic stethoscopes to connect
medical specialists from a medical center to
patients in rural healthcare sites. The physician provides assessment and evaluation of
new and follow-up patients in a variety of
specialties and then sends recommendations
to the primary care provider. A specially
trained nurse or physician assistant or technician attends the “video visit” with the
patient and acts as the physician’s “hands”
while using special cameras that allow the
physician to visualize and examine the
patient as he or she would in their regular
clinics office.
Results from a randomized controlled trial
by Berman et al. (2012) demonstrated
improved health outcomes and cost-effectiveness in high-risk patients with end-stage
renal disease using remote technology (RT)
for home health monitoring with remote
care nurse (RCN) support. Self-assessment
procedures used as therapeutic interventions to facilitate behavioral changes and
yield positive treatment outcomes have been
reported. It has also been suggested by the
World Health Organization that the quality of the relationship between patient and
healthcare provider (e.g., nurse, physician)
is an important determinant of treatment
adherence and may promote self-management and better outcomes. Numerous
studies report patients face several obstacles
(some self-described) in self-management
programs (e.g., pain, diabetes, chronic conditions), such as inadequate family support,
transportation, pain and fatigue, low selfefficacy, depression, and lack of discipline.
Michel Tousignant’s clinical research team
also found that high levels of satisfaction
with healthcare increase patients’ motivation
and treatment adherence.
A national model for telemedicine care
and service is realized through Kentucky
Telecare housed at the University of
Kentucky, Chandler Medical Center.
Providing access to patients in rural and
underserved communities in Kentucky,