Amesh A. Adalja, MD, FACP, FACEP, January 23, 2015
Telemedicine is increasingly being recognized as a transformative technology that has the capacity to improve medical care delivery. Many specialties have availed themselves of this technology, and major medical centers are investing in the development of telemedicine programs. Radiology, pathology, and dermatology—because of the nature of the care these specialties provide—have been early adopters of this technology, but almost all of medicine could effectively utilize telemedicine. A recent paper published in Clinical Infectious Diseases attempts to catalog telemedicine’s use in treating infectious diseases.1
In this study Parmer and colleagues at the University of Ottawa performed a literature search focused on the use of telemedicine to manage both acute and chronic infectious diseases. Their search identified multiple publications that detailed the use of telemedicine in the management of infectious diseases.
Among the acute infectious diseases for which telemedicine was employed were bacterial endocarditis, bacteremia, skin/soft tissue infections, and urinary tract infections. Chronic infections for which it was used included hepatitis C, HIV, and tuberculosis.
In all of the studies identified, the results showed that the use of telemedicine was beneficial and/or equivalent to standard in-person care. In some of the acute care studies, decreased hospital length of stay, decreased costs, and improved antimicrobial stewardship were additional benefits. With chronic infectious diseases, response and adherence to therapy were found to be similar to usual care.
Parmer and colleagues have made an important contribution in showing how infectious disease physicians can use telemedicine to leverage their expertise. Consultation with infectious disease physicians has been shown to improve outcomes with various infections, but not every locale or hospital is fortunate enough to have access to an infectious disease physician. Telemedicine is a means to overcome that deficiency in a safe and effective manner. Such a force multiplier could also be used to improve antimicrobial stewardship activities and to facilitate earlier diagnosis and situational awareness of what might be early signs of emerging infectious diseases. While reimbursement and credentialing may pose significant obstacles to the widespread adoption of telemedicine in every state, studies such as this one can provide the impetus for adopting telemedicine—even if in only a rudimentary form—and can help put it within the reach of all hospitals.