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Early Evidence, Future Promise of Connected Health

Health Affairs Thematic Issue

Three articles in the February issue of Health Affairs examine the benefits and challenges presented by telehealth and how to prepare for Medicaid expansion.

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The success of the Affordable Care Act (ACA) will depend on embracing technology that allows providers to reach more patients, treat them effectively and efficiently, and track their progress over time. With partial sponsorship from the California Health Care Foundation (CHCF), the February 2014 issue of the journal Health Affairs explores the early evidence and future promise of connected health, which includes telemedicine, telehealth, and mobile health.

The issue includes three articles that result from CHCF-supported work. The first two investigate the benefits and challenges of telehealth services, which promise to play an increasingly important role in health care delivery, and the third examines how the Oregon Medicaid program addressed the needs of newly insured patients.

More detail on each article, with a toll-free link to access the full text, is below.

  • "Analysis of Teladoc Use Seems to Indicate Expanded Access to Care for Patients Without Prior Connection to a Provider," by Lori Uscher-Pines and Ateev Mehrotra, offers new insight into the types of patients that seek tele-enabled visits, and what kind of care they require after. Using data from Teladoc, one of the largest telehealth services in the United States, the authors compared patients who sought tele-visits to peers who visited hospital emergency departments or doctor offices for similar problems. The study shows that Teladoc users were younger, more affluent, and less likely to have an established relationship with a health care provider. In addition, patients using the Teladoc service had fewer (6%) follow-up visits to any setting, in contrast to the comparison group, which had more follow-up visits to the ED (20%) or a physician's office (13%).
  • "For Telehealth to Succeed, Privacy and Security Risks Must Be Identified and Addressed," by Joseph Hall and Deven McGraw, describes safeguards that the telehealth industry should consider. A growing array of body sensors, apps, and medical devices perform clinical miracles, from detecting medical emergencies to relaying health data between patients to providers. While these technologies have tremendous potential benefits, they also pose inherent risks related to the privacy and security of patient data. The authors suggest that establishing a comprehensive regulatory framework will help protect against unintended data breaches and engender greater patient and provider trust in telehealth.
  • "New Medicaid Enrollees in Oregon Report Health Care Successes and Challenges," by Heidi Allen, Bill Wright, and Katherine Baicker, discusses their series of in-depth qualitative interviews and examines the health care interactions and health perceptions of 120 patients three years after gaining Medicaid coverage in Oregon. The findings show that 60% of the newly covered patients regularly accessed health care services. Many patients in this group also revealed that building a positive relationship with their physician and continuing to seek care over time were critical to improving their health. However, the 40% of patients who sought care only occasionally pointed to a variety of reasons, including the perception of few health problems, confusion about their coverage, and negative encounters with providers. The authors conclude with recommendations for how states can improve the experiences and outcomes for new Medicaid enrollees.

The full articles are available at no charge through the External Links below.

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