Research Profile – A Different Kind of House Call

UBC researchers are studying the implementation of home-based telehealth programs.

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Communications technologies are making our world smaller. With your computer or smartphone, you can video chat with someone on the other side of the world. These technologies may help solve one of the most vexing challenges in health care: connecting patients to health care providers.

Telehealth enables patients to send their health information to or consult with health care providers using technology (e.g. phone, videoconference, computer, smartphone). It could be particularly valuable to Canadians who live in remote areas and have limited access to health care.

But before provinces start investing heavily in telehealth, they need more data on how the technology should be implemented, where it will be most effective and, most importantly, how it will affect patient outcomes.

Dr. Sandra Jarvis-Selinger at the University of British Columbia is scouring the existing research on a particular kind of telehealth called telehome monitoring to help provide some of these answers. She and her team have collected and analyzed all the available research on this type of home-based telehealth.

“We wanted this project to develop applicable information that decision makers in the health authorities could enact in the course of their daily job activities and support decisions about making allocations, whether it be human resources, funding or strategic directions,” says Dr. Jarvis-Selinger.

With funding from the Canadian Institutes of Health Research, the researchers are looking specifically at how telehealth can be used to help patients manage chronic conditions, such as diabetes and cardiovascular disease. They have found that the strength and amount of evidence varies considerably from disease to disease.

For example, the researchers found numerous studies showing that cardiovascular disease patients using home-based telehealth had a high level of usage and program adherence. For stroke patients, there were many studies comparing traditional patient visits to a health care provider with home-based telehealth. The research suggested that the telehealth outcomes were comparable to in-person interactions.

One of their main conclusions from the review was that when trying to assess home-based telehealth, you need to consider a number of factors such as the technology being used, how it fits within existing health care systems, and the patient demographic, to name a few. And there were large gaps in the research, such as the economic impact of home-based telehealth and the influence of comorbidity – the presence of more than one disease.

“[The research studies] reviewed usually included individuals with a single chronic disease, because that’s what they were studying,” says Dr. Jarvis-Selinger. “But we know from the health care side of things that it’s not usually that simple – for example, patients with diabetes can also have a high incidence of high blood pressure or heart disease.”

According to Dr. Jarvis-Selinger, one of the main obstacles to implementing telehealth technologies can be the gap between the researchers and the decision makers.

“We need to identify opportunities for partnerships early on,” says Dr. Jarvis-Selinger. “That really helps researchers like myself understand and ask questions from an applied point of view. How will our investigations help decision makers and other key stakeholders positively impact change?”

That is why Dr. Jarvis-Selinger is collaborating with the people who will ultimately use her findings. She and her team have also hosted two knowledge translation forums, which have included representatives from the British Columbia health authorities, non-governmental organizations and patient advocacy groups, as well as health care professionals.

The researchers want to ensure that their findings are widely disseminated and have a sustainable impact.

“We not only want to understand how technology can support health care but also want to use technology to help decision makers access evidence-based research in an easy and useful way,” says Dr. Jarvis-Selinger.

"We need to identify opportunities for partnerships early on. That really helps researchers like myself understand and ask questions from an applied point of view."
– Dr. Sandra Jarvis-Selinger, University of British Columbia