Evidence in the care continuum - one of the keys to the telemedicine’s success or failure?

Josep M. Picas

It’s notorious that there are a great number of experiments, publications and studies on the application of telemedicine. Over the last few years, this phenomenon that we could label as the "apps revolution" has given telemedicine a great boost. However, the results, in many cases, have not reached the expectations. 

Many studies have tried to identify the causes of this unsuccessful outcome. In a brief reference, we could mention the professionals’ inertia and resistance to change in their work processes, errors of design, i.e. not being focused on patients, regulatory aspects, lack of resources and patient adherence problems caused by, to name just two, little health literacy or the digital gap issue.

Meaningful use of electronic medical records

If you want to know if something is serious in health policy, check whether a budget allocation has been reserved for its implementation. Therefore I consider relevant that in 2011, the US federal government started a long term incentive program (until 2020) for the adoption of electronic medical records (EMR). The program is called "Meaningful use" which could be translated as meaningful use of medical records. That is, it encourages not the investment in information systems but its use and is measured by various indicators grouped into 3 stages.

Earlier this year Botta and Cutler published "Meaningful use: floor or ceiling?" an article where the process of encouragement was studied from expert interviews and from data from implementing a survey of American Hospital Association. Well, according to this analysis, the "Computerised Physicians Order Entry" (computerized physician orders) increased their deployment when they were encouraged by the "Meaningful use" program and even went ahead in the use of barcodes for drug delivery, action that was not encouraged by the government program (see figure).