The Good, the Bad, and the Ugly

http://ctel.org/2019/07/the-good-the-bad-and-the-ugly/

As with any new technology, it takes time to figure out best practices. Mistakes are made. Success is followed by failure, and the cycle repeats. It is all part of the process. Telehealth, of course, is no different. One thing that providers in the field are still trying to figure out: prescribing standards and antibiotic management guidelines for commercial telehealth providers. Unfortunately, as we’ve previously reported, a study from earlier this year showed “that commercial telehealth programs were over-prescribing antibiotics to children.” The American Academy of Pediatrics (AAP), as highlighted in a recent article from the Post and Courier, looked at children with acute respiratory infections and what type of provider they visited: telehealth, urgent care, or primary care. When going to a telehealth provider, over 50 percent of children received an antibiotic, compared to the nearly 30 percent that received antibiotics when visiting a primary care provider.

Though the number still remains on the higher side for primary
care providers, they are more likely to follow antibiotic management guidelines
than telehealth providers, who tend to prescribe even for viral infections. This
is not a new issue; the American Telemedicine Association, among others, has
already expressed concern that direct-to-consumer care could result in
over-prescribing. And over-prescribing is not to be taken lightly, as the Post
and Courier
emphasizes: “According to the Mayo Clinic, an overuse of
antibiotics can lead to the development of bacteria that is resistant to
treatment.” Obviously, that is not in the best interest of the children being
treated, or of anyone who takes antibiotics. This is why pediatric-specific
evaluations, antibiotic management guidelines, and follow-up care are so
important for all providers, telehealth or otherwise, to abide by. 

Though such research seems to reflect poorly on telehealth, studies
like this one from the AAP are extremely important if telehealth is to be taken
seriously. The research helps providers discover the areas of weakness as well
as areas of strength. It is all part of the process of discovering those best
practice standards. As the Medical University of South Carolina’s Dr. David
McSwain told the Post and Courier, “Without research on telehealth, we are just
making our best guess as to what is going to work and what isn’t.”

Click here to read the Post and Courier article on antibiotic overprescribing and telemedicine.

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Thanks !

Thanks for sharing this, you are awesome !