Telemedicine ‘trebles death rate’ in elderly patients

An analysis in the US has suggested the remote monitoring of elderly patients is linked to substantially increased death rates, casting doubt on the Department of Health’s flagship project to roll out greater access to telemedicine. The findings come as the DH confirmed the full results of their Whole Systems Demonstrator Project will be published shortly in the BMJ, after criticism that it had not published the full results.

The American study is a further blow to ambitious plans to increase the use of telemedicine in the NHS to save the health service up to £1.2bn over five years. Data from the WSD project released earlier this year showed a 45% reduction in mortality and a 20% fall in emergency admissions in patients with access to telemedicine – but this new study on a separate US project published in the Archives of Internal Medicine this week showed remote telemonitoring was associated with increased mortality in vulnerable patients.

The study of 205 elderly patients with a high risk of hospitalisation showed a significant increase in the mortality rate over 12 months, with rates over 12 months for the telemonitoring group at 14.7%, compared with 3.9% for the usual care group. Telemonitoring made no difference in hospitalisation rates, with rates of 63.7% in this group, compared with 57.3% in the usual care group. The report also found no differences in emergency department visits, compared with pre-enrollment.

The researchers were unable to explain the differences, but suggested it could be because an increased number of interventions and tests in the telemonitoring group.

The paper said: ‘The difference in mortality between the two groups could be due to the lower-than-expected mortality among the usual care group or could represent higher mortality among the telemonitoring group because of increased access to healthcare that occurred with telemonitoring.’

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