Table 4.
Summary of the interventions and outcomes of the included studies in adult populations.
| Source (Country) | Purpose | Telemedicine intervention | Main findings |
| Agrawal 2014 [51] (India) | Improve blood donor recruitment, retention, and relationship management | Call center staffed with personnel to conduct phone calls and send SMS text messages to recruit and build relationships with blood donors | Feasibility: Telerecruitment contributed to 63% of in-house and 13% of total donations Clinical outcomes: Telerecruitment helped establish relationships with blood donors and the society in general |
| Applebaum 2012 [52] (United States) | Determine the relationship between therapeutic alliance through telephone delivered cognitive behavioral therapy and psychotherapy outcomes in survivors of hemopoietic stem cell transplantation with posttraumatic stress disorder | Telephone-administered cognitive behavioral therapy | Clinical outcomes: Therapeutic alliance by telephone cognitive behavior therapy predicted decreased depressive symptoms, decreased general distress, and lower likelihood for re-experiencing symptoms |
| Bakitas 2015 [53] (United States) | Investigate the effect of early versus delayed palliative care on the quality of life of advanced-stage cancer patients | Weekly telehealth nurse coaching sessions | Clinical outcomes: No statistically significant evidence to support improved patient-reported outcomes in early versus late palliative care groups Statistically significant improved 1-year survival rate in early versus late palliative care groups (P=.04) |
| Barcellona 2013 [54] (Italy) | Compare the effect of a point-of-care home monitoring testing device supplemented by telemedicine with conventional monitoring in patients chronically treated with anti-vitamin K antagonists | TAONet telemedicine platform allowed patients to send international normalized ratio (INR) results and other clinical information to the Thrombosis Centre, as well as communicate with providers, adjust medications, and screen for serious events | Clinical outcomes: Greater blood checks and fewer missed INR checks in the home monitoring group Significant increase in time spent within the therapeutic range in the unstable group with home monitoring compared to conventional monitoring No significant difference in time spent within the therapeutic range in the stable group with home monitoring compared to conventional monitoring |
| Blissit 2015 [55] (United States) | Compare the effect of telephone versus face-to-face care on time spent within the therapeutic range for patients on warfarin | Pharmacist-managed care via telephone for patients taking warfarin | Clinical outcomes: No significant difference in time spent within the therapeutic range, significant bleeding rates, death rates, and thromboembolic events between face-to-face and telephone groups |
| Breen 2015 [42] (Australia) | Evaluate a real-time remote telemedicine system to improve monitoring and management of side-effects in patients with blood cancers | Smart phone app collected ambulatory patient health data in real time and transmitted this information to the treatment hospital where alerts were generated for actioning based on imputed patient data | Satisfaction: Patients reported increased feelings of empowerment and health awareness and adherence with the use of the application Clinical outcomes: Patients were better able to recall side-effects when using the application. |
| Burwick 2018 [56] (United States) | Identify ways to improve care of patients with monoclonal gammopathy of undetermined significance through e-consult use | Review of electronic hematology consults for monoclonal gammopathy of undetermined significance through e-consult use | Accessibility: Short time (2 days) to completion of e-consult Majority of e-consults were low risk |
| Cecchini 2016 [57] (United States) | Evaluate the efficacy of e-consults for the management of hematological disorders | Electronic consults with hematologists | Satisfaction: 65% of patients who responded said they preferred e-consults over face-to-face visits All providers who responded said they were either “satisfied” or “very satisfied” with e-consults Feasibility: 18% drop in face-to-face consults within 2 years of e-consult implementation |
| Clarke 2011 [58] (Canada) | Assess oncology telehealth usage in British Columbia | Oncology and genetic counselling appointments conducted with tele-conferencing units | Feasibility: Medical oncology teleconferences occurred more often than genetic counseling and medical genetics Clinical outcomes: A single medical oncologist conducted 58.7% of all telehealth encounters in 2009 Most common telehealth appointment types were gastrointestinal cancer and lymphoma |
| Compaci 2011 [59] (France) | Assess the feasibility and benefit of Ambulatory Medical Assistance phone calls in monitoring aggressive B-cell lymphoma treated with R-CHOP therapy | Standardized 10-minute telephone call twice a week by an oncology nurse to monitor vitals and side-effects during chemotherapy treatment | Clinical outcomes: Lower incidences of secondary hospitalization, delayed treatment, and reduced relative dose intensity, toxic death, and red blood cell transfusion compared to literature |
| Flannery 2009 [60] (United States) | Define telephone call volume, distribution, and reason in an ambulatory oncology practice | Telephone triage line managed by nurses to address patient symptoms | Feasibility: Seven calls were made or received for every 10 scheduled appointments Most calls were made on Monday mornings 30% of calls were made for more than one reason |
| Hung 2014 [61] (Australia) | Evaluate the impact of telephone counseling on nutrition and exercise after peripheral blood stem cell transplantation | Telephone counseling sessions conducted by a dietitian or exercise physiologist every 2 weeks for up to 100 days after transplantation | Clinical outcomes: Increased, but not statistically significant, protein intake (P=.17), cognitive functioning (P=.34), and social functioning (P=.17) in the extended care group versus usual care group Decreased, but not statistically significant, weight loss (P=.06) in the extended care group versus usual care group |
| Kirsh 2015 [62] (United States) | Analyze the impact of e-consults in improving specialty care access for veterans | E-consult service for various specialties |
Feasibility: Hematology had the second highest (after cardiology) rate of e-consults Clinical outcomes: Within the first 3 months after an e-consult, there was a decreased likelihood of a subsequent face-to-face visit (P<.001) Within the first 3 months after an e-consult, there was an increased likelihood of a primary care visit (P<.001) |
| Najafi 2017 [63] (United States) | Evaluate the feasibility and acceptability (by providers) of an inpatient e-consult service | E-consult service for subspecialist consults | Feasibility: Majority of hospitalists and consultants believe that e-consults are easy to use and efficient Hematology had the second highest volume of e-consults Satisfaction: All hospitalists who completed the survey were satisfied with quality 43% of consultants who completed the survey felt they were able to provide high-quality care |
| Overend 2008 [64] (Canada) | Determine the efficacy, safety, and patient satisfaction of a nurse-led teleclinic to manage patients with indolent and chronic hematological malignancies | Nurse-led teleclinic interviews for hematology/oncology patients in between oncologist visits | Satisfaction: 82% of patients felt strongly that they could talk easily and openly, and that the provider was able to understand their situation to provide satisfactory care 62% reported they would participate in a teleclinic again Accessibility: Majority of patients did not feel that they needed to see a physician in person |
| Philip 2015 [65] (United States) | Evaluate the efficacy of a telephone-based pharmacist anticoagulation service | Telephone-based anticoagulation service run by pharmacists | Clinical outcomes: Increase in clinical pharmacy patient volume at ambulatory care clinics after the intervention No significant difference in time in the therapeutic range, hospitalization from thrombotic events or bleeding, work hours, and project completion rates between groups |
| Prochaska 2017 [66] (Germany) | Compare the outcomes of oral anticoagulation patients managed by an eHealth-based coagulation service versus regular medical care | Electronic file was used to manage medication and data at remote locations and interface between patients and providers | Clinical outcomes: eHealth service participants had lower rates of bleeding, hospitalization, and all-cause mortality compared to participants who received regular medical care |
| Reid 2011 [67] (Ireland) | Investigate the usage and patient/caller profile of a nurse-led chemotherapy telephone helpline | Telephone service run by nurses experienced in oncology and chemotherapy to address patient questions and concerns | Feasibility: 7498 calls received by helpline service 35.2% of patients called with multiple symptoms or concerns Accessibility: 47.5% of face-to-face consultations were avoided 4.3% of e-consults resulted in a follow-up referral that was not already scheduled Clinical outcomes: 36.8% of calls led to direct medical assessment |
| Skeith 2017 [68] (Canada) | Analyze the use and impact of e-consults in managing thromboembolic conditions | E-consult service for thrombosis medicine | Feasibility: Most common referral topics were thrombophilia testing, superficial venous thrombosis, and venous thromboembolism anticoagulation Satisfaction: Positive responses by primary care providers regarding the e-consult service |
| Syrjala 2011 [69] (United States) | Describe the development and feasibility of a new online survivorship care program for cancer patients treated with hemopoietic stem cell transplantation | Survivorship care delivered remotely through an online platform | Feasibility: 57% of participants required staff contact at least one time, usually for minor technical issues, or help in enrollment or the baseline assessment Most contacts were initiated by email instead of telephone |
| Testa 2005 [70] (Italy) | Implement a telemedicine system to deliver the same quality of care as traditional medicine in anticoagulation management, especially for those living far away from an anticoagulation center | Remote anticoagulation management via an electronic medical record system through which patients or health centers can send INR data to an anticoagulation clinic | Clinical outcomes: No difference in time in the therapeutic range between anticoagulation clinics (73%) and telemedicine use in general practitioner units (73.4%) Telemedicine use in nursing homes showed a lower percentage in the therapeutic range (66%) compared to anticoagulation clinics (73%) No difference in major complication rates between telemedicine use in peripheral units and anticoagulation clinics |
| Woods 2000 [72] (United States) | Evaluate the efficacy of the Georgia statewide telemedicine program in improving access to health services for patients with sick cell disease in remote areas | Telemedicine clinic for sickle cell patients with assistance of nurses at remote locations | Feasibility: Progressive increase in telemedicine clinic productivity over the course of the study Accessibility: Rural outreach increased from 19% to 29% of total clinic activity over the course of the study |
| Woods 1999 [73] (United States) | Compare patient satisfaction between telemedicine encounters and standard care for the management of sickle cell disease in adults | Telemedicine clinic for sickle cell patients with assistance of nurses at remote locations | Satisfaction: No significant difference in patient satisfaction between telemedicine and standard care groups Patients in the standard care group were more likely to offer positive open-ended comments than the telemedicine group Reasons for negative comments in the telemedicine group included confidentiality, technology, and access |
| Woods 1998 [71] (United States) | Evaluate the efficacy of a telemedicine clinic for adult sickle cell patients | Telemedicine clinic for sickle cell patients with assistance of nurses at remote locations | Clinical outcomes: No significant difference in clinic encounter time between telemedicine and standard care groups |
| Wright 2007 [74] (Canada) | Evaluate the efficacy and acceptability of an e-clinic for management of allogeneic blood and stem cell transplant patients | E-clinic visits at local health centers using videoconferencing technology | Clinical outcomes: High adherence rate for follow-up visits (87.5%) Improved symptom management Satisfaction: High satisfaction with e-clinic visits |