Effectiveness and cost-effectiveness of telehealth in rural and remote emergency departments: a systematic review protocol

Christina Tsou; Suzanne Robinson; James Boyd; Andrew Jamieson; Robert Blakeman; Kylie Bosich; Justin Yeung; Stephanie Waters; Delia Hendrie

doi:10.1186/s13643-020-01349-y

Effectiveness and cost-effectiveness of telehealth in rural and remote emergency departments: a systematic review protocol

Syst Rev. 2020 Apr 17;9(1):82. doi: 10.1186/s13643-020-01349-y.

Authors

Christina Tsou¹, Suzanne Robinson², James Boyd³, Andrew Jamieson⁴, Robert Blakeman⁵, Kylie Bosich⁶, Justin Yeung⁶, Stephanie Waters⁷, Delia Hendrie²

Affiliations

¹ Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia. Christina.tsou@curtin.edu.au.
² Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
³ La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora, VIC, 3086, Australia.
⁴ WA Country Health Service, 189 Wellington Street, Perth, WA, 6000, Australia.
⁵ Consumer and Community Health Research Network, Level 6, 6 Verdun Street, Nedlands, WA, 6009, Australia.
⁶ WA Country Health Service (Command Centre), Royal Perth Hospital, Level 6, Wellington Street, Perth, WA, 6000, Australia.
⁷ WA Country Health Service, Royal Perth Hospital, Level 6, Wellington Street, Perth, WA, 6000, Australia.

Abstract

Background: Emergency telehealth has been used to improve accessibility of rural and remote patients to specialist care. Evidence to date has demonstrated effectiveness and cost-effectiveness of telehealth in rural and remote emergency departments within a variety of contexts. However, systematic reviews to date have not focused on the rural and remote emergency departments. The purpose of this study is to review the outcome measures used in evaluations of emergency telehealth in rural and remote settings and assess evidence relating to their effectiveness and cost-effectiveness.

Methods: Randomised controlled trials, non-randomised controlled trials, and full and partial economic evaluations (e.g. cost-effectiveness, cost-benefit, and cost-utility analyses) of telehealth in rural and remote emergency departments will be included. Comprehensive literature searches will be conducted in multiple electronic databases (from 1990 onwards): MEDLINE (Ovid), Cochrane Library, Scopus, CINAHL, ProQuest, EconLit, CRD databases (e.g. NHS Economic Evaluation database), and Tufts Cost-Effectiveness Registry. Two authors will independently screen all citations, full-text articles, and abstract data. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. A systematic narrative synthesis will be provided with information presented in the text and tables to summarise and explain the characteristics and findings of the studies. If feasible, we will conduct random effects meta-analysis.

Discussion: This review will identify gaps in the current body of evidence relating to the effectiveness and cost-effectiveness of rural and remote emergency telehealth services. By confining to articles written in the English language, this analysis may be subjected to publication bias and results need to be interpreted accordingly. We believe the results of this review could be valuable for the design of future economic evaluations of emergency telehealth services implemented in the rural and remote context.

Systematic review registration: PROSPERO CRD42019145903.

Keywords: Clinical effectiveness; Cost-effectiveness; Economic evaluation; Remote; Rural health; Rural population; Telehealth; Telemedicine; Treatment outcome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cost-Benefit Analysis
Emergency Service, Hospital
Humans
Meta-Analysis as Topic
Rural Population
Systematic Reviews as Topic
Telemedicine*
Text Messaging*