A Systematic Review Identifying Adverse Health Outcomes and Mortality Rates Associated with Telehealth

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions. Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative synthesis. Of the 78 included studies 8 were included in the quantitative synthesis resulting in 2 meta-analyses. The results of the meta-analysis suggest that monitoring patients using telehealth techniques is associated with 40% lower mortality risks among patients suffering from heart failure, compared to those who received traditional care. The results of the random-effects meta-analysis showed the pooled relative risk of mortality to be 0.60, indicating that patients that underwent telemonitoring had a lower mortality risk compared with the patients that underwent usual care. Among patients with heart implants, patients who received telemonitoring had a 35% lower mortality risk compared to patients receiving traditional care. Conclusions: While RCTs of telehealth interventions demonstrate enhanced patient outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.