Telemedicine in the tertiary liver unit: A feasibility study

Daniel J. Havaj; Svetlana Adamcová-Selčanová; Klaudia Mesíková; Janka Vnenčáková; Daniela Žilinčanová; Natália Kubánek; Karolína K. Šulejová; Zuzana Mesárošová; Juraj Šváč; Radovan Lapuník; Viktória Ďurajová; Ľubomír Skladaný

doi:10.5114/ceh.2024.145492

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Telemedicine in the tertiary liver unit: A feasibility study

Daniel J. Havaj

¹

,

Svetlana Adamcová-Selčanová

¹

,

Klaudia Mesíková

²

,

Janka Vnenčáková

¹

,

Daniela Žilinčanová

¹

,

Natália Kubánek

¹

,

Karolína K. Šulejová

¹

,

Zuzana Mesárošová

¹

,

Juraj Šváč

¹

,

Radovan Lapuník

³

,

Viktória Ďurajová

²

,

Ľubomír Skladaný

¹

2nd Department of Internal Medicine of the Slovak Medical University Faculty of Medicine, HEGITO (Div Hepatology, Gastroenterology, and Liver Transplant), F. D. Roosevelt Teaching Hospital, Banská Bystrica, Slovakia
Office of Biomedical Research, F. D. Roosevelt Teaching Hospital, Banská Bystrica, Slovakia
Department of Public Economics and Regional Development, Faculty of Economics, Matej Bel University in Banská Bystrica, Slovakia

Clin Exp HEPATOL 2024; 10, 4:

DOI: https://doi.org/10.5114/ceh.2024.145492

Online publish date: 2024/12/12

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Aim of the study:
Chronic liver disease is a global cause of morbidity and mortality. Slovakia has a high prevalence but an inadequate hepatology network. The COVID-19 pandemic catalysed telemedicine (TM) as a potential solution, which we aimed to investigate.

Material and methods:
We conducted a retrospective cohort study to evaluate the feasibility and benefits of TM for liver cirrhosis and posttransplant patients, consisting of two phases, TM1 and TM2. The main outcomes were 1) cumulative endpoint of feasibility, uptake/acceptance, adherence (TM1), and fidelity (TM1, TM2), 2) the po- tential to reduce the length of hospital stay, avert unnecessary hospital admissions, and expedite the search/recall process in case of serious signals mediated by TM. Although not analysed in this study, we have recorded variables necessary for investigating associations of TM use with clinical outcomes and healthcare expenditure.

Results:
The study included 95 patients. The adherence documented by the termination of monitoring at the designated time was higher in TM2 (81.7% vs. 58.3%). The proportion of patients terminated due to death or the physician’s decision decreased (16.9% vs. 29.2%) and was based on their discretion, unrelated to any health complications (1.4% vs. 12.5%). The clinical impact was reflected in the hospitalization rate, particularly shortened hospitalization in 11.3%, averted/prevented hospital admissions in 14.1%, and accelerated rehospitalization in 11.3% in the subsequent phase with alert-based interventions.

Conclusions:
This study showed that adherence to TM was high and integrating TM helps to reduce hospitalization rates. Despite the identified limitations, TM has the potential to improve the quality and substantially reduce the cost of care.

keywords:

Telemedicine in the tertiary liver unit: A feasibility study

Daniel J. Havaj 1 , Svetlana Adamcová-Selčanová 1 , Klaudia Mesíková 2 , Janka Vnenčáková 1 , Daniela Žilinčanová 1 , Natália Kubánek 1 , Karolína K. Šulejová 1 , Zuzana Mesárošová 1 , Juraj Šváč 1 , Radovan Lapuník 3 , Viktória Ďurajová 2 , Ľubomír Skladaný 1

telemedicine, liver transplantation, feasibility, chronic liver disease