BACKGROUND Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care. METHODS This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher's exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. RESULTS The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p = 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. CONCLUSIONS Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits. TRIAL REGISTRATION ClinicalTrials.Gov ID: NCT03528850 Date Registered (Retrospective): 5/18/2018. Status: Completed. IRB #: 970227.

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远程护理转换 (TTOC)：一项为期 12 个月的随机对照试验，评估远程医疗的使用以实现三重目标。

背景技术护理过渡不佳会导致医疗成本增加、急诊科室过度使用、再住院率增加，并导致患者体验和结果不佳。这项研究评估了远程医疗在改善护理过渡方面的可行性。方法 这是一项为期 12 个月的随机对照试验，评估远程医疗（远程患者监测和视频就诊）的使用与标准护理转换的比较，主要结果是重新入院和急诊科利用，次要结果是获得护理、药物管理以及依从性和患者参与。收集了电子病历数据、健康信息交换数据和电话调查数据。创建多变量逻辑回归模型来评估远程医疗对医院再入院、急诊室利用率、药物依从性的影响。使用卡方检验或费舍尔精确检验来比较远程医疗组和对照组之间的分类变量的百分比。T 检验或 Wilcoxon 秩和检验用于比较两个随机组之间的平均值和中位数。结果 该研究于 2017 年 6 月至 2018 年期间进行，纳入 102 名患者。与标准护理相比，远程医疗患者更有可能进行药物协调 (p = 0.013)，并且坚持用药的可能性是对照组的 7 倍 (p = 0.03)。远程医疗患者表现出热情 (p = 0.0001)，并相信远程医疗可以改善他们的医疗保健 (p = 0.0001)。远程医疗对急诊科利用率 (p = 0.691) 和再入院率 (p = 0.31) 均无统计学意义。100% 的远程医疗患者认为干预措施很有价值，98% 的患者表示如果有机会，他们将继续使用远程医疗来管理其医疗保健需求，94% 的患者表示远程患者监控技术很有用。结论 远程医疗可以改善出院后护理的过渡，提高患者的参与度和用药依从性。尽管这项研究无法显示远程医疗对减少医疗保健利用率的影响，但需要进行更多的研究，以了解远程医疗对防止可避免的再次入院和急诊就诊的真正影响。试验注册 ClinicalTrials.Gov ID：NCT03528850 注册日期（回顾）：2018 年 5 月 18 日。状态：已完成。IRB 号：970227。