Use of Remote Assessment Tools to Substitute Routine Outpatient Care: A scoping review. (Preprint)

BACKGROUND The increasing global demand for healthcare, driven by demographic shifts, the rise of personalized medicine, and technological innovations, necessitates novel approaches to healthcare delivery. Digital remote assessment tools have emerged as a promising solution, enabling hybrid care models that combine traditional and remote patient management. These tools support the quadruple aim of healthcare by enhancing the monitoring and evaluation of patient-reported data, thereby improving patient care, boosting operational efficiency, reducing costs, and improving the experience of patients and clinicians. This review seeks to understand how remote assessment tools are utilized for routine consultation substitution in adult tertiary care centers. OBJECTIVE This scoping review aims to evaluate the implementation and health outcomes of digital remote assessment tools used for routine consultation substitution in tertiary care centers. The objectives include assessing the extent of use, types, and effectiveness of these tools in substituting conventional outpatient care, with a focus on adult patient interventions. METHODS A comprehensive scoping review was conducted, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The review focused on studies that utilized internet-dependent remote assessment technologies for patient data transfer in hospital settings. A detailed search strategy was employed across multiple databases, with studies selected based on predefined inclusion and exclusion criteria. Data extraction and analysis were performed by independent reviewers, with a focus on the functionalities of the tools and their alignment with the Quadruple Aim of Healthcare. RESULTS The review included twelve studies, highlighting a growing interest in remote assessment technologies across diverse clinical settings. The interventions varied in length, from four weeks to 12 months, and demonstrated a range of functionalities, including symptom monitoring and post-surgical follow-ups. The use of these tools was associated with improved clinical outcomes, such as timely intervention for clinical deterioration and enhanced clinical protocol adherence. Additionally, potential cost savings were identified in terms of reduced unplanned healthcare contacts and optimized clinical resource utilization. Patient and clinician experiences were generally positive, with high adherence to remote assessments and an appreciation for the personalized and timely care facilitated by these technologies. Barriers included high initial setup costs for digital technologies, leading to an inflated cost per patient in small sample studies. CONCLUSIONS Digital remote assessment tools offer significant potential to enhance healthcare delivery by improving health outcomes, reducing costs, and enriching patient and clinician experiences. Their flexibility and adaptability make them suitable for various clinical contexts, supporting the personalization of care and operational efficiency. While digital remote assessment tools offer significant potential, careful consideration of implementation strategies, equity, cost, and clinician and patient experiences is crucial for successful clinical integration.