Improving Pain Care Through Telemedicine: Future or Folly?

In this issue, Liddy et al. [1] report their findings regarding improving access to chronic pain services through the use of telehealth e-consultative services. Dr. Liddy and her colleagues tackled a common problem of access to pain medicine consultative services in North America and found that e-consultative services greatly improved access to patient care in the Ottawa health care system. Using these services, patient information was reviewed in a median response time of less than 2 days, compared with an average wait time of 6 months or greater (up to 2.5 years) with a conventional referral and in-person consultation. Although this is significantly longer than the anticipated wait times in the United States (US), it does mirror the challenges of prompt access to care, particularly for patients in rural settings or those of lower socioeconomic status that rely on state or indigent care programs, which may further limit their access to care. The referring primary care physicians greatly valued the service in >90% of cases, citing benefits provided to both patients and themselves, and including avoidance of unnecessary in-person referrals. Unfortunately the study did not capture the patient-perceived value in the e-consultative service. The format of their intervention, … kevin.vorenkamp{at}gmail.com