Experiences and results of operating telemedicine-based mobile healthcare services in rural Hungarian areas

Ábel Perjés, Eszter Iván, Dániel Eörsi, Rita Kovács, Anita Pálinkás, Ferenc Vincze, János Sándor, Péter Maróti, Ferenc Nagy

Keywords: telemedicine; rural health; underserved population; chronic diesease; hypertension; diabetes

Background:

Healthcare access is a main problem in rural, socioeconomically underprivileged areas. The Hungarian Charity Service of the Order of Malta operates a telemedicine-based mobile healthcare program (MHP) in 35 rural settlements. MHP units are vans equipped with broadband internet connection, a high-resolution teleconference platform, devices enabling certain aspects of the physical examination via telemedicine and additional diagnostic tools, such as point-of-care lab devices. These units are operated by a trained nurses who meet the patients in person, while the physician performs consultations using the teleconference platform.

Research questions:

We aimed to measure the performance of MHP regarding care delivery and effect on chronic disease management.

Method:

Patient traffic data were collected from the electronic health records system of MHP .
From patients visiting MHP units in the first six months (01.04.2023-31.10.2023) of operation, 3 cohorts were formed, based on their chronic condition: hypertension, type-2 diabetes and obesity. Disease markers (blood pressure, HgbA1C, weight) were measured for each cohort upon the first and last visits at the MHP (with min. 30 days separation).

Results:

The overall serviced population is approx. 26,000 (35 settlements). 2571 people had at least one consultation at MHP, with 6918 consultations overall in 2024. The average number of care events per person was 2.69 (SEM:0.02). The proportion of patients with controlled blood pressure grew from 12,3% to 19,5% in the hypertension cohort, and from 25.0% to 52.8% in the diabetes cohort. The relatively short time was not sufficient to identify any trend in weight and in diabetes or lipid markers.

Conclusions:

Our early results show that MHP can effectively deliver medical care and improve chronic disease management in underprivileged regions. Further data collection and analysis is currently executed by the research group, in order to accurately assess the performance of telemedicine-based healthcare services.

Points for discussion:

Outcome markers of care

Telemedicine feasibility

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