Telehealth, the delivery of medical care remotely, is hoped to increase access to specialty services or decrease health care utilization. Physicians can provide telehealth to each other or to patients. Specialists often treat complex patients who can be adequately cared for only in academic hospitals, suggesting that providing specialty services via telehealth will reallocate rather than reduce system utilization. Here I use agent-based modeling to investigate telehealth's effects on clinical outcomes and system utilization in medical toxicology. I found that physician-physician telehealth increased patient health but system utilization did not change. The effects were more pronounced as clinical complexity increased. Physician-patient telehealth increased cost and system utilization but not clinical outcomes. Within the limitations of our approach, these results suggest that telehealth is more cost-effective for improving generalist access to specialist knowledge than in providing care to the public.

翻译：摘要：远程医疗是一种远程提供医疗服务的模式，旨在提升专科服务的可及性或降低医疗资源利用率。医生既可以通过远程医疗相互协作，也可直接为患者提供服务。专科医生通常收治仅在学术医院才能得到充分治疗的复杂患者，这表明通过远程医疗提供专科服务可能导致资源重新分配，而非减少系统负荷。本文采用基于智能体的建模方法，研究远程医疗在医学毒理学领域中对临床结局与系统利用率的影响。研究发现，医生间远程医疗可改善患者健康，但系统利用率未发生变化；且随着临床复杂程度的增加，该效应更加显著。医生-患者远程医疗虽增加了费用和系统利用率，但未改善临床结局。在模型局限性范围内，这些结果表明：相较于直接向公众提供服务，远程医疗在提升全科医生获取专科知识方面更具成本效益。