The design of pilot telecare projects and their integration into mainstream service delivery

Barlow, James; Bayer, Steffen; Curry, Richard

doi:10.1258/135763303322196132

Cited by 20 publications

(7 citation statements)

References 5 publications

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“…Many studies took place with enthusiastic supporters using home-grown technologies and the observed benefits may not therefore be replicable in other contexts, or when scaled-up for use in routine settings [105], [106], [107], [108].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

et al. 2013

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BackgroundTelehealthcare involves the use of information and communication technologies to deliver healthcare at a distance and to support patient self-management through remote monitoring and personalised feedback. It is timely to scrutinise the evidence regarding the benefits, risks and costs of telehealthcare.Methods and FindingsTwo reviewers searched for relevant systematic reviews published from January 1997 to November 2011 in: The Cochrane Library, MEDLINE, EMBASE, LILACS, IndMed and PakMed. Reviewers undertook independent quality assessment of studies using the Critical Appraisal Skills Programme (CASP) tool for systematic reviews. 1,782 review articles were identified, from which 80 systematic reviews were selected for inclusion. These covered a range of telehealthcare models involving both synchronous (live) and asynchronous (store-and-forward) interactions between provider and patients. Many studies showed no differences in outcomes between telehealthcare and usual care. Several reviews highlighted the large number of short-term (<12 months) feasibility studies with under 20 participants. Effects of telehealthcare on health service indicators were reported in several reviews, particularly reduced hospitalisations. The reported clinical effectiveness of telehealthcare interventions for patients with long-term conditions appeared to be greatest in those with more severe disease at high-risk of hospitalisation and death. The failure of many studies to adequately describe the intervention makes it difficult to disentangle the contributions of technological and human/organisational factors on the outcomes reported. Evidence on the cost-effectiveness of telehealthcare remains sparse. Patient safety considerations were absent from the evaluative telehealthcare literature.ConclusionsPolicymakers and planners need to be aware that investment in telehealthcare will not inevitably yield clinical or economic benefits. It is likely that the greatest gains will be achieved for patients at highest risk of serious outcomes. There is a need for longer-term studies in order to determine whether the benefits demonstrated in time limited trials are sustained.

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Section: Discussionmentioning

confidence: 99%

The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

et al. 2013

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“…Barlow & Venables (2003) and Gann et al (1999) argue that this is partly due to suppliers pursuing a technology-push, rather than demand-pull approach, resulting in a gap between consumer requirements for systems which are useful for managing everyday tasks and the available products. In the case of telecare applications, 'user needs' are especially complex because of the variety of stakeholders, and include their compatibility with service delivery organisation and the capability for integration with existing systems that support service delivery (Barlow et al, 2003b;Sixsmith & Sixsmith, 2000).…”

Section: Progress Towards the Visionmentioning

confidence: 99%

Flexible Homes, Flexible Care, Inflexible Organisations? The Role of Telecare in Supporting Independence

2005

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Telecare' involves the use of information and communications technologies to provide support for vulnerable individuals living in the community. The UK government wishes to make telecare available in all homes that need it by 2010. This expansion is seen as central to the improvement of older people's independence and quality of life by enabling them to live at home whenever possible. The paper discusses the range of initiatives now in place to facilitate the introduction of telecare in the UK. It argues that while there is now experience of telecare through pilot and demonstration schemes, moving to mainstream service delivery is far from straightforward. Using a case study of a telecare scheme, along with supplementary data from other schemes, the paper explores the reasons why it may be hard to meet government objectives. These include the organisational and cultural characteristics of local care institutions and the complexity of scheme objectives. It draws conclusions on the challenges in meeting aspirations for mass telecare over the next decade and on the future role of the housing stock in care provision.

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“…Potentially, greater investment in telehealth could reduce the use of long-term health services and increase economic benefits covering larger number of patients. Therefore, pilot projects should be designed with evaluation in mind, and consideration given to the integration of telehealth applications within the care system [7]. As we have noted, much less information is available on the economic case for investing in such applications.…”

Section: Telemedicinementioning

confidence: 99%

Information and communication technology in chronic diseases: a patient’s opportunity

et al. 2013

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The increasing aging population, the prevalence of chronic diseases and rising costs have brought about some unique health care challenge to our global society. In response to the unmet health care needs, researchers are actively seeking for innovative solutions that target for (1) prevention of diseases and (2) personalized diagnosis and treatment. It is envisaged that by taking preventive measures for health monitoring, diagnosing and treating patients with a personalized approach at an early stage of disease development, health care will be more cost effective and sustainable. The authors provide an overview of the advancements in Information and Communication Technology (ICT), and explain how some innovative health solutions, through the use of Telemedicine, can now be an opportunity for patients and their family.

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The design of pilot telecare projects and their integration into mainstream service delivery

Cited by 20 publications

References 5 publications

The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview

Flexible Homes, Flexible Care, Inflexible Organisations? The Role of Telecare in Supporting Independence

Information and communication technology in chronic diseases: a patient’s opportunity

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