Authors' objectives:

VHA’s Office of Patient Care Services (OPCS) requested a review of new technologies for home telehealth. Since clinical research on novel information technologies (or new uses of established ones) inevitably will lag behind technology availability, TAP expanded its charge to an overview of systematic reviews for home telehealth.

OPCS also asked that TAP identify current business or marketplace issues for home telehealth, providing a global overview of the telemedicine, E-health, mobile health, telehealth, and personal E-health technologies marketplaces, including information and resources on the market leaders, potential partners, and future trends. Accordingly, this review is organized in two parts:
Part I: published research evidence on the effectiveness or cost-effectiveness of home telehealth to improve patient outcomes.
Part II: business/marketplace trends and issues for telemedicine.

Authors' recommendations: The literature on telehealth is vast and diffuse, with systematic reviewers culling through thousands of citations to arrive at trivial inclusion numbers. This size and scope is reflected in the often equally diffuse reviews. While all report methods in sufficient detail to qualify for inclusion here, a subset barely do: they lack focused questions and/or robust qualityassessment for included studies, thus primarily supplying qualitative catalogues of primary study coverage rather than answers to defined questions.Other TAP reviews relevant here and available on request include:Patient Centered Care (2006), which covers the effectiveness of self-management programs for chronic diseases Nurse-led Primary care (2009), including telephone triage and support programs. Among the reviewers planning statistical pooling of research results in meta-analyses, many ultimately opted against for reasons of heterogeneity; the few that did complete meta-analysis acknowledged substantial if not statistically impossible variations in study populations and telehealth interventions. TAP includes these reviews in spite of their limitations: the size and scope of available research provides answers of a kind, certainly guidance for a research agenda.TAP’s focused searches resulted in a more manageable number of citations but similar conclusions on the state of the evidence: The quality, access, or cost benefits of telehealth interventions remain more potential than well-defined through rigorous research. VA’s ongoing research (Tables1-4) will make important contributions.

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/Hometelehealth2010.pdf

Year Published: 2010

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)