A framework for evaluating telehealth programs must consider socioeconomic aspects--not just the technological--argue researchers in an article published online in Telemedicine and e-Health.
Costs, benefits, barriers and outcomes, including clinical outcomes, are among the integral socioeconomic factors at play in telehealth implementations, they say.
The framework's key characteristics include implementations that are loosely coupled and easy to use, describe a wide range of telehealth programs and can be expanded to meet future needs.
Socioeconomic factors are just one of six key dimensions the researchers describe in their proposed framework, which also includes:
- Health domain: Each requires its own information and technology, such as oncology, neurology or dermatology.
- Telehealth services: This covers both clinical--diagnosis, consultation, case review--and nonclinical applications, such as medical training, consumer education and supervision.
- Telehealth technologies: Traditionally two basic types: store-and-forward/asynchronous and real-time/synchronous, but new ones coming on the scene.
- Communication technologies from traditional telephone lines to the high-speed broadband network.
- Environment settings: These might include hospitals, outreach clinics, health centers, home and mobile. And it might call for use of various devices using different modes of communication such as text, image, audio, video and multimodal.
Advanced telecommunication infrastructures are bringing telehealth to a wider swath of people worldwide, but the researchers also note growth in devices that don't rely on high bandwidth, such as fall detectors, bed occupancy sensors, door exit sensors and pill dispensers.
The authors point to a lack of consensus on terminology as a detriment to effectively evaluating telehealth programs. One recent study found seven unique definitions of telehealth in use across the U.S. government.
While studies in the U.K. concluded that telehealth was not cost effective nor did it improve patients' quality of life, recent Marshall University research found that e-ICUs provide benefits for hospitals, despite high costs.
To learn more:
- read the research (.pdf)