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Self monitoring vs telehealth

Excellent comment by Mary Hawkins on the EHI article. There is a lack of evidence for most specific implementations of telehealth. This could be because, as Mary suggests, self-monitoring already happens without devices being directly linked to the EHR or health services - but with the patient or local carer doing the monitoring and calling the health services when needed.

It may be that the technology is moving on faster than the evidence base can keep up with, so there is little incentive to invest in long-term research projects to evaluate technology and methods that will be out of date when the research results are out.
It could also be that we will not call it "telehealth" when it works. Thousands of people are using online weight monitoring and calorie counting tools - these could be linked up to provide extracts to the NHS. Gym equipment and pedometers provide electronic logs of the exercise that people are doing in a way that could be linked to EHR data - either for routine care, or for better targeting of care.

Maybe the way to get "telehealth" working is not to look at buying and installing new kit -- but looking at the way that existing kit and information is being used, and seeing how services can be adapted to make better use of the existing information landscape. Helping patients to become "expert patients" and use the data and data processing tools that they have, and helping healthcare delivery services to be more proactive in finding and reaching out to those who will benefit from their attention, rather than waiting for patients to make appointments. This will accelerate improvements in health outcomes, and will result in a better definition of what useful telecare services might look like.

By Charlie McCay