Evaluation
Policy makers, administrators and health care professionals need clear answers to questions such as: Does a technology offer a clinical advantage over the alternatives? Is it a better use of scarce resources than conventional alternatives? Who would benefit from its use?
Health technology assessment is the process of systematically reviewing existing evidence about new technologies and providing an evaluation of their effectiveness (e.g. in clinical and cost terms) on the health of patients and on the health care system.
These fundamental - and difficult - questions depend on formal evaluation, usually by a multi-disciplinary team of researchers. In the case of telemedicine/e-health work, the team will include experts with proficiency in areas such as clinical care, technology and health economics.
Assembling the evidence
An information specialist will systematically search the literature, including the 'grey' literature, to find all available information about the topic in question. The lead researcher will also solicit information directly from manufacturers, authors of reports and other experts in the field
It is often necessary to conduct prospective surveys to gather the required data from telemedicine and e-health users, including patients, doctors and health service administrators. In a nascent field like telemedicine, it is sometimes necessary to conduct safety and feasibility studies before an evaluation can be completed.
Synthesizing and interpreting the evidence
After the data-collection stage, there is a well-defined process to synthesize and analyze the evidence, in order to minimize bias and ensure transparent, reproducible results.
Previous evaluations in which COH staff have been involved include:
- real-time teledermatology in UK general practice (societal perspective) [1]
- real-time telepaediatrics in Queensland (family perspective) [2]
- real-time assessments of elderly people in residential homes in Queensland (provider perspective). [3]
References
Wootton R, Bloomer SE, Corbett R, Eedy DJ, Hicks N, Lotery HE, Mathews C, Paisley J, Steele K, Loane MA. Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis. British Medical Journal 2000; 320: 1252-1256
Smith AC, Youngberry K, Christie F, Isles A, McCrossin R, Williams M, Van der Westhuyzen J, Wootton R. The family costs of attending hospital outpatient appointments via videoconference and in person. Journal of Telemedicine and Telecare 2003; 9 (suppl. 2): 58-61
Hassall S, Wootton R, C Guilfoyle C. The cost of allied health assessments delivered by videoconference to a residential facility for elderly people. Journal of Telemedicine and Telecare 2003; 9: 234-237
