Why is BMJ so negative about telehealth?

BMJ has done research: “to assess the effect of the second generation1, home based telehealth on health related quality of life, anxiety, and depressive symptoms over 12 months in patients with long-term conditions.” The conclusion is: “Telehealth did not improve quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease, diabetes, or heart failure over 12 months. The findings suggest that concerns about potentially deleterious effect of telehealth are unfounded for most patients.”

The question at Vitaphone and on different LinkedIn discussions arose: “Why is BMJ so negative about telehealth?” We, at Vitaphone think that Richard Stubbs of the NHS East London has a good explanation for this:

“Maintaining quality of life in a time of increasing demand on limited resource is a considerable challenge in itself. Telehealth can be regarded as a form of “channel shift” in which the NHS’s default of face to face support can be substituted by remote support for patient self care. Such changes have happened in many areas of live and indeed Newham Council’s channel shift service delivery strategy has already saved millions of pounds. I think this is a better, or at least different, context for discussion of the benefits of telehealth rather than QALYs.”

Indeed this is a better perspective. The quality of life did not improve by using telehealth but it did not deteriorate either and with the limited resources that is a whole accomplishment.

1 = Second generation systems have a non-immediate analytical or decision-making structure. Data transfer is synchronous—that is, there is some real-time processing of patient data using, such as, automated algorithms to interpret the data. Care providers can recognize important changes in essential measurements, but delays can occur if the systems are only active during office hours.

Source: BMJ

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