The Institut Avedis Donabedian-UAB on commission by the Fundació TicSalut this year made a bibliographical study of more than 125 scientific articles on unattended healthcare models through ICTs.
In the presentation at the TecnoCampus Mataró-Maresme, Dr. Sunyol made an introduction to the concepts to define unattended healthcare models based on the use of ICTs for transmitting information. All of the concepts drawn from this are gathered in one single concept, which is eHealth, and in which we must distinguish different disciplines and subunits, such as telemedicine. However, at the present time there is a lack of definitions for each of the terms, which causes certain confusion both in the area of research and healthcare.
Today, telehealth is more highly developed in territories such as the United States, with outstanding experiences such as that of the Veterans Health Administration (VHA) and Kaiser Permanente-, in the Canadian province of Ontario, Australia, Israel, Denmark, Scotland and the United Kingdom. In Catalonia, several interesting initiatives in telemedicine have already been started up, said the directress of the Institut Avedis Donabedian-UAB.
With respect to the British experience, Dr. Sunyol highlighted the case study of the ambitious NHS Whole System Demonstration Trial, designed as a test bed to support large investment decisions. Although the studies made reveal falls in mortality and hospitalisation, the interventions are too expensive and the researchers have not managed to assess the social costs and the full benefits as well as the added value of these kinds of ICT initiatives in health for society.
“Although there is a very large body of knowledge in the areas of unattended healthcare, the studies show limitations due to lack of consistent definitions, the small signs and the short follow-up time,” were the conclusions of the talk. Furthermore, although two thirds of the reviewed studies indicate that ICTs have an important impact on unattended healthcare, everything seems to show that there are areas in which it is not at all clear that the models developed up to the present time actually work. “In telehealth it is necessary to consider the content, the context and the implementation,” explains Dr. Sunyol.
Therefore the monographic study reveals the need to start research projects in order to consolidate the positive proof on the actual clinical effects of the telemedicine projects, the cost effectiveness of the interventions and the impact on the use of health resources. The reflections of the study must support the exploration of priorities for the future implementation of unattended models in the Catalan health system.
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