The Department of Health’s Whole System Demonstrator (WSD) trial – the largest of its kind conducted to date – analysed the effects of telehealth on more than 3,000 patients across three areas in England: Cornwall, Kent and Newham. Researchers at the Nuffield Trust led a key strand of the evaluation – this considered the impact of telehealth on patients’ use of hospital services and mortality rates. The remaining evaluation strands are due to be published shortly.
Although associated with fewer hospital admissions and lower mortality, emerging evaluation results show that telehealth was probably not cost effective at usual thresholds. However, the methodology deployed in the trial – randomised control – continues to raise vital questions about how best to evaluate the impact of fast developing technologies such as telehealth and telecare. With the Department of Health’s 3 Million Lives campaign now being implemented, there is a need to consider how future evaluative studies might best be designed.
Therefore, further work will need to go into the design of the telehealth technology and monitoring systems, questions about broader service design, or business and cost models. More research may provide valuable insights and help assess whether improvements are on track, but is there appetite for another randomised controlled trial?
- Considered what can be learnt from the implementation of telehealth at scale and question how this should be monitored and evaluated;
- Identified the lessons to be learnt from the WSD evaluation and consider how these can be reflected in future studies;
- Explored the extent to which new innovations in telehealth should be evaluated;
- Discussed the usefulness of telehealth research to practitioners.
You can find the findings of the Whole System Demonstrator cluster randomised trial on the BMJ website: http://www.bmj.com/content/344/bmj.e3874