BackgroundMany systematic reviews exist on the use of remote patient monitoring (RPM) interventions to improve clinical outcomes and psychological well-being of patients with heart failure. However, research is broadly distributed from simple telephone-based to complex technology-based interventions. The scope and focus of such evidence also vary widely, creating challenges for clinicians who seek information on the effect of RPM interventions.ObjectiveThe aim of this study was to investigate the effects of RPM interventions on the health outcomes of patients with heart failure by synthesizing review-level evidence.MethodsWe searched PubMed, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Library from 2005 to 2015. We screened reviews based on relevance to RPM interventions using criteria developed for this overview. Independent authors screened, selected, and extracted information from systematic reviews. AMSTAR (Assessment of Multiple Systematic Reviews) was used to assess the methodological quality of individual reviews. We used standardized language to summarize results across reviews and to provide final statements about intervention effectiveness.ResultsA total of 19 systematic reviews met our inclusion criteria. Reviews consisted of RPM with diverse interventions such as telemonitoring, home telehealth, mobile phone–based monitoring, and videoconferencing. All-cause mortality and heart failure mortality were the most frequently reported outcomes, but others such as quality of life, rehospitalization, emergency department visits, and length of stay were also reported. Self-care and knowledge were less commonly identified.ConclusionsTelemonitoring and home telehealth appear generally effective in reducing heart failure rehospitalization and mortality. Other interventions, including the use of mobile phone–based monitoring and videoconferencing, require further investigation.

The terms 'telemedicine', 'telehealth' and 'e-health' are often used interchangeably. We examined the occurrence of these terms in the Scopus database. A total of 11,644 documents contained one of the three terms in the title or abstract. Telemedicine was the most common term, with 8028 documents referring to it, followed by e-health (n = 2573) and then telehealth (n = 1679). Telemedicine was referred to in documents from 126 countries; the terms telehealth and e-health were found in publications from 55 and 99 countries, respectively. Documents with telemedicine in their title or abstract first appeared in 1972, and continued to appear at a low rate until 1994 when they started to increase rapidly; telehealth showed a similar pattern, but with the growth beginning about five years later. Although articles containing the term e-health appeared later than the other two terms, the rate of increase was higher. Articles (journal papers) were the most common type for the three key terms, followed by conference papers and review articles. Publication rates for telemedicine or telehealth or e-health were compared with two other relatively new fields of study: Minimally Invasive Surgery (MIS) and Highly Active Antiretroviral Therapy (HAART). Publications concerning HAART seem to have reached a peak and are now declining, but those with the three key terms and those concerning MIS are both growing. The variation in the level of adoption for the three terms suggests ambiguity in their definition and a lack of clarity in the concepts they refer to.