A “matter of communication”: A new classification to compare and evaluate telehealth and telemedicine interventions and understand their effectiveness as a communication process

Abstract

This article attempts to define functions and applications of telemedicine and telehealth in order to achieve a simplified and comprehensive taxonomy. This may be used as a tool to evaluate their efficacy and to address health policies from the perspective of the centrality of information in the healthcare. Starting from a lexical frame, telemedicine or telehealth is conceived as a communication means and their action as a communication process. As a performance, the communication is related to the health outcome. Three functions ( telemetry, telephasis, and telepraxis) and nine applications are identified. Understanding the mechanisms of telemedicine and telehealth effectiveness is crucial for a value-driven healthcare system. This new classification-focusing on the end effect of telemedicine and telehealth and on the type of interactions between involved actors-moves toward a new and simplified methodology to compare different studies and practices, design future researches, classify new technologies and guide their development, and finally address health policies and the healthcare provision.

Patient Experiences of Web-Based Cognitive Behavioral Therapy for Heart Failure and Depression: Qualitative Study

“…At a conceptual level, wCBT can be described as a form of telehealth, that is, a system that enables patients to access health education and support for self-care usually through the internet [ 32 ]. In line with Colucci et al [ 33 ], wCBT can be seen as a form of telepraxis with applications of interventions, support, and education to the patient by a health care professional. Though there is no consensus definition of telehealth or telemedicine, most definitions include or acknowledge a physical distance between the health care provider and the person receiving health care [ 34 ].…”

How does it work? Factors involved in telemedicine home-interventions effectiveness: A review of reviews

“…An important hypothesis worth investigating is the role of an improved patient-physician relationship and increased contacts [ 7 , 15 , 52 , 62 ] in affecting disease management, as it may trigger or enhance several other factors (education, support, self-efficacy, satisfaction, engagement). ICT are primarily a communication strategy, and a way to enhance communications, and their effectiveness probably stems from this primary mechanism [ 16 ]. Data transfer creates a close patient-carer relationship [ 66 ].…”

“…The expected, relevant differences in the included reviews regarding scopes, methods and examined IBI prevented a systematic analysis. Indeed, the difficulty of comparing different IBI was already reported [ 16 ] and many of the included reviews themselves [ 1 , 18 , 20 – 27 ] reported how the heterogeneity of studies (in design, population, duration, intervention, outcome assessed, etc.) affected the choice of methodology (e.g.…”

“…The most relevant difficulty to face, however, is probably the one related to the reported efficacy of telemedicine: this might have a multi-factorial origin, and be attributable to more than one factor involved in interventions, or also to their synergistic interaction [ 15 ]. We might find an answer through the proper comparison between different studies and ICT-based interventions in the healthcare system (IBI), but the lack of a unified and universally recognized classification of ICT use is a limitation [ 16 ]. In addition, some relevant outcomes ‒ other than clinical effectiveness–should be considered more carefully, including, for instance: patient-related outcomes, such as improvements in quality of life and quality of healthcare; and healthcare organization-related outcomes, such as improvements in healthcare provision and accessibility, cost reductions, and avoidance of inappropriate health service utilization.…”

“…Especially when the purpose is, for example, to support or replace usual care with telemedicine home-interventions (THI)–interventions where, using an ICT, a telecure action is performed delivering a cure function, e.g. a telemetry [ 16 ], to a patient based at home, without an access to a clinic or a hospital ‒ such approach may help to develop the most effective telemedicine model, plan appropriate healthcare services accordingly, and manage available healthcare resources efficiently.…”