Design of telehealth trials – Introducing adaptive approaches

Law, Lisa M; Wason, James

doi:10.1016/j.ijmedinf.2014.09.002

Cited by 24 publications

(17 citation statements)

References 33 publications

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“…However, RCTs are thought to be impractical for telemedicine program evaluation (138,139) . One solution was suggested by Law& Wason (140) to overcome this problem which is the utilisation of "adaptive designs" in the field of telemedicine, where new unfixed decisions can be applied in the period after the trial have started. Moreover telemedicine research is considered to be, and viewed as, an implementation research which is defined as "the scientific study of the processes used in the implementation of initiatives, as well as the contextual factors that affect these processes" (141) .…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

AlDossary

Martin‐Khan

Bradford

et al. 2017

International Journal of Medical Informatics

108

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Our systematic review identified only 137 telemedicine services. This suggests either telemedicine service implementation is still not a part of mainstream clinical services, or it is not being reported in the peer-reviewed literature. The depth and the quality of information were variable across studies, reducing the generalisability. The reporting of service implementation and planning strategies should be encouraged. Given the fast paced technology driven environment of telemedicine, this may enable others to learn and understand how to implement sustainable services. The key component of planning was underreported in these studies. Studies applying and reporting more rigorous methodology would contribute greatly to the evidence for telemedicine.

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Section: Discussionmentioning

confidence: 99%

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

AlDossary

Martin‐Khan

Bradford

et al. 2017

International Journal of Medical Informatics

108

View full text Add to dashboard Cite

show abstract

“…Implementation of telehealth, defined as technologies that enable patients and clinicians to exchange information about their health state remotely [ 1 ], has suffered from slow adoption and ‘pilotitis’ in parts of the UK and Europe [ 2 , 3 ]. Reasons for the failure of telehealth to become part of routine care are multi-faceted, with the mixed evidence of cost effectiveness often cited as one of the leading factors [ 4 – 6 ]. More specifically, inconclusive results from the Whole Systems Demonstrator trial in England are often referenced in discussions about the inability of telehealth to be scaled up in the UK [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Implementing solutions to improve and expand telehealth adoption: participatory action research in four community healthcare settings

Taylor

Coates

Wessels

et al. 2015

BMC Health Serv Res

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BackgroundAdoption of telehealth has been slower than anticipated, and little is known about the service improvements that help to embed telehealth into routine practice or the role of frontline staff in improving adoption. This paper reports on participatory action research carried out in four community health settings using telehealth for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.MethodsTo inform the action research, in-depth case studies of each telehealth service were conducted (May 2012–June 2013). Each service was then supported by researchers through two cycles of action research to implement changes to increase adoption of telehealth, completed over a seven month period (July 2013–April 2014). The action research was studied via observation of multi-stakeholder workshops, analysis of implementation plans, and focus groups.ResultsAction research participants included 57 staff and one patient, with between eight and 20 participants per site. The case study findings were identified as a key source of information for planning change, with sites addressing common challenges identified through this work. For example, refining referral criteria; standardizing how and when patients are monitored; improving data sharing; and establishing evaluation processes. Sites also focused on raising awareness of telehealth to increase adoption in other clinical teams and to help secure future financial investment for telehealth, which was required because of short-term funding arrangements. Specific solutions varied due to local infrastructures, resources, and opinion, as well as previous service developments. Local telehealth champions played an important role in engaging multiple stakeholders in the study.ConclusionsAction research enabled services to make planned changes to telehealth and share learning across multiple stakeholders about how and when to use telehealth. However, adoption was impeded by continual changes affecting telehealth and wider service provision, which also hindered implementation efforts and affected motivation of staff to engage with the action research, particularly where local decision-makers were not engaged in the study. Wider technological barriers also limited the potential for change, as did uncertainties about goals for telehealth investment, thereby making it difficult to identify outcomes for demonstrating the added value over existing practice.

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“…The potential of adaptive designs as well as their particular application to telehealth trials has been discussed previously. 24 …”

Section: Discussionmentioning

confidence: 99%

Use of an embedded, micro-randomised trial to investigate non-compliance in telehealth interventions

2016

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Design of telehealth trials – Introducing adaptive approaches

Cited by 24 publications

References 33 publications

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

Implementing solutions to improve and expand telehealth adoption: participatory action research in four community healthcare settings

Use of an embedded, micro-randomised trial to investigate non-compliance in telehealth interventions

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