Telehealth: The effects on clinical outcomes, cost effectiveness and the patient experience: a systematic overview of the literature

Telehealth is seen as a way of improving access to patient care for long term conditions and there is a considerable volume of published literature available. This report provides an overview of the best available evidence by summarising recent systematic reviews. It was found that there is more evidence for some conditions than others, but on the whole the trends are largely positive suggesting that telehealth is effective in: • Reducing patient mortality and hospital admissions for chronic heart failure • Reducing hospital admissions for COPD • Reducing blood pressure in hypertension, improving glycaemic control in diabetes and reducing symptoms in asthma For a wide range of other clinical outcomes and across conditions, telehealth seems to be as good as usual patient care, suggesting that it is fulfilling its promise of increasing access to services. Patients appear to be satisfied with telehealth services across a wide range of conditions, although there may be a need for considering individual patient requirements in some contexts. However there is a debate regarding the quality and nature of evaluations of telehealth systems and this cannot be ignored. Repeated systematic reviews have commented on the quality of evaluations. Future evaluations should incorporate mixed methods or a realist approach to examine what works for whom and why; this may well provide the way forward in examining in more depth the more meaningful effects of telehealthcare.