How to use the telehealth database
The database can be searched using your own search terms, but we recommend using a combination of the selections in the three drop-down boxes:
1. Type of evidence
Quality is an important criterion in order to make judgements on the value of evidence. To enable this, searches can be refined to only include evidence of ‘high quality’ as well as the ‘wider evidence-base’.
Evidence of the highest quality
This category represents the evidence that would be most likely be accepted for inclusion in a systematic review. It includes systematic literature reviews; randomised controlled trials/clinical trials; and peer-reviewed qualitative studies (minimum 80 participants). Such information is typically used to make evidence-based decisions.
The wider evidence base
This category represents the evidence that would most likely not be accepted for inclusion in a systematic review. However, it represents a body of knowledge that is typically used to make evidence-informed decisions. It may include:
- qualitative studies (peer reviewed, less than 80 participants)
- case studies / examples / early findings from pilots / research in progress
- opinion surveys / patient surveys / questionnaires / focus groups
- theory / economic modelling
- policy documents and papers
- expert writer opinion / books / unpublished theses / non-systematic reviews
- anecdote / conference proceedings
Has any evidence been excluded?
The database only cites studies where evidence of ‘impact’ is provided. This includes individual or population-based outcomes (such as health outcomes, changes in dependency levels, user experiences) as well as system outcomes (such as cost-effectiveness, rates of emergency admissions, bed utilisation). The database does not contain evidence reporting on organisational development.
The database places no restrictions on the source of the evidence that may be included in the database. Hence, the database may include publicly-available evidence published or sponsored by telecare and telehealth vendors. Users of the wider-evidence must therefore treat with caution the information available both in terms of its quality and potential subjectivity.
Through listing sources of information in the wider evidence base, The database is not in any way accrediting or attributing credibility or value to the information provided.
2. Type of long-term condition or client group
The database provides a drop-down list of conditions and client-groups in order for searches to be refined.
In providing this list, we have defined long-term conditions as follows:
Long-term conditions are chronic conditions that require ongoing management over a period of years or decades. This includes a range of health conditions such as non-communicable diseases (such as cancer and heart disease); some communicable diseases (such as HIV/Aids) and mental health disorders (from depression through to more acute conditions such as schizophrenia) as well as ongoing physiological impairments (such as blindness, joint disorders and acute back pain).
This database also includes evidence on two ‘client groups’ – the frail elderly, and children and adolescents – as well as those with learning disabilities. Obesity is also included as a special category. Whilst none of these can be strictly regarded as long term conditions they are included to ensure the relevance of the database to both health and social care users.
Where a specific condition is being examined for a specific client group (eg, diabetes in children; dementia in frail elderly) the evidence will have been placed in the condition-specific category (ie, diabetes and dementia respectively).
Where the evidence examines more than one specific condition and/or examines patients with co-morbidity, the reference is placed under the ‘various or multiple long-term conditions’ category.
3. Type of technology
The drop down list of technology categories enable refinement to be made by the main purpose of the telecare or telehealth system being implemented.
This list enables a distinction to be made between the following:
- Home-based medical applications – typically technologies designed to enable self-care at home without regular support from a health or social care professional.
- Vital-signs monitoring – typically involving the remote exchange of physiological data between a patient at home and medical staff at a GP surgery or hospital to assist in diagnosis and monitoring, such as blood glucose monitoring.
- Safety and security monitoring – typically the continuous, automatic and remote monitoring of real time emergencies in order to manage the risks associated with independent living.
- Information and support services – typically the provision of telephone or internet-based advice and support systems either with care professionals, peer groups, on-line educational resources or a combination.
An additional category, where such technology is combined (or is not defined) has been included.
The categories chosen are intentionally non-specific to any particular telehealth and telecare equipment modality, such as those used by NHS PASA in its National Framework Agreement for Telecare.
These categories were adapted from those used in the most recent and comprehensive systematic review of the benefits of home telecare by James Barlow and colleagues