Transforming the patient experience with telehealth in Europe

Overview

To assist European countries to meet the growing demands for healthcare services, the United4Health (U4H) project focused on finding ways to maximise new technology, such as telehealth solutions, to help improve healthcare, access to care, self-management and resource utilisation.  The project was partially funded under the ICT Policy Support Programme (ICT PSP) as part of the Competitiveness and Innovation Framework Programme by the European Commission and ran from January 2012 to December 2015.

U4H utilised the results and good practices from previous projects and trials, including the Renewing Health project, and delivered solutions designed to be scaled up within regions. The programme involved nearly 12,000 patients from deployment sites representing a variety of healthcare delivery organisations across the EU.  The services deployed targeted patients living with Diabetes, Chronic Obstructive Pulmonary Disease (COPD) or Cardiovascular Disease.  Each telehealth service aimed to transform the patient’s experience using remote monitoring, giving them a central role in the management of their own condition in a way that was convenient to their daily lives.

In addition to sharing the learning associated with designing and adopting innovative health and care service models, the project’s core philosophy was that the telehealth solutions should provide value for citizens, healthcare providers and payers by improving access to services (locally or in the home), reducing costs (reduced home visits, fewer emergency admissions to hospital), and increasing care quality; thereby delivering more personalised tailored care with easier involvement of family and carers.

For more information on the project findings and outcomes, please see the project final deliverables.  With respect to the final evaluation outcomes, please note that:

The pragmatic, observational study approach of the U4H project evaluation focused on an assessment of the clinical, organisational and economic impact of telehealth deployments, following best practice wherever possible.  Significant delays in the procurement o necessary infrastructure, coupled with associated organisational changes in some U4H deployment sites, resulted in the total number of patients recruited for telehealth and ‘usual care’ being less than originally planned.  This posed a significant challenge to the project evaluation, which was further compounded by a number of issues which also impacted on the data analysis:

  • The composition of the comparator groups varied, with some sites including the same patients before the intervention, and others identifying a different prospective group.  The intervention and comparator groups were significantly different and not matched at baseline, indicating a potential selection bias.  Significant heterogeneity of healthcare resource use was found among the deployment sites.

  • The data was incomplete in a non-random, but systematic way.  This lack of data availability made it difficult to arrive at definitive conclusions. It is acknowledged that the above limitations may have created biases relating to the comparative advantages of telehealth which, as a result, are not fully validated. The reader should take this into account when considering the findings of the evaluation.