The costs of telecare and telehealth

The Whole Systems Demonstrator (WSD) evaluation was designed to investigate the costs and outcomes associated with two forms of telemonitoring technology – telehealth and telecare – in the context of ‘whole-systems’ care and support (Bower et al., 2011). The WSD telecare and telehealth trials took place within three local authority areas (‘sites’) in England, these areas being covered by four Primary Care Trusts (PCTs). The evaluation employed two pragmatic, cluster-randomised trials: of telehealth in a population with long-term conditions, and of telecare in a population with social care needs. The unit of randomisation was the general practice. Within each practice, eligible patients in one of the study populations (social care needs or long-term conditions) were allocated to the relevant technology (telecare or telehealth, respectively); each practice acted as a control for the other technology and eligible patient population. The WSD evaluation comprised both quantitative and qualitative research. The WSD telehealth and telecare trials drew on routine data to examine the effectiveness of these technologies on use and costs of health and social care. Administrative datasets covered the use of hospital and primary care physician services, as well as social care services such as residential and nursing home care and domiciliary care, and mortality (Steventon et al., 2012, 2013). About half of the trial participants also consented to be part of nested (WSD telecare and telehealth questionnaire) sub-studies, collecting participant-reported data on a range of outcome measures and on the use of health and social care services (Cartwright et al., 2013; Henderson et al., 2013b; Bower et al., 2011).