The Digital Agenda for Europe predicts economic and social benefits for governments and citizens arising from the use of healthcare ICTs. However, despite the overwhelmingly positive rhetoric of policy documents and industry hype, evidence of these benefits remains weak and inconsistent. This paper considers some of the reasons for this mismatch and its implications for effective decision making. It focuses on applications of telehealth and mobile health, which are attracting unprecedented levels of investment at the current time. Drawing on insights from studies by the author and colleagues, it considers the challenges presented by evaluations of complex interventions in complex settings and points out difficulties with attributing cause and effect where impacts may be caused as much by organisational changes as by the technologies whose implementation prompts them. Examples from studies of home based and mobile telehealth for long term conditions such as asthma, diabetes, COPD and hypertension illustrate the unexpected ways in which eHealth can both generate costs and add value, sometimes in ways that are hard to quantify. It reflects on the need for better evidence to inform eHealth strategy and procurement decisions and calls for the use of creative paradigms for evaluating innovations in practice, recognising the 'co-creation' of value in the context of healthcare redesign and delivery.
Biography Claudia Pagliari PhD FRCPE is a Senior Lecturer in Primary Care and Health Informatics, based in the Centre for Population Health Sciences at the University of Edinburgh. Originally trained as a psychologist, she has worked in the area of health technology assessment for over 16 years, specialising in the study and evaluation of eHealth. Her work involves a range of methods, including controlled clinical trials, qualitative studies of implementation processes, user-centred design and citizen engagement, particularly in the areas of telehealth and electronic health records. She has a longstanding interest in interdisciplinary research paradigms and leads the Edinburgh interdisciplinary research network in eHealth and the MSc programme in Health Informatics. http://uk.linkedin.com/pub/claudia-pagliari/6/32/a53 http://www.researchgate.net/profile/Claudia_Pagliari/ Copyright © 2013 by the paper's authors. Copying permitted for private and academic purposes.