Evidence and decision making when going beyond pilots

At the eHealth Forum Athens 2014, the SmartCare project was presented as an example of a large-scale initiative. The last session of the eHealth Forum “Evidence and decision making when going beyond pilots”, organized by United4Health, provided a stage for three cross-national projects aiming for application of innovative telemedicine services and integrated care services. The main objectives of Renewing Health, United4Health and SmartCare are: to grant evidence of clinical effectiveness and quality of life improvement deriving from particular interventions in different settings; and to evaluate economic and organizational outputs.

The first topic of the workshop was the importance of joining up the health and social care sector for the benefit of the ageing population of Europe. Integrated care is meant to improve the cost-effectiveness of care systems, the patient’s care satisfaction and the health and well-being of people and populations. Since integrated care is quite complex, it’s unlikely to follow a single path. Therefore, it is essential to consider the service, managerial, organizational and professional level and to put them in their local or regional contexts.

Renewing Health is currently the largest RCT (Randomized Controlled Trial) of telemedicine in the world. Although negative results occurred, the project demonstrates that some evidence can be provided through RCT-approach. The following presentation of United4Health illustrated that telehealth interventions were similar or better than usual care for quality of life and patient satisfaction outcomes, even though the available evidence is still limited. To better assess the economic and organizational impacts of an intervention, a real-life approach is recommended. Similar lessons were learned in the SmartCare project, which aims to combine social and health care. Instead of using RCTs to provide evidence on benefits, the development of predictive models for health and social care was suggested.