Telemedicine: To RCT or not to RCT?


Though telemedicine has been around for decades, arguments are still raging over whether projects need to be clinically evaluated using randomised controlled trials …

History indicates that telemedicine evaluation is too often an afterthought considered following the more important issues of putting a programme together, if it is considered at all. Why, say its protagonists, do we need to evaluate telemedicine, if patients are happy with it, their lives are easier and they are getting as good a service as they would be in hospital? And why, if it’s making clinicians’ lives easier to boot and saving them time, why not put some of the money that’s being saved into reimbursing it?

But the naysayers would argue that formal randomised controlled trials (RCT) are necessary – and that many have shown that there are negligible benefits, at least so far, of telemedicine. And that other forms of medical care are subject to rigorous testing, so telemedicine should be the same.

There is concern about the wisdom of rapid deployment of telemedicine systems before we have established technical standards, effective clinical protocols, and organisational structures for its proper implementation.

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