Abstract
Model for ASsessment of Telemedicine Applications (MAST) is a health technology assessment (HTA) inspired framework for assessing the effectiveness and contribution to quality of telemedicine applications based on rigorous, scientific data. This study reports from a study of how it was used and perceived in twenty-one pilots of the European project RENEWING HEALTH (RH). The objectives of RH were to implement large-scale, real-life test beds for the validation and subsequent evaluation of innovative patient-centered telemedicine services. The study is a contribution to the appraisal of HTA methods. A questionnaire was administered for project leaders of the pilots. It included questions about use and usefulness of MAST for (i) preceding considerations, (ii) evaluation of outcomes within seven domains, and (iii) considerations of transferability. Free text spaces allowed for proposals of improvement. The responses covered all pilots. A quantitative summary of use and a qualitative analysis of usefulness were performed. MAST was used and considered useful for pilot evaluations. Challenges included problems to scientifically determine alternative service options and outcome within the seven domains. Proposals for improvement included process studies and adding domains of technological usability, responsible innovation, health literacy, behavior change, caregiver perspectives and motivational issues of professionals. MAST was used according to its structure. Its usefulness in patient centered pilots can be improved by adding new stakeholder groups. Interdependencies between scientific rigor, resources and timeliness should be addressed. Operational options for improvements include process studies, literature reviews and sequential mini-HTAs for identification of areas for more elaborate investigations.
Highlights
The responses came from northern Norway (Diabetes Mellitus [DM]), central Greece (DM, chronic heart failure [CHF] and chronic obstructive pulmonary disease [COPD]), Norrbotten region, Sweden (DM and CHF), Veneto region, Italy (DM, COPD, CHF, and chronic diseases), Veneto region, Italy, Catalonia, Spain (COPD), southern Denmark (COPD and DM), southern Denmark, Carinthia, Austria (DM), south Karelia, Finland (DM and CHF), and Berlin, Germany (DM and COPD)
One respondent commented on expenditure reduction, which might override quality considerations for vulnerable patient groups: “Patient maturity to use this kind of information and communication technology (ICT) applications was important, because the patients with these diagnoses are mostly elderly people
The overall impressions were that Model for ASsessment of Telemedicine Applications (MAST) was used to assess: (i) preceding considerations, assessment within seven domains, and transferability; (ii) whether services were based on scientific standards and guidelines for developing a basis for investment decisions; and (iii) applicability and relevance to patient-centered pilots
Summary
Model for ASsessment of Telemedicine Applications (MAST) is a health technology assessment (HTA) inspired framework for assessing the effectiveness and contribution to quality of telemedicine applications based on rigorous, scientific data. Methods: A questionnaire was administered for project leaders of the pilots. It included questions about use and usefulness of MAST for (i) preceding considerations, (ii) evaluation of outcomes within seven domains, and (iii) considerations of transferability. Challenges included problems to scientifically determine alternative service options and outcome within the seven domains. Proposals for improvement included process studies and adding domains of technological usability, responsible innovation, health literacy, behavior change, caregiver perspectives and motivational issues of professionals. Operational options for improvements include process studies, literature reviews and sequential mini-HTAs for identification of areas for more elaborate investigations
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