Miller’s conceptualisation of telehealthcare was adapted to define it as ‘the provision of personalised health care from a distance’.8 This definition encapsulates the following key considerations:
Self-care technologies, self-education, and websites without professional feedback were excluded. This study aimed to concentrate on interventions with an emphasis on ‘personalised’ or ‘tailored’ health care. This required a focus on patient–professional interactions enabled by distance communications technologies. Telehealthcare includes active professional feedback to patients, and excludes passive, automated feedback.9
Telehealthcare encompasses both synchronous (for example, telephone, mobile phone) and asynchronous communication modalities (for example, e-mail and text message). The synchronous approaches allow real-time communication between patient and professional, whereas asynchronous approaches enable patient data to be stored in packages and forwarded at specified intervals (for example, once a week) for review by the healthcare professional.
How this fits in
Chronic obstructive pulmonary disease (COPD) is increasingly common and now poses a substantial health problem in many parts of the world. Governments and industry are optimistic that telehealthcare will help manage the care burden of these people. This study found consistent evidence that telehealthcare helps people with COPD stay out of emergency departments and hospitals. Telehealthcare did not appear to affect the death rate or patients’ quality of life.
