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Integrating service development with evaluation in telehealthcare: An ethnographic study

Lookup NU author(s): Dr Tracy Finch, Professor Carl May



Objectives: To identify issues that facilitate the successful integration of evaluation and development of telehealthcare services. Design: Ethnographic study using various qualitative research techniques to obtain data from several sources, including in-depth semistructured interviews, project steering group meetings, and public telehealthcare meetings. Setting: Seven telehealthcare evaluation projects (four randomised controlled trials and three pragmatic service evaluations) in the United Kingdom, studied over two years. Projects spanned a range of specialties - dermatology, psychiatry, respiratory medicine, cardiology, and oncology. Participants: Clinicians, managers, technical experts, and researchers involved in the projects. Results and discussion: Key problems in successfully integrating evaluation and service development in telehealthcare are, firstly, defining existing clinical practices (and anticipating changes) in ways that permit measurement; secondly, managing additional workload and conflicting responsibilities brought about by combining clinical and research responsibilities (including managing risk); and, thirdly, understanding various perspectives on effectiveness and the limitations of evaluation results beyond the context of the research study. Conclusions: Combined implementation and evaluation of telehealthcare systems is complex, and is often underestimated. The distinction between quantitative outcomes and the workability of the system is important for producing evaluative knowledge that is of practical value. More pragmatic approaches to evaluation, that permit both quantitative and qualitative methods, are required to improve the quality of such research and its relevance for service provision in the NHS.

Publication metadata

Author(s): Finch TL, May CR, Mair FS, Mort M, Gask L

Publication type: Article

Publication status: Published

Journal: British Medical Journal

Year: 2003

Volume: 327

Issue: 7425

Pages: 1205-1208

Print publication date: 22/11/2003

ISSN (print): 0959-535X

ISSN (electronic):

Publisher: BMJ Group


DOI: 10.1136/bmj.327.7425.1205

PubMed id: 14630758


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