Home telehealth: connecting care within the community
International Journal of Integrated Care, 1 February 2007 - ISSN 1568-4156
Book review
Home telehealth: connecting care within the community
Edited by Richard Wootton, Susan L. Dimmick, Joseph C. Kvedar
London, England: Royal Society of Medicine Press, 2006, pp 280,
ISBN 1 85315 657 4
Dennis L. Kodner, PhD, Professor of Urban Public Health, Hunter College, The City University of New York

A variety of forces are driving the use of technology in the health care field—population ageing, chronic illness, quality outcomes, self-care, patient empowerment, consumer convenience, and rising costs. From an integrated care perspective, mobile communications, remote monitoring and other innovative technologies—the core applications of what is increasingly known as telehealth, telemedicine or telecare—can serve as a kind of glue to hold the health (and social) care team together, enhance patient–provider relationships, and support new, better and more efficient models of coordinated, patient-centred care.

Home telehealth: connecting care within the community presents a comprehensive overview of, and practical guide to, the latest developments and applications of telehealth technology in the home and community-based settings. This excellent compendium is edited by three well-known international ‘gurus’ and contains contributions of 60 other experts from Australia, Canada, France, Germany, Italy, Japan, Spain, the United Kingdom, and the United States. It not only covers a wide range of technologies and programmes for various target groups. In addition, telehealth is examined from several other important vantage points, the most important being the growing evidence base.

The book is organised around four sections. Section I gives the reader a solid introduction to the basics of home telehealth. The discussion of outcome measures, economic evaluation, patient and provider satisfaction, business modelling, and the body of evidence on telehealth will be of interest to policy-makers, planners, programme managers, clinicians and researchers alike. Section II looks closely at specific techniques, including ‘smart homes,’ wound management, chronic disease management, and fall monitoring, as well as technological applications in quarantine and isolation situations to prevent the spread of communicable diseases such as SARS. Section III demonstrates how telehealth flexibly addresses the unique needs of particular at-risk populations (HIV/AIDS, home dialysis, diabetes, congestive heart failure and other cardiac patients, home-bound elderly, children with special needs, asthma, and palliative care); also further considered is how such services improve access to quality care. Finally, Section IV is about the future. In addition to a contributed chapter which considers the financial implications of telehealth's widespread implementation, the editors conclude with their vision of the future—one with which I tend to agree. Despite a variety of cited obstacles—technical, economic, organisational, and behavioural—telehealth is sure to become a permanent part of mainstream medicine, thus enabling the redesign of clinical services, closer connections between professionals who share care and patients on the receiving end, and the rise of more activated, self-directed consumers.

This state-of-the-art book is a must-read for anyone interested in integrated care and the critical role that technology plays in shaping, delivering and supporting comprehensive, coordinated services for patients or clients with complex conditions.