To the Editor The article by Ong et al1 adds further evidence on the lack of efficacy of telemonitoring in reducing the risk of relevant clinical outcomes. There are some issues that may help to better understand why telemonitoring does not stand up to its potential. The first issue comes from the experience of the Whole System Demonstrator2 that showed that a telemonitoring system may not be effective unless it is integrated with a specific offer of health services. An example comes from telemonitoring in chronic obstructive pulmonary disease where the importance of background health services in the context of telemonitoring experiences has been clearly shown.3 The intervention provided in the trial by Ong et al consisted of a telephone call suggesting to contact the usual health care provider if monitored parameters exceeded predetermined thresholds. The study does not report participant adherence to this indication, nor the action eventually taken; therefore, we do not know if the lack of effectiveness of telemonitoring is owing to poor value of the information obtained by the system (lack of efficacy) or to inadequate action taken to respond to derangements in the monitored parameters.
Pedone C, Incalzi RA. Telemedicine in Heart Failure—Ineffective or Just Ill Used? JAMA Intern Med. 2016;176(7):1034–1035. doi:10.1001/jamainternmed.2016.2854
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