Applying an integrated approach to the design, implementation and evaluation of a telemedicine system.

Abstract

Telemedicine evaluations are usually decoupled from other aspects of design and implementation, and therefore not considered until late in the project cycle. In addition to this, evaluations are often performed by outside bodies without an interest in the outcome, a practice intended to strengthen the independence and objectivity of the findings. In this paper, we describe an alternative approach in which the design, implementation and evaluation of a telemedicine system were considered to be complementary stages of the project occurring in parallel and where members of the project team were involved in all three. We demonstrate the advantages of this approach through the ECHONET project - a trial of an experimental system implemented in the context of Intensive Care across two hospitals in Tasmania, Australia. This paper describes benefits associated with this integrated approach. Innovative aspects of the approach include the number of pre-implementation activities such as stakeholder interviews, design workshops and a baseline study, which enabled the project to adapt to the complex needs of its health context. The integration of the design, implementation and evaluation activities enabled the project to adapt to changing needs as the project evolved, and ensured that it was evaluated against appropriate criteria.