I like the question in the title of this Intellect Computing item, but perhaps not for the reason that Telecare Aware readers or the author, John Hoggard, of the Transformational Government Programme Executive, might expect.
Although a number (the majority?) of telehealth companies are promoting remote monitoring devices for diabetes care, is there really evidence that reporting the results of blood glucose levels into monitoring software has better outcomes than if people keeping their own record and respond to variations accordingly? I guess we may have to wait a few years until the result of Newham’s part of the Whole System Demonstrator Programme (search Telecare Aware for WSD) to find out, but I doubt it, somehow.
Independent studies have shown the t+ system to reduce in HbA1c levels of 0.5% – 1.0% over 6 months. We have not done a controlled study against paper diaries although most patients on the studies were expected to be using paper diaries before the t+ intervention, so the improvement is over and above that standard means of care. There was also an improvement in compliance over a simple electronic diary.
(Speculating) Perhaps the perception that someone else is monitoring the data increases compliance and the motivation to observe changes in levels and correlate them with changes in physical status? I can see that this might have an extra effect in teaching patients to self-manage. You might then expect an occasional phone call from the person doing the monitoring when a reading is out of the expected range to be a strong reinforcement.
If that were so, it would imply that participation in such a programme (rather than the particular technology) might be the key factor, which, in turn would argue that a cheap system could be as effective as an expensive one.