Canadian mHealth heart failure pilot: qualitative gains vs. brick wall of cost, workload

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A recently published study out of University of Toronto illustrates the double bind of telehealth at present. Qualitatively, in this small group (n=22) study, there were strong directional findings when mHealth supports conventional care for heart failure. BlackBerry (!) based monitoring of various devices and daily symptom questions improved patient self-care, awareness of their condition and motivation, as well as clinician proactivity and decision support. The problems were the all-too-familiar 1) how to pay for it (and this in a centralized health system) and 2) clinician work load increases, 3) lack of clinic readiness. Perceptions and Experiences of Heart Failure Patients and Clinicians on the Use of Mobile Phone-Based Telemonitoring (Journal of Internet Medical Research)


  1. Trevor Cradduck

    Your comment about the Canadian health care system being “centralized” needs some clarification. The large majority of docs in Ontario are paid on a fee for service basis. If there is no fee schedule for the remote monitoring they do not receive remuneration for their services. In some instances groups of docs are paid a salary. In those instances it is easier for them to adopt a new and innovative form of care delivery.