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Comment & Response |

Telemedicine in Heart Failure—Ineffective or Just Ill Used?

Claudio Pedone, MD, PhD, MPH1; Raffaele Antonelli Incalzi, MD1
[+] Author Affiliations
1Department of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
JAMA Intern Med. 2016;176(7):1034-1035. doi:10.1001/jamainternmed.2016.2854.
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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.

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July 1, 2016
Maulik D. Majmudar, MD; Timothy Dy Aungst, PharmD
1Healthcare Transformation Lab, Massachusetts General Hospital, Boston2Harvard Medical School, Boston, Massachusetts
3Massachusetts College of Pharmacy and Health Sciences University, Worcester
JAMA Intern Med. 2016;176(7):1035. doi:10.1001/jamainternmed.2016.2857.
July 1, 2016
Michael K. Ong, MD, PhD; Patrick S. Romano, MD, MPH; Gregg C. Fonarow, MD
1Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles2Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California
3Department of Internal Medicine, University of California, Davis, Davis4Department of Pediatrics, University of California, Davis, Davis
1Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles
JAMA Intern Med. 2016;176(7):1035-1036. doi:10.1001/jamainternmed.2016.2860.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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