Health technology assessment in its local contexts: studies of telehealthcare
Open accessAbstract
Health technology assessment (HTA) is one of the major research enterprises of late modernity, reaching into fields of previously autonomous professional practice, and critically interrogating the organisation and delivery of health care. The 'evaluation' of new health technologies within the field of HTA is increasingly a normative political expectation, as discourses of 'evidence-based' practice run through health policy in the UK and elsewhere. Despite its importance in governing the direction of innovation in health care delivery, there are hardly any empirical studies of HTA in practice. In this paper, we draw on two ethnographic studies of telehealthcare implementation and evaluation in the UK to explore the practical conduct of HTA, and we focus specifically on the social organisation and conduct of randomised controlled trials of these new technologies. The paper examines how evaluation forms a mediating set of practices that make the embedding or normalisation of a new technology possible; and present a simple model of the social and technical contingencies within the evaluation process.
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Existing evidence on eHealth readiness mainly relates to organizational readiness within the health service or the readiness of health professionals, patients, or carers for a specific single digital health service.
“However, the existing evidence mainly relates to organizational readiness within the health service [17,18] or the readiness of health professionals [19-21], patients or carers for a specific single digital health service [22].”
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“Clearly, introducing ICT initiatives into health care has implications for established organizational arrangements, professional work and patterns of work organization (Heath et al. 2003; May et al. 2003a, 2003b), and vice versa.”
BackgroundBowes, A. M., & McColgan, G. (2012) · Research on Aging · doi:10.1177/0164027511427546 · Cited by 50 · see citing works
“As Dant (2006) and May et al. (2003) suggested, the interactions of technical innovations with human relations must be a central concern for future evaluations of telecare.”
BackgroundMay, C. R., Finch, T. L., & Rapley, T. (2020) · Edward Elgar Publishing eBooks · doi:10.4337/9781788975995.00013 · Cited by 49 · see citing works
Self-citationTeleconsultation in geriatrics: Impact on professional practice
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“[24] C.”
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Speed, C., Heaven, B., Adamson, A., Bond, J. B., Corbett, S. S., Lake, A. A., May, C. R., Vanoli, A., McMeekin, P. J., Moynihan, P. J., et al. (2010) · Health Technology Assessment · doi:10.3310/hta14520 · Cited by 43 · see citing works
Self-citationHealth technology assessment: Research trends and future priorities in Europe
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Bases for assessments made by telephone advice nurses
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“becomepart of everyday practice) [1–6].”
Telehomecare for Vulnerable Populations: The Evaluation of New Models of Care
Gagnon, M., Lamothe, L., Hebert, M., Chanliau, J., & Fortin, J. (2006) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2006.12.324 · Cited by 35 · see citing works
“18 telehomecare.”
Striving for evidence in e-health evaluation: Lessons from health technology assessment
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In search of the sociotechnical configurations of telemedicine
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Digitized patient–provider interaction: How does it matter? A qualitative meta-synthesis
Andreassen, H., Dyb, K., May, C. R., Pope, C. J., & Warth, L. L. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.08.036 · Cited by 29 · see citing works
Self-citationParry, S. W., Deary, V., Finch, T. L., Bamford, C. H., Sabin, N., McMeekin, P. J., O'Brien, J. T., Caldwell, A., Steen, N., Whitney, S. L., et al. (2014) · Trials · doi:10.1186/1745-6215-15-210 · Cited by 30 · see citing works
“May and colleagues have employed these methods previously [64-66].”
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“Evaluations of e-Health/m-Health technologies are often criticized for the poor quality of research de-sign and the lack of consensus on the appropriate evaluation methodology (1;11).”
BackgroundThe Emerging Social Science Literature on Health Technology Assessment: A Narrative Review
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Telemedicine Technology Assessment Part I: Setup and Validation of a Quality Control System
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“Many studies on the telemedicine evaluation 6–8 addressed different aspects of telemedicine applications, such as clinical accuracy, 9,10 clinical effectiveness, 11,12 and patient satisfaction.”
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Making sense of technology adoption in healthcare: meso-level considerations
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“telecare providers and equipment manufacturers [14].”
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“tive of clinicians, technical experts, evaluators, managers, policy actors and patients [33,34] and by HamiltonBrown which considers the tension between research and clinical practice in the area of substance abuse treatment”
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The Chronic Disease Strategy for Australia
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“Telehealthcare solutions are politically attractive, appearing to offer links between clinicians and patients separated by time and space (Hendy et al., 2012; May et al., 2003).”
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UK Telehealth Initiatives in Palliative Care: a Review
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Evidence-Informed Health Policy: Using Research to Make Health Systems Healthier
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May, C., Rapley, T., & Kaner, E. (2006) · Addiction Research & Theory · doi:10.1080/16066350600609883 · Cited by 22 · see citing works
Self-citationMedical Innovations: Their Diffusion, Adoption, and Critical Interrogation
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“For instance, in the UK, the telemedicine, like the Telehealthcare service, has facilitated the interactions between patients and clinicians thus improving the quality of cares (May et al. 2003).”
BackgroundExploring routine use of telemedicine through a case study in rehabilitation.
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Use of telemedicine to support neonatal resuscitation
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Massazza, A., May, C. R., Roberts, B., Tol, W. A., Bogdanov, S., Nadkarni, A., & Fuhr, D. C. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114994 · Cited by 19 · see citing works
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Technische Unterstützung für Menschen mit Demenz?
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“There are numerous advantages derived from e-health, both for health institutions and professionals [6], focusing on organizational readiness related to health services [7] and health professionals’ readiness [8].”
Going Against the Grain of Optimism: Flour Fortification in Pakistan
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“The use of telehealth can empower patients with chronic and advanced illness and improve symptom monitoring and management by providing a clear and good communication pathway between the patient, and its family and the healthcare providers [19,30,33,44].”
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“, 2015), derived from a complex intervention in clinical care (May et al., 2003) and thus may suit pragmatic interventions such as nurse DV screening research.”
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“In diverse and significantly differing projects the capabilities of IHTs were being utilized, although they were rarely transformed into enduring services after the projects were finished [46].”
Background
- Authors
- May, C., Mort, M., Williams, T., Mair, F., & Gask, L.
- Affiliations
- Newcastle University (GB)
- Lancaster University (GB)
- University of Liverpool (GB)
- University of Manchester (GB)
- Corresponding author
- May, Carl
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2003-08
- Volume
- 57
- Issue
- 4
- Pages
- 697-710
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2064741069
- Cited by
- 147
- References
- 51
- Citations by year
- 2026: 3 · 2025: 2 · 2023: 2 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 3 · 2018: 7 · 2017: 3 · 2016: 4 · 2015: 6 · 2014: 8 · 2013: 8 · 2012: 7
- FWCI
- 13.62
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
- Keywords
- health technology assessment, telemedicine, randomized controlled trials, evidence-based practice, health policy, technology implementation, healthcare innovation
- MeSH terms
- Anthropology, Cultural, Decision Making, Organizational, Diffusion of Innovation, Evaluation Studies as Topic, United Kingdom, Humans, Interviews as Topic, Policy Making, State Medicine, Technology Assessment, Biomedical, Randomized Controlled Trials as Topic, Telemedicine, Organizational Case Studies
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