Synergus

This blog is to provide a brief background to the coming webinar by Dr Kristian Kidholm about the topic “HTA evaluation of e-health solutions” based on the The Model for Assessment of Telemedicine (MAST). The MAST framework is a result from an initiative 2009 by the European Commission to assess telemedicine applications. The initial publication about the framework was published 2012¹

In mid-2017 a scoping review of the 22 studies which have applied MAST was published, summarizing the experience².  There a couple of issues that we found especially interesting in the article:

• The tension between the value of RCT vs Real World Evidence
  “Eleven of the included empirical studies used a RCT study design. One criticism of RCTs is that they measure the efficacy of a telemedicine intervention as opposed to the effectiveness. This is due to the controlled environment in which they sometimes operate, rather than the real world needed to measure effectiveness. Hence, clinical effectiveness may be better assessed using longer study periods, alternative study designs, for example prospective cohort study and performing the study only when the telemedicine intervention has normalised into everyday practice. On the other hand, the internal validity of these studies may be lower because of a higher risk of bias that cannot always be controlled for. This does not preclude the need to perform RCTs to provide evidence supporting the normalisation of a telemedicine intervention.” ²
   
• The importance to understand the organization implication of Telemedicine  / e-health
  “The implementation of telemedicine may introduce major organisational changes. These changes include process change (e.g. workforce, staff training and resources, interaction, communication, task shifting), structural change (e.g. geographic spread), or cultural changes (e.g. culture, attitude, and management).2 As a result, investigation of organisational aspects is included as a domain in the multidisciplinary MAST framework.” 2

The framework has been used in many countries and in different disease areas.

Don’t miss this important webinar with Dr Kidholm.

1. Kidholm, Kristian, Anne Granstrøm Ekeland, Lise Kvistgaard Jensen, Janne Rasmussen, Claus Duedal Pedersen, Alison Bowes, Signe Agnes Flottorp, and Mickael Bech. “A MODEL FOR ASSESSMENT OF TELEMEDICINE APPLICATIONS: MAST.” International Journal of Technology Assessment in Health Care 28, no. 01 (January 2012): 44–51. https://doi.org/10.1017/S0266462311000638.
    
2. Kidholm, Kristian, Jane Clemensen, Liam J Caffery, and Anthony C Smith. “The Model for Assessment of Telemedicine (MAST): A Scoping Review of Empirical Studies.” Journal of Telemedicine and Telecare 23, no. 9 (October 2017): 803–13. https://doi.org/10.1177/1357633X17721815.