Table 1 Models for Home Telehealth Implementation
From: Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study
Model | Advantages | Disadvantages |
|---|---|---|
1. Distributed Model Services are operated independently by each clinical unit or organisation. | Greater local control Easier to tailor to own needs | Cannot obtain economies of scale Difficulty with interoperability with external services Harder to scale up or down in response to changing demand Development needs to be done separately in each organisation, hence increased time needed to implement |
2. Centralised Government Model State government provides all aspects: clinical services, technical network, device supply, management and IT support. | Small marginal cost to add home telehealth to an existing large ICT service Easy to scale up and down | A generic service may not suit all models of care Meeting privacy and security criteria may cause delays or abandonment of the service Restrictions on use of the service in the private sector |
3. Centralised Commercial Model A commercial entity provides all technical services, and may also include clinical services. | Off-the-shelf products with more rapid implementation Easy to scale up and down Economies of scale for larger contracts | Less responsive to local needs May be limited to particular devices and systems Risk of higher-priced service contracts in a monopoly market |
4. Centralised Consortium Model A group of providers forms a new not-for-profit entity. | Off-the-shelf products with more rapid implementation Providers have influence over the consortium Potential for the consortium to generate revenue and reduce costs for members The consortium can be a driver and innovator in the field | Time and effort required to build relationships, bring the partners together and construct agreements Potential conflict of members’ interests Members will initially have to fund central operations |