Table 1.
How to Evaluate the Effectiveness of Telemental Health
| Measures |
| Starting points |
| Case report, series, or mix of patients |
| Project or program description |
| Qualitative analysis: impressions, perceptions, or information to form additional questions |
| Cost, cost comparison, or cost offset, often of “direct” costs |
| Project or program evaluation, sometimes retrospective |
| Small(er) total n |
| Micro- (e.g., one party) analysis |
| Some control of variance or limited interplay of variables |
| Cross-sectional analysis |
| Goals |
| Prospective, question-based |
| Comparison group |
| Study design “same as” or “equal to” |
| Noninferiority trials |
| Study design randomized controlled trial |
| Cost-effectiveness, -benefit analysis with computations of direct and indirect costs |
| Evaluation that “drives” the objectives and prospectively collected |
| Generally, large(r) total n (but not always guarantee “good” study) |
| Micro- (all parties individually) and macro- (system-wide=patient, provider, clinic, health system, community, and other parties) analyses |
| Analysis of variance |
| Longitudinal analysis |
| Access |
| Increased access to care |
| Improved level of, or quality of, existing care |
| Specific to the need (e.g., consultation–liaison rather than management [only] to primary care) |
| Complements or integrates service delivery (or prevents use of more intensive or costly service) |
| Quality of care |
| Reliable/valid |
| Diagnosis and assessment |
| Detection of limitations and process to “control” for them is delineated |
| Improved level of, or quality of, existing care |
| Specific to the need (e.g., consultation–liaison rather than management [onl] to primary care) |
| Complements or integrates service delivery (or prevents use of more intensive or costly service) |
| Population |
| Setting |
| Satisfaction and related intangibles (e.g., empowerment) |
| Costs |
| Technology |
| Adequate description of equipment, bandwidth, frames per second, and other parameters |
| Data on failures, problems (i.e., reliability) |
| Time, effort, and other “hidden” costs of “new” technologies (e.g., asynchronous telepsychiatry) |
| Administration |
| Feasibility |
| Level of coordination to initiate, maintain, and financially support |