In this case the telemedicine service adopted by a health economy in England was based on enabling patients to have on-line or ‘virtual’ consultations with hospital staff.

The service was implemented for patients with confirmed COPD and it was estimated by the hospital trust that around 20% of in-person hospital admissions could be replaced by on-line consultations, with a commensurate saving in healthcare resource use.

We undertook an analysis of data on hospital activity to measure the impact of telemedicine on acute services. In addition, we used qualitative methods to identify facilitators and barriers to the use of the telemedicine services among patients.

The analysis of impact was based on a before-and-after comparison of telemedicine patients with non-telemedicine patients, as an RCT was not feasible in this context. We reported the results for impact on hospital use and the net financial impact in a report to the client.

As part of this, we also provided the client with a number of scenarios including a threshold analysis, indicating at what level use the telemedicine programme would result in a net cost reduction.