Model for Assessment of telemedicine - MAST

Model for assessment of telemedicine (MAST) is a framework for assessment of the value of telemedicine.

Telemedicine services may have many different types of outcomes and can be studied in many ways. In order for those who develop new telemedicine services to produce the information that healthcare managers need for making decisions on investment in telemedicine, a model for assessment of telemedicine (MAST) was developed. This work was done in 2010 through stakeholder workshops and on the basis of a systematic literature review.

If the objective of an assessment of telemedicine applications is to describe effectiveness and contribution to quality of care and to produce a basis for decision making, then MAST defines the relevant assessment framework fulfilling this objective as a multidisciplinary process which summarizes and evaluates information about the medical, social, economic and ethical issues related to the use of telemedicine in a systematic, unbiased, robust manner.

This statement is based on the definition of HTA in the EUnetHTA project. Key concepts are "multidisciplinary" and "systematic, unbiased and robust". The first concept implies that the assessments should include all important outcomes of the applications for patients, clinicians, healthcare institutions and society in general. The others imply that assessments should be based on scientific studies and methods, scientific criteria for quality of evidence and scientific standards for reporting of results, e.g. as described in EQUATOR Network.

In practice the use of MAST includes three steps:

Firstly, the assessment must start with preceding considerations in order to determine whether it is relevant for an institution at a given point in time to carry out the assessment. This step involves mainly assessment of the maturity of the technology and the organization planning to use it. If the technology is not matured and have not been tested in practice, then pilot studies must be carried out to mature the technology before a multidisciplinary study is initiated.

Secondly, after the preceding considerations, the multidisciplinary assessment is carried out in order to describe and assess the different outcomes of the telemedicine application. This involves assessment of ouctomes within the following seven domains:

Thirdly, in relation to the description of the outcomes, an assessment should also be made of the transferability of the results to other settings or countries.

MAST is the most widely used framework for assessment of telemedicine in Europe. The model is used in large EU funded telemedicine project like Renewing Health, United4Health, Smartcare and inCASA. These projects include more than 20.000 patients and more than 18 randomised controlled trials. A large number of individual telemedicine projects also use MAST e.g. Patient@home, Durand-Zaleski (2013) and Campos et al. (2013)

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