Methods

MAST - Model for Assessment of Telemedicine

Patient@home wants to document the effects of the welfare and telemedicine technologies developed in the project using the MTA-based (Medical Technology Assessment) and interdisciplinary evaluation model MAST.

MAST (Model for Assessment of Telemedicine) is a European evaluation model, which is currently used in more than 30 studies of telemedicine and welfare technology and in more than 20 European regions. The model is also recommended as a framework for evaluation of telemedicine in the Danish Regions' Telemedicine Strategy (2011).

The model stems from a wish to evaluate telemedicine by (1) describing impacts and contributions to the quality of treatments and by (2) creating a basis for decision making when implementing telemedicine solutions. In practice, the MAST model evaluates telemedicine solutions through the following three steps:

Step 1: Pre-assessment
• Is the technology mature?
• Legal and economic conditions

Step 2: Multidisciplinary assessment (domains)
• Health problem and technology
• Safety
• Clinical efficacy
• The patient's perspectives
• Economic aspects
• Organisational aspects
• Socio-cultural , ethical and legal aspects

Step 3: Transferability
• Cross-border
• Scalability
• Generalisability

Step 1 contains a preliminary assessment and is aimed at assessing whether the technology is sufficiently developed or matured such that an impact evaluation can be carried out. It may be necessary to conduct pilot studies or to clarify legal or economic conditions prior to the implementation of major studies.

In Step 2 the multidisciplinary evaluation of the effects of the technology used is implemented. The effects and descriptions of the technology used are divided into seven domains that are adapted to telemedicine solutions. Telemedicine has often an impact on the patient's experience of the treatment, or provides opportunities to manage own disease (empowerment). Therefore, MAST contains an independent patient domain.

In Step 3 an assessment is conducted of the transferability of the impact results described in the previous step. If, for example, the multidisciplinary assessment in step 2 is based on studies made in U.K., it may be necessary to "translate" the results into a Danish context. This could imply an assessment designed to determine whether the telemedicine effects of a 20% reduction in the number of bed days can be transferred to Danish hospitals. Also, studies conducted in small hospitals may be difficult to transfer directly to large university hospitals having more complex patient groups.