This omission is important, given concerns about the potential detrimental effects of telehealth on patients.

For this part of the WSD Evaluation, we assessed the hypothesis that introduction of a broad class of home based telehealth improves quality of life, anxiety, and depressive symptoms over a 12 month period for patients with chronic obstructive pulmonary disease, diabetes, or heart failure, compared with usual care only.Participants Patients with chronic obstructive pulmonary disease (COPD), diabetes, or heart failure recruited between May 2008 and December 2009.Main outcome measures Generic, health related quality of life (assessed by physical and mental health component scores of the SF-12, and the EQ-5D), anxiety (assessed by the six item Brief State-Trait Anxiety Inventory), and depressive symptoms (assessed by the 10 item Centre for Epidemiological Studies Depression Scale).Evaluations of service innovations such as telehealth need to assess the effect from the patient’s perspective, using self report measures such as quality of life (Qo L), psychological outcomes, and acceptability of services.This approach is in line with the developing agenda on patient reported outcomes,13 14 15 16 17 and complements more familiar outcomes such as service use, costs, and mortality.