**4.8 Clinical benefits in patients with other diseases**

Use of telehealth has been reported for the management of other diseases, such as monitoring patients during the acute phase of a disease (sometimes called hospital at home), recovery and release from hospital, rehabilitation, and in high acuity settings such as specialist residential homes. For example, in [63] ECG recordings taken from residents feeling unwell in residential homes were used to recognise cardiac tamponade in one instance and myocardial infarction in a second, which allowed prompt intervention and management.

## **4.9 Health and wellness**

Health and wellness is an often considered area for telehealth. This would be typified by the wearing of a "smart" watch that includes capability to perform measurements of pulse oximetry at the wrist, which may be used to determine the level of blood oxygen and heart rate. Devices may also include sensors to count steps, GPS to determine distance covered, and timers to monitor periods of exercise. Whilst such monitoring may be of interest to the individual and may influence adoption of improved lifestyle and impact on health, there is little evidence that this type of monitoring provides data with clinical value, as often the data is unreliable and of poor quality.

There are efforts to integrate similar sensors within clothing, but there are practical problems in where the sensors can be placed conveniently and provide meaningful and reliable clinical measurements.

Most frequently sensors are integrated in a chest belt of some form, which can then monitor ECG and respiration. This has been implemented as a vest, but most patients do not like the constricted feel. For women, it can be integrated into items such as the bra.
