The basic literature search was used. Additionally the resulst of Assessment Element TEC5 (B0001) were used to categorize into the settings.

The following studies provided information about the context: {54},{27},{47},{66},{53},{37},{18},{21},{72},{9},{7},{15}

 A change into multidisciplinary management of HF patients was observed over the last 15 years. {27} Education is seen as one of the key points leading a 37% reduction (P=0.004) of readmission to the hospital for HF or for cardiovascular disease. {42} Telemonitoring aims to shift the focus on control of the disease towards the patient who is supported by the care team. A good relationship between care providers and patients is important. {27} Tele-healthcare can also be seen as an intensification of more conventional methods of delivering care towards optimal comprehensive care as recommeded by guidelines. {27}

The primary function of telemedicine is to provide specialist consultation to distant communities, rather than to provide support for self-management of chronic disease. However, home telecare is a rapidly evolving domain and increasingly focused on supporting the patient rather than the health professionals. Home telemonitoring is used for different modalities and encompasses the use of audio, video, and other telecommunication technologies to monitor patient status at a distance. {49},{,35},{44}, {18} It can be seen as an automated process for the transmission of data on a patient’s health status from home to the respective health care setting. {54} {72}. Hence, telemonitoring does not involve the electronic transmission of data by a health care professional at the patient’s location. {54} {15}.

The tele monitoring interventions are heterogeneous in terms of monitored parameters and HF (heart failure) selection criteria and lack detail in the components of the care packages and usual care {53}

Also the telemedicine equipment varies in the different projects, as do the roles, numbers and education of healthcare professionals, which also makes it difficult to generalise the results from one project to another. The legal framework diverge from country/region to country/region {47} and has to be carefully studied and compared to those of the countries/regions where the studies took place.

 There seems to be potential for self care at home to reduce mortality and morbidity and to improve symptoms in patients suffering from HF, whereas lack of knowledge about disease-specific self-care behaviours is associated with non-adherence to recommended self-care practices. {37}In Europe HF clinics are common and often situated at the hospital or at primary health care centre. Very few of the HF management programmes offer home care and there is a lack of  collaboration across the primary-secondary care interface and a lack of continuity of care. {37}

„Monitoring is not a treatment but rather a different way of systematically organizing effective care.“ {9}.

This continuity of care is seen to be achieved by nurses acting as case manager for the patients at home and in liason among members of the health care team. {21}.

Settings  {21}{72}{9}{7}{15}