We recently reviewed > 1,000 articles and were able to identify a very small number of high-quality studies (Table 1) that have attempted to use telemonitoring as an adjunct clinical tool within intermediate care alongside or as a comparison with “best” guideline-based practice. Many studies that we reviewed simply described the technology. Our primary outcome measures were hospital readmission rates, length of stay, unscheduled health care, and exacerbations at home, and secondary outcomes were changes in health behavior and quality of life. Our review found a lack of telemonitoring homogeneity because of the different technologies used in these studies and the fact that many studies reported high attrition rates. Of particular interest, some studies reduced readmission rates and length of stay; however, these improvements were not mirrored in positive changes in quality-of-life scores. Although it appears that several studies did seem to show a change in the number of unscheduled care events, the differing types of technology used, their monitoring schedules, patient populations, and the lack of a guideline-based best practice comparator according to the intermediate care guideline2 brings a challenge to the clinical interpretation of these results. It has been previously noted that intermediate care may not be a suitable option for 75% of patients with COPD presenting to hospitals for assessment of an exacerbation,13 and technology reduces this potential number of patients further. On completing this review, we find it difficult to recommend to commissioners the addition of this technology to intermediate care and see the need for better quality studies in the future that can establish a clear role for telemonitoring as an adjunct to intermediate care.